Medications to Control Psoriasis and Prevent Flare Ups

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The various diseases called psoriasis are defined by large patches of discolored and abnormally textured skin. This occurs when the production of skin cells spirals out of control, reaching rates as much as ten times higher than normal. This overabundance causes the cells to accumulate in the outer layer of skin and create psoriasis’ characteristic plaques. The body’s immune system doesn’t recognize plaques as healthy tissue, instead interpreting them as invasive bodies. In its attempts to eliminate these buildups, the immune system sends T cells to attack the excess skin cells, causing swelling, inflammation and discomfort. This reaction in turn causes the production of additional skin cells, which then induces the increased production of T cells, perpetuating the autoimmune cycle. Luckily for psoriasis patients, there are many effective treatments that can help to control and prevent flare ups, particularly in the case of plaque psoriasis, the most common incarnation of the disease. Phototherapy and topical treatments are the most widely deployed, with other treatments held in reserve for more severe and resistant.

Phototherapy

The application of intense light, either in the form of artificial ultraviolet rays or natural sunlight, is often effective in the treatment of psoriasis. Regardless of which form of light is used, treatment sessions involve short, carefully controlled exposure to the source. These regulated exposures to ultraviolet radiation inhibits skin cell growth, but if they are not properly managed by an expert, such intense light can instead promote the division and proliferation of cells, thereby increasing the problem instead of treating it. There are several varieties of ultraviolet phototherapy that can be used to treat psoriasis, such as UVB lasers and narrow-band UVB rays. Phototherapy has been shown to be effective as a solo treatment, but doctors often prescribe it in tandem with oral or topical approaches that will increase the patient’s sensitivity to light and therefore bolster the effects of the treatment.

Topical Treatments

Topical methods of treating psoriasis pursue a three-pronged approach. They reduce and remove scaling, slow excess skin cells’ growth, and reduce the inflammation induced by the autoimmune disease. Corticosteroids are amongst the most common treatments used to ease inflammation. They can be purchased over-the-counter, but in more severe cases can be prescribed in greater strengths. Their effectiveness may, however, decrease over time and even disappear entirely. They work best when used as short-term treatments for flare ups, as they can also cause skin to thin when they are applied for long periods. Calcineurin inhibitors and retinoids are two other means of treating inflammation topically. The former are effective short-term approaches for treating sensitive areas of skin, but they are known to increase the chance of psoriasis sufferers additionally developing lymphoma and skin cancer. Retinoids, derived from vitamin A, increase sensitivity to light and so are often used in tandem with phototherapy. Topical retinoids are preferable to oral forms, since the latter increases chances of birth defects in the children of psoriasis sufferers. Vitamin D analogues are also used to stem the overly prolific growth of skin cells that leads to psoriasis flares. Another option is anthralin, which not only inhibits skin cell growth but also smoothes skin by removing scales. However, anthralin can cause irritation and stains, and so is usually only applied for a brief period. Salicylic acid is also often used to remove cells and eliminate scales. Doctors can provide strong prescriptions for more problematic flares, but the drug is available over the counter for milder cases. It is safe to combine with other topical treatments to increase the effectiveness of each. For people suffering from scalp psoriasis, it is available in hair care products.

Advanced Approaches

Other psoriasis solutions include oral and injected medications, which are typically used only for more extreme or resistant flares that are unaffected by other treatment options. These can target and reduce inflammation, and some (such as methotrexate) also inhibit the growth of skin cells. However, these approaches incur more severe side effects than frontline treatments. They are often only deployed for erythrodemic psoriasis, pustular psoriasis or psoriasis concurrent with arthritis. Another means of controlling psoriasis is to modify the operation of the immune system. An immunosuppressant called cyclosporine and the broad category of drugs called biologics alter the immune system and prevent it from attacking the body’s own tissue. However effective these may be for controlling psoriasis, though, altering the immune system’s functions means that it cannot perform its normal tasks as efficiently, leaving the patient open to potentially fatal infections. Other side effects, such as organ damage and increased blood pressure, may also be incurred and increase in severity over the treatment’s duration. Because medical science is still grappling with the causes of autoimmune disorders, psoriasis still remains a bit of a black box for doctors as well as patients. However, this lack of comprehensive knowledge spurs continued research and development of new medications and treatments that can more effectively manipulate the immune system and ease flares. As knowledge progresses, psoriasis suffers can look forward to the day when risky treatments give way to methods that safely mitigate, or even cure, the disease.