Psoriasis: Treatment Options
There are four general clinical and several non-clinical alternative approaches to psoriasis treatment.
Currently there is no cure for psoriasis. Between psoriatic outbreaks, patients may take extra care of the skin that is prone to developing lesions, guarding against injury and infection.
Clinical treatments for psoriasis attempt to:
- Remove existing scale and soothe the skin
- Reduce inflammation
- Slow down/ interrupt immune system activity (either locally or throughout entire body (systemic))
- Destroy abnormally proliferating skin cells
Forms of psoriasis treatment include:
- Topical Treatment
- UV Phototherapy (light therapy)
- Systemic and Biologic Treatment
- Alternative Treatment
Treatment for psoriasis depends on disease type and severity classification (mild, moderate, or severe):
- Body surface involvement (% of body surface)
- Physical severity
- Erythema or redness & inflammation, type and amount of plaque
- Area of body affected
- Hand, foot, scalp, genital and perineal/ rectal surfaces, may be considered more physically severe
- Symptoms of pruritus (itching) and pain
- Remission length
- Presence of arthritis
- Quality-of-Life (QoL) Score
It should be noted that 1% of the body surface for most individuals is typically taken as about the same as the surface of the palm of the hand (not including fingers). Psoriasis covering more than 10% is automatically considered severe. Psoriasis covering less than 10% may be considered severe depending on area of the body (palms of hands, soles of feet, genitals, face, etc.) and QoL score.
The Therapeutic Treatment Ladder
Depending on disease type and severity, treatment is typically oriented towards the least “toxic” treatment for patients. For mild psoriasis, as determined both by physical attributes and QoL score, the typical first-line treatment is medicated topical applications. Mild psoriasis that is un-responsive to medicated topical treatments typically qualifies for UV phototherapy, or even more aggressive systemic or biologic drug treatment. Moderate and severe psoriasis is typically treated either with UV phototherapy or systemic or biologic drug treatment as a first line therapy, and may be used in combination with medicated topical treatments, and/ or systemic drugs.