How to treat psoriasis?
The type of treatment prescribed for psoriasis depends on several factors the most important being the severity of the condition in the individual. Treating PS is a very hit and miss affair although there are standard procedures and medications available it is the individual that must be treated. In general the beginning of treatment will usually commence with the less harmful medications at the doctors disposal and will progress to more extreme measures if the patient does not respond. There is always a trade of effectiveness of the medication versus the side effects.The armoury at the disposal of the dermatologist is growing and there are an ever increasing array of treatments offering new hope to sufferersTopical Compounds
- Coal Tar
- Sulphur Ointment
- Urea compounds
- Steroid preparations
- Dithranol
- Vitamine D derivative(Dovonex)
- Vitamine A derivatives (Retinoids)
Other Medication
- PUVA
- Methotrexate
- Cyclosporine
- Oral Retinoids
- Oral Vitamin D (Vitamin D2 & D15)
- Genetic modifiers
Coal Tar
Coal tar in one form or another has been used to treat psoriasis for hundreds of years it is an incredibly complex chemical compound and it is till not known today which one of these thousands of components is responisible for the modification of psoriasis lesions. In its raw state it is simply a crude black tar it is then blended with petroleum products, alcohol,and various emoluments at concentrations of up to 10%. Coal tar is used in a variety of ways it is used in bathing compounds,Lotions and shampoos and of couse creams and ointments. (Alphosyl Cream TM is an easily applied form of coal tar cream and re4latively clean to apply and use)It is one of the tried and tested remedys for psoriasis and is still extensively used today in comprehensive treatment routines. It is messy and does smell strongly it also stains clothes and bedding but it does work and wont kill you.Sulphur Ointment
Likewise this compound is one of the age old treatments for psoriasis. It is a yellow powder which is compounded with petroleum and emoluments such as lanoline . It can be used in conjunction with coal tar treatments. Also can be compounded into shampoos and lotions. It has a strong anti bacterial action and is an efficient fungicide. It smells characteristically of rotten eggs and can burn sensitive skin. It is used extensively in hospital treatment programs but can be messy to use at home. It is interesting to note that sulphurous springs can in my experience be very beneficial to psoriasis.Salycilic acid
Salicylic acid compounds are very useful for stripping off the scale build up that occurs in chronic psoriasis. Due to the nature of the condition scale can build up to several millimeters in thickness and it is a vital part of treatment that this build up is effectively removed. Salycilic acid is blended with petroleum jelly at concentrations between 1 and 5 % and is used to soften scales which can the easily be removed after treatment in a warm bath. It is usual to apply the ointment in the morning under bandages or cling film and remove in the afternoon or earlier if the desired effect is achieved. Urea compounds can also be used to achieve scale removal.Dithranol
Dithranol also known as Lassars paste is a very effective remedy for psoriasis lesions it has been used for many years and is a thick off white paste which is applied directly to the lesions and left on for 24 hours. It stains anything it comes into contact with and can irritate unaffected skin.Treatment is usualy started with low concentrations and as resistance is built up the dosage can be increased to a maximum of about 5% concentration.It is not advisable to use this product in any sensitive areas of the body.Dovonex
Dovonex is a relatively new treatment and is a synthesised vitamin D derivative(Calcipotreol). Please not that it is not the same as vitamin D which can be purchased from health shops and vitamin D has no effect on psoriasis lesions. It is an expensive but effective form of treatment with very few side effects and is one of the safest and most effective treatments for psoriasis available today. It should be used with care in sensitive areas of the body and not applied to unaffected skin and treatment should be limited to no more than 100g in one week.Symptoms of an over dose of Dovonex include weakness, fatigue, drowsiness, dizziness, headache, decreased appetite, nausea, vomiting, and high levels of calcium in the blood.
