I have had psoriasis for 13 years now infact i got it the day after the birth of my first daughter! It has never ever gone away even after using many different treatments from the doctors! Can anyone advise on any good treatments…
There can be substantial variation between individuals in the effectiveness of specific psoriasis treatments. Because of this, dermatologists often use a trial-and-error approach to finding the most appropriate treatment for their patient. The decision to employ a particular treatment is based on the type of psoriasis, its location, extent and severity. The patient’s age, gender, quality of life, comorbidities, and attitude toward risks associated with the treatment are also taken into consideration.
Medications with the least potential for adverse reactions are preferentially employed. If the treatment goal is not achieved then therapies with greater potential toxicity may be used. Medications with significant toxicity are reserved for severe unresponsive psoriasis. This is called the psoriasis treatment ladder. As a first step, medicated ointments or creams are applied to the skin. This is called topical treatment. If topical treatment fails to achieve the desired goal then the next step would be to expose the skin to ultraviolet (UV) radiation. This type of treatment is called phototherapy. The third step involves the use of medications which are ingested orally or by injection. This approach is called systemic treatment.
Over time, psoriasis can become resistant to a specific therapy. Treatments may be periodically changed to prevent resistance developing (tachyphylaxis) and to reduce the chance of adverse reactions occurring. This is called treatment rotation.
 Topical treatment
Bath solutions and moisturizers help sooth affected skin and reduce the dryness which accompanies the build-up of skin on psoriasis plaques. Medicated creams and ointments applied directly onto psoriasis plaques can help reduce inflammation, remove built-up scale, reduce skin turn over, and clear affected skin of plaques. Ointment and creams containing coal tar, dithranol (anthralin), corticosteroids, vitamin D3 analogues (for example, calcipotriol), and retinoids are routinely used. The mechanism of action of each is probably different but they all help to normalise skin cell production and reduce inflammation.
The disadvantages of topical agents are variabily that they can often irritate normal skin, can be awkward to apply, cannot be used for long periods, can stain clothing or have a strong odour. As a result, it is sometimes difficult for people to maintain the regular application of these medications. Abrupt withdrawal of some topical agents, particularly corticosteroids, can cause an aggressive recurrance of the condition. This is known as a rebound of the condition. Topical lotions and creams that contain fragrances should be avoided as they will sting when applied.
Some topical agents are used in conjunction with other therapies, especially phototherapy.
It has long been recognised that daily, short, nonburning exposure to sunlight helped to clear or improve psoriasis. Niels Finsen was the first physician to investigate the theraputic effects of sunlight scientifically and to use sunlight in clinical practice. This became known as phototherapy.
Sunlight contains many different wavelengths of light. It was during the early part of the 20th century that it was recognised that for psoriasis the therapeutic property of sunlight was due to the wavelengths classified as ultraviolet (UV) light.
Ultraviolet wavelengths are subdivided into UVA (380–315 nm), UVB (315–280 nm), and UVC (< 280 nm). Ultraviolet B (UVB) (315–280 nm) is absorbed by the epidermis and has a beneficial effect on psoriasis. Narrowband UVB (311 to 312 nm), is that part of the UVB spectrum that is most helpful for psoriasis. Exposure to UVB several times per week, over several weeks can help people attain a remission from psoriasis.
Ultraviolet light treatment is frequently combined with topical (coal tar, calcipotriol) or systemic treatment (retinoids) as there is a synergy in their combination. The Ingram regime, involves UVB and the application of anthralin paste. The Goeckerman regime combines coal tar ointment with UVB.
Psoralen and ultraviolet A phototherapy (PUVA) combines the oral or topical administration of psoralen with exposure to ultraviolet A (UVA) light. Precisely how PUVA works is not known. The mechanism of action probably involves activation of psoralen by UVA light which inhibits the abnormally rapid production of the cells in psoriatic skin. There are multiple mechanisms of action associated with PUVA, including effects on the skin immune system.
