Psoriasis Treatments
Psoriasis can cause your skin to feel itchy and irritated, appearing red, inflamed, and patchy. This discomfort can not only affect your physical well-being but also lead to feelings of embarrassment or self-consciousness, impacting your psychological health. That's why at Ashcroft Pharmacy, we're committed to offering a service that prioritizes holistic health and meets your individual needs. We stock a wide range of prescription and non-prescription creams, gels, ointments, and foams specifically formulated to prevent, treat, and manage dry skin conditions, including psoriasis (characterized by scaly, pink patches of thickened skin) and seborrhoeic dermatitis, also known as dandruff, seborrheic eczema, and seborrheic psoriasis. When it occurs in infants, it's called cradle cap.
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Psoriasis Key Information
Psoriasis
Psoriasis is a skin condition caused by unusual production of skin cells that results in skin build-ups. It is a long-term skin condition that leaves your skin dry and inflamed. Psoriasis can be managed by taking psoriasis treatments based on the type of psoriasis you are suffering from.
Types of psoriasis
Plague psoriasis
Plague psoriasis is the most common type of psoriasis. This type of plaque affects skin areas like the knees, elbows, scalp, and lower back. It presents as large patches (plagues), that are inflamed and itchy. The plagues are covered with silver scales and may appear reddishGuttate psoriasis
Guttate psoriasis
Guttate psoriasis, also known as raindrop or teardrop psoriasis, presents as many small, red, scaly spots on the skin. These spots can be itchy or sore.
Guttate psoriasis is commonly found on the limbs, neck, scalp, or trunk. This type of psoriasis is a result of throat infection, medications, injury on the skin, or illnesses. It's most common in teenagers, young adults, and children
Pustular psoriasis
Pustular psoriasis is characterised by small, pus-filled pustules that often appear on the palms and soles of the feet. The surrounding skin becomes red, tender, and may crack, especially when walking or using your hands. As the pustules dry, they turn brown and crusty. Pustular psoriasis is less common than other types of psoriasis and is not contagious.
Scalp psoriasis
Scalp psoriasis occurs on the whole scalp or in patches. It mostly affects the skin around the hairline, the back of the neck, and behind the ears.
Symptoms of scalp psoriasis include inflamed, red, and flaky skin that resembles dandruff. You may experience tight, sore, and itchy skin on your scalp which may lead to hair loss or thinning of the hair.
Nail psoriasis
Nail psoriasis affects the fingernails and toenails. Nail psoriasis symptoms include thickening, crumbling, and discoloration of the nails, nails coming out easily, and pitting and dents on the nail surface.
It's easy to confuse fungal nail infection with nail psoriasis, therefore seek medical advice and get diagnosed by a professional.
Inverse psoriasis
Inverse psoriasis is most common on the armpits and under the breasts. Its symptoms include pain sores under the affected skin areas.
Erythrodermic psoriasis
Erythrodermic psoriasis is a type of psoriasis caused by sunburns, infections, or some medications. Its symptoms include skin shedding and severe redness on the affected skin areas.
Similarities between psoriasis and eczema
- They have no cure
- They can be treated using topical corticosteroids to relieve symptoms
- Causes symptoms such as red, flaky, and crusty patches on the skin.
The difference between psoriasis and eczema
Psoriasis
- Causes thick, raised, red patches covered with silvery-white scales.
- Can appear anywhere on the body, commonly the elbows, knees, scalp, lower back, and sometimes nails.
- Skin becomes thickened, inflamed, and may crack or feel sore.
- Caused by overactive immune response leading to rapid skin cell production.
- Can occur at any age but is most common in adults under 35.
Eczema (Atopic dermatitis)
- Causes red, dry, and very itchy skin; may also appear cracked, weepy, or rough.
- Commonly appears in skin folds, such as the inner elbows, behind the knees, neck, and around the eyes.
- Skin usually appears less thick than in psoriasis, and itching tends to be more intense.
- The exact cause is unknown but is linked to a combination of genetics, immune response, and skin barrier weakness.
- Most common in children, but can affect any age and may continue into adulthood.
