Solutions to skin trouble

Research suggests that defects in gene function are a possible cause for psoriasis. The unpredictability of the medical condition makes it difficult to state how skin patches will appear, distribute, or respond in someone who has been recently diagnosed with psoriasis.

Its severity varies. In some cases there is only a single patch while for other patients the entire body is affected. One in 4 people may experience joint pain due to psoriasis of the joints, and 1 in 10 may experience swelling or even deformity of the joints. This feature discusses skin psoriasis and treatment options.

What are the treatments available for psoriasis?

Doctors generally treat psoriasis in incremental steps based on the type and severity of the disease, the extent of the areas involved, and the patient’s responsiveness to initial treatments. This is sometimes called the 1-2-3 approach.

*Step 1 involves application of medicines on the skin surface (topical treatment).
*Step 2 focuses on treatments with specific types of light (photo therapy).
*Step 3 is needed only in case both Step 1 and Step 2 fail, and involves taking medicines internally, usually orally (also referred to as systemic treatment).

Sometimes, topical treatment is enough to clear psoriasis. Some patients respond well to sunlight, corticosteroid ointments and medicines derived from vitamin D3, vitamin A (retinoids), and coal tar or anthralin. Other topical measures, such as bath solutions and moisturisers, may be soothing but are seldom strong enough to clear lesions over the long term. They may have to be combined with more potent remedies to be effective.

Does severe psoriasis need treatment?

Yes. Severe psoriasis definitely requires urgent and early medical attention.

Is severe psoriasis harmful if left untreated?

Yes. Psoriasis is a condition where the immune system is in an activated state. A constantly activated immune system can result in various problems like myocardial infarction (heart attack), stroke and high levels of cholesterol, blood pressure and sugar.

What are the treatments for severe psoriasis?

Severe psoriasis requires medicines to be taken either orally or through injections. Methotrexate is a standard medicine for severe psoriasis and psoriatic arthritis (joint pains). It is usually given as a tablet to be taken orally once a week or as an injection. The only condition while taking this medicine is that the patient is free of any kind of liver or kidney disease.

Cyclosporin is another standard systemic therapy for extensive psoriasis, provided the patient does not have any kidney disease. While it helps to rapidly clear psoriasis, a quick recurrence of lesions has been observed in some people when the medicine is discontinued. Biologics are being talked about in the treatment of psoriasis. Even in the US and the UK, biologic therapy does not come cheap or easy, and is administered only to those patients who have failed the first two conventional treatments. Moreover, their safety in pregnancy is not clearly known. There is also some concern regarding a slightly increased risk of malignancy in old age.