What You Need to Know about Psoriasis Treatment
Consulting an experienced skin specialist is crucial when seeking psoriasis treatment. Vizag is now a major hub for health tourism. We have a number of patients travelling from Orissa, Chhattisgarh and other surrounding states, seeking treatment for psoriasis. Doctors collect all the important information about your condition and your medical history before discussing treatment. It is also important for you to understand what psoriasis is and the several forms it manifests itself in.
Psoriasis is a chronic condition which alters the life cycle of skin cells. Normal skin cells take around 28 days to regenerate. However in people with psoriasis the skin cells regenerate within 4-5 days. This causes a buildup of extra cells on the skin surface which form thick scale like patches that are itchy and sometimes red and painful. It is not contagious, but a genetic disorder triggered by a variety of environmental factors, which vary from person to person. Such factors include; injury, allergic reaction especially topical creams and ointments, some bacterial and yeast infections, obesity, excessive alcohol consumption, some medication, exposure to UV light, smoking and hormonal changes amongst other factors. Avoiding exposure to these conditions and trigger factors is crucial to managing psoriasis.
Types of psoriasis
Psoriasis is classified into a number of ways depending on the areas of involvement, severity, size/ shape of the plaques, etc. The exact type of psoriasis you have will be explained by our dermatologist. In Visakhapatnam the commonest type of psoriasis we see is ‘acral psoriasis’, also called ‘palmoplantar psoriasis’, where the hands and feet are affected. This is basically classification by ‘location’. Other location based psoriasis types include ‘flexural psoriasis’ which affects body folds, ‘nail psoriasis’ and ‘scalp psoriasis’. The classical type of psoriasis described in text books is ‘chronic plaque psoriasis’, appearing as thick plaques on the knees, elbows, spine and scalps mostly. ‘Pustular psoriasis’ is a severe form manifesting in pus filled spots and needs urgent medical attention. ‘Guttate psoriasis’ presents in the form of 1-3 cm sized round plaques all over the body. This is usually an acute condition that follows a throat infection and lasts for a few months and resolves completely with treatment. However the condition can recur with repeated sore throat infection. ‘Erythrodermic psoriasis’ is the most severe form of psoriasis in which the whole becomes red and sore. This is a medical emergency, often requiring hospital admission and close monitoring.
Treatment of Psoriasis
Treatment of psoriasis takes different forms. There are topical treatments, phototherapy, systemic including acitretin/ immunosuppressants and finally biologics. Unfortunately psoriasis cannot be cured. All the treatments above are meant to control and slow down the formation of skin cells by suppressing the immune system or by controlling the DNA activity in the cells. The aim of treatment is to control the disease with as little medication as possible.
Topical treatments refer to creams and ointments which are applied on the skin surface and can be used alone to treat moderate cases of psoriasis or combined with other treatment methods for severe cases. Obviously topical treatments are the ones with the least side effects. Topical treatment options include topical corticosteroids, vitamin D analogues, topical retinoids, coal tar, calcineurin inhibitors, salicylic acid and moisturizers.
Phototherapy is the next preferred option, where topicals do not work, or are not feasible to apply due to the extent of the disease. Ultraviolet-B (UVB) and Psoralen-Ultraviolet-A (PUVA) are the main modes of phototherapy. UVB phototherapy is preferred over PUVA due to its better side effect profile.
Biologics and systemics are basically drugs taken to treat moderate to severe psoriasis. They differ in their mode of action and side effect profile. Systemic immunosuppressant’s like methotrexate and cyclosporine have been in use for more than a hundred years. We are well aware of their long and short-term side effect profile. They are taken by mouth in pill or liquid form or given by injection for psoriasis treatment. In vizag, biologic therapies are also available. Biologics are protein based drug that have only been in the market for a few years. They target specific parts of the immune system in their working and are either injected or given by intravenous infusion. They have a comparable efficacy to other standard therapies as above, but their longer term side effects are unknown. Thus, they are reserved for people who do not respond to standard treatments. Moreover they are very expensive compared to standard therapies.
With proper management and treatment plan, psoriasis can be controlled to such an extent that it does not in any way reduce the quality of your life. Consult are doctors now to discuss which treatment option would suit you best.