Dark glasses must be worn during PUVA treatment because there is a risk of cataracts developing from exposure to sunlight. PUVA is associated with nausea, headache, fatigue, burning, and itching. Long-term treatment is associated with squamous-cell and melanoma skin cancers.
 Systemic treatment
Psoriasis which is resistant to topical treatment and phototherapy is treated by medications that are taken internally by pill or injection. This is called systemic treatment. Patients undergoing systemic treatment are required to have regular blood and liver function tests because of the toxicity of the medication. Pregnancy must be avoided for the majority of these treatments. Most people experience a recurrence of psoriasis after systemic treatment is discontinued.
The three main traditional systemic treatments are the immunosupressant drugs methotrexate and ciclosporin, and retinoids, which are synthetic forms of vitamin A. Other additional drugs, not specifically licensed for psoriasis, have been found to be effective. These include the antimetabolite tioguanine, the cytotoxic agent hydroxyurea, sulfasalazine, the immunosupressants mycophenolate mofetil, azathioprine and oral tacrolimus. These have all been used effectively to treat psoriasis when other treatments have failed. Although not licensed in many other countries fumaric acid esters have also been used to treat severe psoriasis in Germany for over 20 years.
Biologics are manufactured proteins that interrupt the immune process involved in psoriasis. Unlike generalised immunosuppressant therapies such as methotrexate, biologics focus on specific aspects of the immune function leading to psoriasis. These drugs are relatively new, and their long-term impact on immune function is unknown. They are very expensive and only suitable for very few patients with psoriasis.
 Alternative Therapy
Antibiotics are not indicated in routine treatment of psoriasis. However, antibiotics may be employed when an infection, such as that caused by the bacteria Streptococcus, triggers an outbreak of psoriasis, as in certain cases of guttate psoriasis.
Climatotherapy involves the notion that some diseases can be successfully treated by living in particular climate. Several psoriasis clinics are located throughout the world based on this idea. The Dead Sea is one of the most popular locations for this type of treatment.
In Turkey, doctor fish which live in the outdoor pools of spas, are encouraged to feed on the psoriatic skin of people with psoriasis. The fish only consume the affected areas of the skin. The outdoor location of the spa may also have a beneficial effect. This treatment can provide temporary relief of symptoms. A revisit to the spas every few months is often required.
Some people subscribe to the view that psoriasis can be effectively managed through a healthy lifestyle. This view is based on anecdote, and has not been subjected to formal scientific evaluation. Nevertheless, some people report that minimizing stress and consuming a healthy diet, combined with rest, sunshine and swimming in saltwater keep lesions to a minimum. This type of “lifestyle” treatment is suggested as a long-term management strategy, rather than an initial treatment of severe psoriasis.
Some psoriasis patients use herbology as a holistic approach that aims to treat the underlying causes of psoriasis.
A psychological symptom management programme has been reported as being a helpful adjunct to traditional therapies in the management of psoriasis. 
It is possible that Epsom salt may have a positive effect in reducing the effects of psoriasis.
 Historical Treatment
The history of psoriasis is littered with treatments of dubious effectiveness and high toxicity. These treatments received brief popularity at particular time periods or within certain geographical regions. The application of cat faeces to red lesions on the skin, for example, was one of the earliest topical treatments employed in ancient Egypt. Onions, sea salt and urine, goose oil and semen, wasp droppings in sycamore milk, and soup made from vipers have all been reported as being ancient treatments.
In the more recent past Fowler’s solution, which contains a poisonous and carcinogenic arsenic compound, was used by dermatologists as a treatment for psoriasis during the 18th and 19th centuries. Grenz Rays (also called ultrasoft X-rays or Bucky rays) was a popular treatment of psoriasis during the middle of the 20th century. This type of therapy was superseded by ultraviolet therapy.
All these treatments have fallen out of favour.
 Future drug development
Historically, agents used to treat psoriasis were discovered by experimentation or by accident. In contrast, current novel therapeutic agents are designed from a better understanding of the immune processes involved in psoriasis and by the specific targeting of molecular mediators. Examples can be seen in the use of biologics which target T cells and TNF inhibitors. Future innovation should see the creation of additional drugs that refine the targeting of immune-mediators further.
