Psoriasis - Treatment

Treatment

Treatment for psoriasis is available in plenty but the disease continues to be a challenge. Therapeutic spas grow 'Doctor Fish', which feed on the patients' excess skin and provide a natural way of disease treatment.


There are various different types of treatment available to treat psoriasis but given its recurrent nature, psoriasis is, indeed, a challenge to treat.

The type of treatment given to a patient largely depends on the age and gender of the individual and also on the severity of the disease.

Low risk medications are initially employed. If ineffective, the treatment is upgraded to a more potent one. This is referred to as the psoriasis treatment ladder.

The success of the treatment is subject to individual variations. Therefore the treatment of this disease is carried out on a trial- and- error basis. However, it must be noted that psoriasis is not a life- threatening disease; if the treatment causes more trauma than the disease itself, then the treatment should be stopped with immediate effect.

a) Topical therapy

Treatment for psoriasis usually begins with topical applications with bath solutions, moisturizers, ointments or creams containing Dithranol or coal tar, anthralin, calcipotriol, activated vit D or corticosteroids.

The aim of this treatment is to control inflammation and skin cell production. This kind of treatment can get clumsy for the patient and cannot be sustained for long periods.

b) Phototherapy

If topical therapy fails to bring about the desired effect then it is time to expose the patient to phototherapy. Here the patient is exposed daily to short periods of sunlight or ultraviolet (UVB) radiations. This photo exposure helps a psoriatic patient considerably.

c) PUVA

Sometimes a topical or an oral administaration of Psoralen along with exposure to UVA helps to bring about relief

d) Medication

Psoriasis that is resistant to both topical application and phototherapy is then treated with drugs . Drugs are either taken orally or they may be injected into the patient.This mode of treatment is called systemic treatment. Some of the popular drugs include-

• Methotrexate (immunosuppressant)
• Retinoids(vit A)
• Cyclosporin (immunosupresant)

Antibiotics are administered when psoriasis is caused by a streptococcal infection.

The standard care for patients with psoriatic arthritis includes anti-rheumatic drugs, like methotrexate. They may also be treated with non-steroidal anti-inflammatory drug or steroid injections.

e) Other agents

Recently, monoclonal antibodies that are raised against entities, such as the Tumor Necrosis Factor(TNF-�) involved in the psoriasis pathogenic pathway, have been proven to be an effective mode of treatment.

f) Alternative therapy

For a very long time alternative therapies like ayurveda, homeopathy, nature cure and Unani have been successfully employed to treat psoriasis.


Many believe that living in a certain climate helps psoriatic patients. Based on this belief several spas, complete with hot springs, have mushroomed in countries like Turkey, that offer the ideal 'climate' for patients. The sun and the sea are reported to have done wonders for many. Salt water alone is not singularly effective. It is the combination of ingredients found in sea water that is reported to do wonders for the patient. These natural ways of treating psoriasis always enjoy popularity.

Besides, there are 'doctor fish' that are grown in these spas that are encouraged to feed on the excess skin on the psoriasis patients.

The history of psoriasis treatment at a global level, is full of dubious treatment claims that are sometimes extremely toxic. Each geographic region has its peculiar treatment stories to tell and claims to treatment 'miracles'. In ancient Egypt cat faeces was applied to the red lesions on the psoriasis patient. Other weird treatment methods have included applying sea salt and urine, goose oil and semen, wasp droppings in sycamore milk and even soup made from vipers.

References:

a) Br J Nurs. 2008 Mar 13-26;17(5):284-90.
Ryan S.

b) J Am Acad Dermatol. 2008 May;58(5):851-64
Gottlieb A, et al

c) J Reprod Med. 2008 Mar;53(3):183-7.
Ben-David G, Sheiner E, Hallak M, Levy A.

d) Clin Chim Acta. 2008 Apr 12.
Pietrzak AT, etal

e) Arch Dermatol Res. 2008 Apr 30
Gunes Y, etal

f)Principles & Practice of Medicine
Davidson

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