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Treatment Options
Psoriasis cannot be cured. It may not develop beyond a single, mild flaring, but regardless of whether your first flaring is mild or severe there is no guarantee that the next, if you have one, will be any worse or any better than the first.
Psoriasis is highly variable; a treatment that works well in one person may be ineffective in another. Some therapies may not fit in with your lifestyle, for example some may require several weekly hospital visits. The key is to find a therapy that clears your psoriasis without disrupting your life.
Most therapies are quite potent and can only be used once a flare has them to counteract a flare and then enjoy a psoriasis-free (remission) period until the next flare when you return to the therapy.
You may also become resistant to your therapy. This will mean that you and your dermatologist will have to work together again to find an alternative therapy. Resistance does not develop in everybody. It is hard not to feel discouraged if this happens, but you've had to find new therapies before and you will do so again. You might actually find that the new therapy is better suited to you.
What Treatments are available?
Some people decide not to treat their psoriasis; others find that one of the many different types of moisturiser that are available is sufficient. Moisturisers are helpful in clearing up the flaky skin that many psoriasis sufferers find embarrassing; however, they will not help with the red plaques.
There are four main classes of psoriasis therapies:
The Stepwise Approach
Treatment of psoriasis/psoriatic arthritis has historically followed a stepwise approach. Patients are initiated on the first step with topical therapies and only progress to the more aggressive therapies if they are unsuccessful with the previous therapy.
|
Step 1 - Topical therapy |
Step 2 - Phototherapy |
Step 3 - Systemic therapy |
|
Over-the-counter products
Topical retinoids Topical steroids Vitamin D analogs |
Broadband UVB Laser Narrowband UVB |
Acitretin Cyclosporin A Methotrexate Systemic steroids |
At the systemic therapy step, due to the limitations of these agents, they are rotated to avoid cumulative toxicity. This approach is not appropriate for all patients as it often involves regimens that are inconvenient. In addition, regular monitoring for serious side effects is required.
Last Updated 24-03-2009
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