As a top-ranked dermatologist in the Wolcott, CT, region, Dr. Jurzyk offers patients the most advanced and effective treatments for mild to severe psoriasis, helping patients feel more comfortable and maintain healthier skin.
What is psoriasis?
Psoriasis is a chronic skin condition that affects about 7.5 million people in the U.S., causing thick, scaly patches of reddish, pinkish or whitish skin called plaques. Psoriasis occurs when the skin renewal process is dramatically “sped up,” resulting in new skin forming before old, dead skin cells can be shed. In the normal skin renewal process, skin cells live for about a month before being shed. But in people with psoriasis, a problem with the immune system causes the skin renewal process to be much faster, typically taking three days to a week. Because the body is unable to shed skin that quickly, a buildup of skin cells forms on the skin surface. Psoriasis is a genetic condition, which means it tends to run in families. It’s not contagious, which means you can neither “catch” it nor pass it on.
What symptoms does psoriasis cause?
The most recognizable symptoms of psoriasis are the plaques that form on the skin surface. In addition to their reddish or pinkish appearance, plaques can become itchy, especially during periods of flareup. If the plaques are scratched or abraded, they can bleed, increasing the risk of skin infection. People with psoriasis may have crusting on the scalp as well as pitted fingernails. Some people develop psoriatic arthritis, a condition that causes pain and inflammation in the joints. Plaques usually (but not always) occur on both sides of the body – for instance, both knees or both elbows. People with psoriasis are also at an increased risk for diabetes, heart disease, irritable bowel syndrome and some other chronic diseases and conditions.
How is psoriasis treated?
Treatment for psoriasis depends on how severe it is. Topical and oral medications are available to help relieve symptoms, and phototherapy or laser treatments may also help.
Mild to Moderate Psoriasis
Mild to moderate psoriasis can generally be treated at home using a combination of three key strategies: over-the-counter medications, prescription topical treatments and light therapy/phototherapy.
The U.S. Food and Drug Administration has approved of two active ingredients for the treatment of psoriasis: salicylic acid, which works by causing the outer layer to shed, and coal tar, which slows the rapid growth of cells. Other over-the-counter treatments include:
- Scale lifters that help loosen and remove scales so that medicine can reach the lesions.
- Bath solutions, like oilated oatmeal, Epsom salts or Dead Sea salts that remove scaling and relieve itching.
- Occlusion, in which areas where topical treatments have been applied are covered to improve absorption and effectiveness.
- Anti-itch preparations, such as calamine lotion or hydrocortisone creams.
- Moisturizers designed to keep the skin lubricated, reduce redness and itchiness and promote healing.
Prescription Topical Treatments
Prescription topicals focus on slowing down the growth of skin cells and reducing any inflammation. They include:
- Anthralin, used to reduce the growth of skin cells associated with plaque.
- Calcipotriene, that slows cell growth, flattens lesions and removes scales. It is also used to treat psoriasis of the scalp and nails.
- Calcipotriene and Betamethasone Dipropionate. In addition to slowing down cell growth, flattening lesions and removing scales, this treatment helps reduce the itch and inflammation associated with psoriasis.
- Calcitriol, an active form of vitamin D3 that helps control excessive skin cell production.
- Tazarotene, a topical retinoid used to slow cell growth.
- Topical steroids, the most commonly prescribed medication for treating psoriasis. Topical steroids fight inflammation and reduce the swelling and redness of lesions.
Controlled exposure of skin to ultraviolet light has been a successful treatment for some forms of psoriasis. Three primary light sources are used:
- Sunshine (both UVA and UVB rays). Sunshine can help alleviate the symptoms of psoriasis, but must be used with careful monitoring to ensure that no other skin damage takes place. It is advised that exposure to sunshine be in controlled, short bursts.
- Excimer lasers. These devices are used to target specific areas of psoriasis. The laser emits a high-intensity beam of UVB directly onto the psoriasis plaque. It generally takes between 4 and 10 treatments to see a tangible improvement.
- Pulse dye lasers. Similar to the excimer laser, a pulse dye laser uses a different wavelength of UVB light. In addition to treating smaller areas of psoriasis, it destroys the blood vessels that contribute to the formation of lesions. It generally takes about 4 to 6 sessions to clear up a small area with a lesion.
Moderate to Severe Psoriasis
Treatments for moderate to severe psoriasis include prescription medications, biologics and light therapy/phototherapy.
Oral medications. This includes acitretin, cyclosporine and methotrexate. Your doctor will recommend the best oral medication based on the location, type and severity of your condition.
Biologics. A new classification of injectable drugs, biologics are designed to suppress the immune system. These tend to be very expensive and have many side effects, so they are generally reserved for the most severe cases.
Light Therapy/Phototherapy. Controlled exposure of skin to ultraviolet light has been a successful treatment for some forms of psoriasis. Two primary light sources are used:
- Sunshine (both UVA and UVB rays). Sunshine can help alleviate the symptoms of psoriasis, but must be used with careful monitoring to ensure that no other skin damage takes place. It is advised that exposure to sunshine be limited to controlled, short bursts.
- PUVA. This treatment combines a photosensitizing drug (psoralens) with UVA light exposure. This treatment takes several weeks to produce the desired result. In some severe cases, phototherapy using UVB light may lead to better results.