Research into antisense oligonucleotides is in its infancy but carries the potential to provide novel theraputic strategies for treating psoriasis
Find out more information about a psoriasis treatment to treat the different types.
I’ve tried almost everything over the counter products such as changing my shampoo to something milder, baby lotion, olive oil, petroleum jelly, oatmeal soaks, and plain oatmeal.
It stings and it’s worse on one side of my lower neck, around the hair line. It’s also up in my scalp. I’ve also used Coal Tar and Soothing Menthol. It works for a little while, then comes back. It’s a never ending battle for this, it’s really driving me crazy and now I have to wear gloves to keep from scratching my scales. I know it’s pretty terrible to bear when you’ve got these silvery scales and red raised bumps from the scales.
I’m on Calcium, Magnesium, and Zinc. I’ve noticed a change in my strength in one of my arms that has had surgery. Much more stronger now. I hope the zinc works for my immune system. I was taking fish oil, but I was in the bathroom most of the time from it.
What are your suggestions? I’m willing to try something until I can get to a doctor. I’m strengthening my immune system because it’s an autoimmune disease and it’s not AIDS or anything around it. Psoriasis isn’t contagious luckily.
Petroleum jelly doesn’t work so I found hydrocortisone cream works to stop the itch. Now I’m using baby lotion to moisturize. I’ll try some of those remedies.
Hi, you can try one of the natural treatments for psoriasis from the Internet – some of them do actually work. For my psor. I use herbal cream by Champori quite successfully. It takes just a couple of weeks to clear the spots and they stay clear for months on end.
Try it: champori is available without prescription and comes with money back guarantee so if it doesn’t work for you – it’s free.
Looking for treatment for psoriasis without toxic side effects? Find your Psoriasis Treatment here.
l need this for school
PS: are emotions a factor that could lead to this disease?
Psoriasis is a common skin disease that affects the life cycle of skin cells. Normally, new cells take about a month to move from the lowest skin layer where they’re produced, to the outermost layer where they die and flake off. With psoriasis, the entire life cycle takes only days. As a result, cells build up rapidly, forming thick silvery scales and itchy, dry, red patches that are sometimes painful.
Psoriasis is a persistent, long-lasting (chronic) disease. You may have periods when your psoriasis symptoms improve or go into remission alternating with times your psoriasis becomes worse.
For some people, psoriasis is just a nuisance. For others, it’s disabling, especially when associated with arthritis. No cure exists, but psoriasis treatments may offer significant relief. And self-care measures, such as using a nonprescription cortisone cream and exposing your skin to small amounts of ultraviolet light, can improve your psoriasis symptoms.
signs and symptoms:
Psoriasis symptoms can vary from person to person but may include one or more of the following:
Red patches of skin covered with silvery scales
Small scaling spots (commonly seen in children)
Dry, cracked skin that may bleed
Itching, burning or soreness
Thickened, pitted or ridged nails
Swollen and stiff joints
Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas. Mild cases of psoriasis may be a nuisance. But more severe cases can be painful, disfiguring and disabling.
Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into complete remission. In most cases, however, the disease eventually returns.
Several types of psoriasis exist. These include:
Plaque psoriasis. The most common form, plaque psoriasis causes dry, red skin lesions (plaques) covered with silvery scales. The plaques itch or feel sore and may occur anywhere on your body, including your genitals and the soft tissue inside your mouth. You may have just a few plaques or many, and in severe cases, the skin around your joints may crack and bleed.
Nail psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration. Psoriatic nails may become loose and separate from the nail bed (onycholysis). Severe cases may cause the nail to crumble.
Scalp psoriasis. Psoriasis on the scalp appears as red, itchy areas with silvery-white scales. You may notice flakes of dead skin in your hair or on your shoulders, especially after scratching your scalp.
Guttate psoriasis. This primarily affects people younger than 30 and is usually triggered by a bacterial infection such as strep throat. It’s marked by small, water-drop-shaped sores on your trunk, arms, legs and scalp. The sores are covered by a fine scale and aren’t as thick as typical plaques are. You may have a single outbreak that goes away on its own, or you may have repeated episodes, especially if you have ongoing respiratory infections.
