The main treatment options remain the medicines both local and oral, phototherapy, alternative medicines, which further branch into many other sub branches. Let us have a look.
1. Medications
Oral and Injectables.
- Immunosuppressants. Used mostly for severe cases to suppress the immune system.
- Methotrexate. This helps suppress the immune system and slow down the growth of cells and division. This is available both in the form of oral and injection.
- PDE4 inhibitors. These help in suppressing the rapidskin cells turnover and also the inflammation.
- Retinoids. These are used in combination with phototherapy for moderate to severe psoriasis.
- Biologic response modifiers. These are injections used to block certain immune molecules. They help in stopping or decreasing inflammation.
Topical therapies
There is a multitude of ointments, creams, lotions, shampoos, solutions, containing corticosteroids which is used for treating mild to moderate psoriasis. Even medicines based of retinoids, vitamin D, coal tar, salicylic acid,anthralin, etc., as well are used for local application in the treatment of psoriasis.
2. Phototherapy
This method involves the use of light for treating psoriasis. This mode of treatment is generally used when the psoriasis is spread widely. It is used to treat large areas of skin affected by psoriasis. More recently, user friendly UV combs (UV 311), UV lamps are available for treatment of psoriasis.
- Sunlight(heliotherapy). This is a continuous but brief period of daily exposure to sunlight.
- Light therapy. It is a first line treatment option used most often for moderate to severe psoriasis. It is used either alone or along with medications.
- Goeckerman therapy. This is a combination of coal tar treatment with light therapy.
- UVB narrowband. UVB narrowband light therapy is administered two or three times a week.
- UVB broadband. This is used in treating widespread psoriasis and is provided in controlled doses.
- PUVA - Psoralen plus ultraviolet A. This treatment uses a light-sensitizing psoralen before initiating exposure of the UVA light to the affected skin.
- Excimer laser. This treatment uses strong UVB light which targets only the affected skin and requires lesser sessions.
3. Alternative Medicine
The use of alternative therapies (ayurveda, homeopathy) is not new. Some of these ayurvedic, home remedies, homeopathy have been found beneficial in psoriasis treatment. These could be categorised asa diet regimen or certain dietary changes, usage of herbal products both orally and for local application, acupuncture, naturopathy, etc.
- Fish oil supplements. It has been noted that taking fish oil orally along with UVB therapy reduces the extent of scales and rashes. Local application of fish oil is also beneficial.
- Aloe vera cream. Aloe vera cream derived from the extract of aloe vera may help significantly reduce itching, scaling, and inflammation. It may provide a soothing effect to the irritated area.
- Oregon grape. This is also used for local application to reduce psoriasis severity.