Psoriasis Health Center

Doctors generally treat psoriasis in steps based on the severity of the disease, size of the areas involved, type of psoriasis, and the patient’s response to initial treatments. This is sometimes called the “1-2-3” approach. Step 1 medicines are applied to the skin (topical treatment). Step 2 uses light treatments (phototherapy). Step 3 involves taking medicines by mouth or injection that treat the whole immune system (called systemic therapy).

Topical Treatment

Medications for topical application may include corticosteroids, vitamin D3 based creams or ointments, retinoin based medications.

Phototherapy

Ultraviolet (UV) light from the sun causes T cells in the skin to die. This reduces inflammation and slows the overproduction of skin cells that causes scaling. A more controlled form of artificial light treatment may be used for mild psoriasis.

Systemic Treatment

For severe forms of psoriasis, medicine taken internally may be best. Some of these medications suppress the immune system. These medications include:

• methotrexate
• cyclosporine
• hydroxyurea
• Enbrel (etanercept)
• Antibiotics for infections that trigger an outbreak of psoriasis

Over time, affected skin can become resistant to treatment, especially when topical corticosteroids are used. Also, a treatment that works very well in one person may have little effect in another. Thus, doctors often use a trial-and-error approach to find a treatment that works, and they may switch treatments periodically (for example, every 12 to 24 months) if a treatment does not work or if adverse reactions occur.