Inverse psoriasis. Mainly affecting the skin in the armpits, groin, under the breasts and around the genitals, inverse psoriasis causes smooth patches of red, inflamed skin. It’s more common in overweight people and is worsened by friction and sweating.
Pustular psoriasis. This rare form of psoriasis can occur in widespread patches (generalized pustular psoriasis) or in smaller areas on your hands, feet or fingertips. It generally develops quickly, with pus-filled blisters appearing just hours after your skin becomes red and tender. The blisters dry within a day or two but may reappear every few days or weeks. Generalized pustular psoriasis can also cause fever, chills, severe itching, weight loss and fatigue.
Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely. It may be triggered by severe sunburn, by corticosteroids and other medications, or by another type of psoriasis that’s poorly controlled.
Psoriatic arthritis. In addition to inflamed, scaly skin, psoriatic arthritis causes pitted, discolored nails and the swollen, painful joints that are typical of arthritis. It can also lead to inflammatory eye conditions such as conjunctivitis. Symptoms range from mild to severe. Although the disease usually isn’t as crippling as other forms of arthritis, it can cause stiffness and progressive joint damage that in the most serious cases may lead to permanent deformity.
The cause of psoriasis is related to the immune system, and more specifically, a type of white blood cell called a T lymphocyte or T cell. Normally, T cells travel throughout the body to detect and fight off foreign substances, such as viruses or bacteria. In people with psoriasis, however, the T cells attack healthy skin cells by mistake as if to heal a wound or to fight an infection.
Overactive T cells trigger other immune responses that cause an increased production of both healthy skin cells and more T cells. What results is an ongoing cycle in which new skin cells move to the outermost layer of skin too quickly — in days rather than weeks. Dead skin and white blood cells can’t slough off quickly enough and build up in thick, scaly patches on the skin’s surface. This usually doesn’t stop unless treatment interrupts the cycle.
Just what causes T cells to malfunction in people with psoriasis isn’t entirely clear, although researchers think genetic and environmental factors both play a role.
Psoriasis typically starts or worsens because of a trigger that you may be able to identify and avoid. Factors that may trigger psoriasis include:
Infections, such as strep throat or thrush
Injury to the skin, such as a cut or scrape, bug bite, or a severe sunburn
Heavy alcohol consumption
Certain medications, including lithium, which is prescribed for bipolar disorder, high blood pressure medications such as beta blockers, antimalarial drugs and iodides
Psoriasis treatments aim to interrupt the cycle that causes an increased production of skin cells, thereby reducing inflammation and plaque formation. Other treatments, especially those you apply to your skin (topical treatments), help remove scale and smooth the skin.
Although doctors choose treatments based on the type and severity of psoriasis and the areas of skin affected, the traditional approach is to start with the mildest treatments — topical creams and ultraviolet light therapy (phototherapy) — and then progress to stronger ones if necessary. The goal is to find the most effective way to slow cell turnover with the fewest possible side effects.
In spite of a wide range of options, psoriasis treatment can be challenging. The disease is unpredictable, going through cycles of improvement and worsening seemingly at whim. Effects of psoriasis treatments also can be unpredictable; what works well for one person might be ineffective for someone else. Your skin can also become resistant to various treatments over time, and the most potent psoriasis treatments can have serious side effects.
Talk to your doctor about your options, especially if you’re not improving after using a particular treatment or if you’re experiencing uncomfortable side effects. He or she can adjust your treatment plan or modify your approach to ensure the best possible control of your symptoms.
Psoriasis treatments can be divided into three main types: topical treatments, light therapy and oral medications.
