Topical Creams and Ointments for Psoriasis
Prescription topical medications applied directly to the skin are a first line of defense in treating psoriasis.Topical medications are usually prescribed for patients with less severe disease conditions. Prescription topical creams and ointments slow down or normalize excessive skin cell growth and reduce inflammation. They may or may not contain steroids. Some topical medications include a synthetic or naturally occurring active form of vitamin D3, anthralin or coal tar. Topical medications for psoriasis take time to show results because of their slow onset of the active components. Some topical medications have side effects which your physician will discuss with you and help you manage.
Ultraviolet Light Phototherapy
Present in natural sunlight, ultraviolet light has powerful anti-inflammatory properties that can clear psoriasis from the skin. UVB (ultraviolet B) penetrates the skin and slows the growth of affected skin cells. Phototherapy treatments are performed three times per week, and most patients become clear after eight to nine weeks. Treatments are safely administered by licensed medical professionals. The cost is covered by Medicare and most insurance plans.
Several forms of phototherapy are available. The type selected is determined by the severity and location of the patient's psoriasis as well as the patient's medical history. Treatment types available include:
• Narrowband UVB: This treatment is safe, highly effective and drug-free. The patient stands in a specially designed cabinet containing UVB light tubes. The affected areas of the body are exposed to the UVB for a short time (from seconds to minutes). The effects generally become noticeable after seven to ten treatments. A typical course is thirty-six prescriptions.
• PUVA (psoriasis ultraviolet A): Prior to treatment, patients ingest a photosensitizer tablet. Seventy-five minutes later, the patient stands in a specially designed cabinet containing UVA bulbs, and the affected areas of the body are exposed to the UVA for a short time.
• Hand/foot PUVA and UVB: PUVA and narrowband UVB treatments can be delivered in a targeted manner for patients with psoriasis or eczema of the hands and/or feet, sparing unaffected areas.
Treatment with the PHAROS EX-308 laser delivers concentrated, high-dose ultraviolet B treatment to psoriatic plaques. Because treatment is limited only to affected areas, the laser may safely deliver higher treatment doses than conventional UVB, leading to faster clearance of the psoriasis. Laser treatment for psoriasis is covered by most major insurance plans.
Biologic Agents for Psoriasis Treatment
The past few years have seen promising advances in the treatment of psoriasis. New types of medication—called biologics because they are made from living organisms—may offer hope to people who haven't had success with other approaches or were uncomfortable with the potential side effects of older medications.
Biologic agents are administered by injection. Different from traditional systemic drugs that impact the entire immune system, biologics target specific parts of the immune system. They treat psoriasis by reducing inflammation in the skin and elsewhere in the body. These medicines are intended to treat patients with moderate to severe psoriasis, patients with psoriatic arthritis, or patients who have failed to respond to other forms of treatment. Selection of a specific agent is based on the patient's medical history, the presence or absence of psoriatic arthritis, and other factors. Biologic agents which we prescribe include:
• Enbrel: Enbrel is self-injected by patients in the convenience of their home. It is intended for long-term, continuous use by persons with moderate to severe psoriatic skin disease or persons with psoriatic arthritis.
• Humira: Humira is self-injected by patients in the convenience of their home. It is intended for long-term, continuous use by persons with moderate to severe psoriatic skin disease or persons with psoriatic arthritis.
• Stelara: Stelara is injected by a health care provider once every three months. It is intended for long-term, continuous use by persons with moderate to severe psoriasis.
• Cosentyx: Cosentyx is indicated for the treatment of moderate to severe plaque psoriasis in adult patients who are candidates for systemic therapy or phototherapy.
Additional agents offered at Psoriasis Treatment Center of New England include:
Soriatane: This oral agent is a modified form of vitamin A. Taken daily, it reduces the thickness of psoriatic plaques. It may be used alone, but usually works best when combined with phototherapy or topical therapy.
Methotrexate: This oral medication is taken once weekly and highly effective for the treatment of psoriasis. Today it is used less often due to its potential to cause undesirable side effects and the availability of safer alternatives. Nevertheless, we offer Methotrexate treatment in limited circumstances.
Neoral (cyclosporine): This is a fast-acting, highly potent medication originally created to prevent the body from rejecting transplanted organs. Despite its efficacy, it is used less commonly today for psoriasis due to its potential to cause undesirable side effects and the availability of safer alternatives. Nevertheless, we offer Neoral treatment in limited circumstances.
Ortezla: Treats psoriasis and psoriatic arthritis by regulating inflammation within immune cells. It inhibits an enzyme known as phosphodiesterase 4, or PDE4. PDE4 controls much of the inflammatory action within the cell, which can affect the level of inflammation associated with psoriatic disease.
Questions and Answers about Psoriasis from the National Psoriasis Foundation (NPF) and National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse, part of the U.S. National Institutes of Health (NIH).
Agape Dermatology Providence, RI
Fax: 401- 421-1120
Agape Dermatology Fall River, MA
Fall River, MA
Fax: 508- 674-8880