Cause of psoriasis
The main cause of psoriasis is the immune system cell known as the T cell.T cells attack and fight bacteria causing the infection but in people with psoriasis, T cells attack healthy skin cells mistakenly.
This triggers the hypodermis to produce new skin cells quickly therefore causing inflammation and skin thickening. Other environmental and biological factors cause psoriasis.
Common triggers of psoriasis
Triggers are factors that result in psoriasis flare-ups. They include:
- Smoking
- Hormonal changes. (occur in women during puberty and menstruation)
- Throat infections
- Medicine interaction
- Alcohol
- Stress
- Skin injuries (cuts, scrapes, or insect bites)
- Immune disorders such as HIV
Psoriasis Treatments
Psoriasis has no exact cure but can be managed with psoriasis treatments. Your pharmacist will determine the best type of treatment depending on the severity of your symptoms and the skin area of treatment.
There are several types of psoriasis treatments, they include topical treatments, systematic medications, and phototherapy.
Topical treatments
Topical treatments are creams and ointments applied on the skin. Psoriasis topical treatments are divided into 4 categories:
Topical steroids
Topical steroids are short-term use of corticosteroids applied in the area of treatments to reduce inflammation. Examples of topical steroids include:
- Eumovate cream&ointment
- Betnovate cream&ointment
- Betnovate scalp lotion
- Betacap 1% scalp application, and Bettamouse foam
Vitamin D preparations
Topical vitamin D is used to decrease inflammation, redness, dry skin, and scaling. They are applied 30 minutes after moisturizing the affected area of treatment. Topical vitamin D is not applied on the face as it can cause skin thinning and calcium buildup in the blood.
Your prescriber may prescribe a topical vitamin D treatment only or combine it with a topical steroid depending on the severity of your symptoms.Examples of Vitamin D gels include:
- Dovonex ointment
- Enstilar foam, and Dovobet gel and ointment.
Moisturizers and emollients
Moisturizers and emollients are designed to hydrate and protect your skin from drying. Moisturizers can be used as a daily skincare routine to increase their effectiveness while emollients are only used during the day for a natural hydration feeling.
Examples of moisturizers and emollients include:
- Diprobase cream
- Dermalex psoriasis cream, and Cetraben cream.
Coal-tar products:
Coal tar is used to treat various skin conditions, such as scalp psoriasis, eczema, and dandruff. It is also available in the form of gel, lotion, and ointments. Coal tar contains anti-inflammatory and anti-scaling properties that relieve psoriasis symptoms.
Coal tar is used together with salicylic acid to shed off the thick scaly skin. Examples of products containing coal tar include:
- T/gel shampoo, and polytar shampoo.
Treatment products containing coal tar and salicylic acid include:
- Cocois ointment, Sebco ointment, and Capasal shampoo.
Systematic medications
Systematic treatments work best on severe psoriasis symptoms. Compared to topical treatment, systematic treatments work in the entire body.
They are available as biological and non-biological treatments. Nonbiological treatments include: injections while biological treatments include tablets and capsules.
Phototherapy
Phototherapy uses ultraviolet light to reduce inflammation in the skin area of treatment. Phototherapy is only performed by a dermatologist. There are 3 categories of phototherapy:
- Combination therapy: This is where you use the topical steroids in combination with the therapy
- UVB therapy: Ultraviolet B lights are used to reduce skin cell production. Your dermatologist may recommend you take 2 to 3 sessions a week.
- PUVA therapy: A combination of ultraviolet A light and ultraviolet B light is used. You can also be recommended to take psoralen tablets or have psoralen applied to your skin.
Preventions
There are lifestyle changes and skin care routines that can reduce the severity of psoriasis symptoms. These prevention measures include:
- Cleaning and trimming your nails.
- Use a humidifier in your workplace or home to prevent your skin from drying.
- Keeping your skin hydrated by using moisturizers after taking a shower.
- Avoid scratching your skin.
Written and reviewed by our qualified team — Mr Suhail Jamil, Superintendent Pharmacist (GPhC 2069518).