Used alone, creams and ointments that you apply to your skin can effectively treat mild to moderate psoriasis. When skin disease is more severe, creams are likely to be combined with oral medications or phototherapy. Topical psoriasis treatments include:
Topical corticosteroids. These powerful anti-inflammatory drugs are the most frequently prescribed medications for treating mild to moderate psoriasis. They slow cell turnover by suppressing the immune system, which reduces inflammation and relieves associated itching. Topical corticosteroids range in strength, from mild to very strong. Low-potency corticosteroid ointments are usually recommended for sensitive areas such as your face and for treating widespread patches of damaged skin. Your doctor may prescribe stronger corticosteroid ointment for small areas of your skin, for stubborn plaques on your hands or feet, or when other treatments fail. To minimize side effects and to increase effectiveness, topical corticosteroids are generally used on active outbreaks until they’re under control.
Vitamin D analogues. These synthetic forms of vitamin D reduce skin inflammation and help prevent skin cells from reproducing. Calcipotriene (Dovonex) is a prescription cream, ointment or solution containing a vitamin D analogue that may be used alone to treat mild to moderate psoriasis or in combination with other topical medications or phototherapy.
Anthralin. This medication is believed to normalize DNA activity in skin cells and to reduce inflammation. Anthralin (Dritho-Scalp or Psoriatec) can remove scale and smooth skin, but it stains virtually anything it touches, including skin, clothing, countertops and bedding. For that reason doctors often recommend short-contact treatment — allowing the cream to stay on your skin for a brief time before washing it off. Anthralin is sometimes used in combination with ultraviolet light.
Topical retinoids. These are commonly used to treat acne and sun-damaged skin, but tazarotene (Tazorac) was developed specifically for the treatment of psoriasis. Like other vitamin A derivatives, it normalizes DNA activity in skin cells. The most common side effect is skin irritation. Although the risk of birth defects is far lower for topical retinoids than for oral retinoids, your doctor needs to know if you’re pregnant or intend to become pregnant if you’re using tazarotene.
Calcineurin inhibitors. Currently, calcineurin inhibitors (tacrolimus and pimecrolimus) are only approved for the treatment of atopic dermatitis, but studies have shown them to be effective at times in the treatment of psoriasis as well. Calcineurin inhibitors are thought to disrupt the activation of T cells, which in turn reduces inflammation and plaque buildup. Calcineurin inhibitors are not recommended for long-term or continuous use because of a potential increased risk of skin cancer and lymphoma.
Coal tar. A thick, black byproduct of the manufacture of gas and coke, coal tar is probably the oldest treatment for psoriasis. It reduces scaling, itching and inflammation. Exactly how it works isn’t known. Coal tar has few known side effects, but it’s messy, stains clothing and bedding, and has a strong odor.
Moisturizers. By themselves, moisturizing creams won’t heal psoriasis, but they can reduce itching and scaling and can help combat the dryness that results from other therapies. Moisturizers in an ointment base are usually more effective than are lighter creams and lotions.
Light therapy (phototherapy)
As the name suggests, this psoriasis treatment uses natural or artificial light. The simplest and easiest form of phototherapy involves exposing your skin to controlled amounts of natural sunlight. Other forms of light therapy include the use of artificial ultraviolet A (UVA) or ultraviolet B (UVB) light either alone or in combination with medications.
Sunlight. Ultraviolet (UV) light is a wavelength of light in a range too short for the human eye to see. When exposed to UV rays in sunlight or artificial light, the activated T cells in the skin die. This slows skin cell turnover and reduces scaling and inflammation. Brief, daily exposures to small amounts of sunlight may improve psoriasis, but intense sun exposure can worsen symptoms can cause skin damage. Before beginning a sunlight regimen, ask your doctor about the safest way to use natural sunlight for psoriasis treatment.
UVB phototherapy. Controlled doses of UVB light from an artificial light source may improve mild to moderate psoriasis symptoms. UVB phototherapy, also called broadband UVB, can be used to treat single patches, widespread psoriasis and psoriasis that resists topical treatments.
Narrowband UVB therapy. A newer type of psoriasis treatment, narrowband UVB therapy may be more effective than broadband UVB treatment. It’s usually administered two or three times a week until the skin improves, then maintenance may require only weekly sessions. Narrowband UVB therapy may cause more severe and longer-lasting burns, however.
Photochemotherapy, or psoralen plus ultraviolet A (PUVA). Photochemotherapy involves taking a light-sensitizing medication (psoralen) before exposure to UVA light. UVA light penetrates deeper into the skin than does UVB light, and psoralen makes the skin more sensitive to the effects of UVA exposure. This more aggressive treatment consistently improves skin and is often used for more severe cases of psoriasis. PUVA involves two or three treatments a week for a prescribed number of weeks. Short-term side effects include nausea, headache, burning and itching. Long-term treatment increases your risk of skin cancer, including melanoma, the most serious form of skin cancer.
Excimer laser. This form of light therapy, used for mild to moderate psoriasis, treats only the involved skin. A controlled beam of UVB light is aimed at the psoriasis plaques to control scaling and inflammation. Healthy skin surrounding the patches remains undamaged. Excimer laser therapy requires fewer sessions than does traditional phototherapy because more powerful UVB light is used. Side effects can include redness and blistering.
Combination light therapy. Combining UV light with other treatments such as retinoids frequently improves phototherapy’s effectiveness. Combination therapies are often used after other phototherapy options are ineffective. Some doctors give UVB treatment in conjunction with coal tar, called the Goeckerman treatment. The two therapies together are more effective than either alone because coal tar makes skin more receptive to UVB light. Another method, the Ingram regimen, combines UVB therapy with a coal tar bath and an anthralin-salicylic acid paste that’s left on your skin for several hours or overnight.
If you have severe psoriasis or it’s resistant to other types of treatment, your doctor may prescribe oral or injected drugs. Because of severe side effects, some of these medications are used for just brief periods of time and may be alternated with other forms of treatment.
Retinoids. Related to vitamin A, this group of drugs may reduce the production of skin cells in people with severe psoriasis who don’t respond to other therapies. Signs and symptoms usually return once therapy is discontinued, however. And because retinoids such as acitretin (Soriatane) can cause severe birth defects, women must avoid pregnancy for at least three years after taking the medication.
Methotrexate. Taken orally, methotrexate helps psoriasis by decreasing the production of skin cells, suppressing inflammation and reducing the release of histamine — a substance involved in allergic reactions. It may also slow the progression of arthritis in some people with psoriatic arthritis. Methotrexate is generally well tolerated in low doses, but when used for long periods it can cause a number of serious side effects, including severe liver damage and decreased production of red and white blood cells and platelets. Taking 1 milligram of folic acid on a daily basis may help reduce some of the common side effects associated with methotrexate.
Azathioprine. A potent anti-inflammatory drug, azathioprine may be used to treat severe psoriasis when other treatment options fail. Taken long term, azathioprine increases the risk of developing cancerous or noncancerous growths (neoplasias) and certain blood disorders. Other potential side effects include nausea and vomiting, bruising more easily than normal, and fatigue.
Cyclosporine. Cyclosporine works by suppressing the immune system and is similar to methotrexate in effectiveness. Like other immunosuppressant drugs, cyclosporine increases your risk of infection and other health problems, including cancer. Cyclosporine also makes you more susceptible to kidney problems and high blood pressure — the risk increases with higher dosages and long-term therapy.
Hydroxyurea. This medication isn’t as effective as cyclosporine or methotrexate, but unlike the stronger drugs it can be used with phototherapy treatments. Possible side effects include anemia and a decrease in white blood cells and platelets. It should not be taken by women who are pregnant or planning to become pregnant.
Immunomodulator drugs (biologics). Several immunomodulator drugs are approved for the treatment of moderate to severe cases of psoriasis. They include alefacept (Amevive), efalizumab (Raptiva), etanercept (Enbrel) and infliximab (Remicade). These drugs are given by intravenous infusion, intramuscular injection or subcutaneous injection and are usually used for people who have failed to respond to traditional therapy or for people with associated psoriatic arthritis. Biologics work by blocking interactions between certain immune system cells. Although they’re derived from natural sources rather than chemical ones, they have strong effects on the immune system and likely pose many of the same risks as other immunosuppressant drugs.
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