Treating psoriasis: What to do if you have psoriasis?

There are various options available to treat psoriasis – from ointments to systemic medications and light therapy. Find out here how you can effectively treat psoriasis and which methods are used and when.

Quick overview: Frequently asked questions and answers

What is the best way to get rid of psoriasis? To treat psoriasis, individually tailored approaches that include ointments, light therapy and, if necessary, medication are recommended. Lifestyle changes, such as a balanced diet and stress reduction, can support treatment.

Can psoriasis go away? A causal treatment is not possible for psoriasis. However, the attacks can be alleviated with various means and the healing process can be accelerated. With appropriate therapy, many of those affected also experience phases without symptoms.

At a glance:

What does psoriasis look like? Pictures of psoriasis

Causal treatment of psoriasis is not possible

Treatment of psoriasis aims to relieve symptoms, shorten an acute attack and prevent new attacks.

The main goal is to maintain or improve the quality of life, as most of those affected are psychologically stressed by their skin disease. There is no causal way to treat psoriasis, so the disease cannot be cured.

What is Psoriasis?

Psoriasis is a chronic, inflammatory skin disease characterized by accelerated skin cell production. It typically causes thickened, flaky and often itchy patches of skin.

It is an autoimmune disease in which the body incorrectly releases increased amounts of messenger substances that cause inflammatory reactions. The disease can progress in episodes, with periods of mild and severe symptoms.

As a result of psoriasis, inflammation of the joints can occur (psoriatic arthritis). The disease can be very stressful and have a major impact on everyday life.

Treat psoriasis with ointments

There is an external treatment for psoriasis (topical therapy).

  • lotions,
  • creams,
  • Anoint,
  • Shampoos and
  • Bath additives.

The most common active ingredients are salicylic acid and urea, each in a concentration of three to ten percent. They serve to remove dead skin cells or scales. They also keep the skin supple, relieve itching and prevent injuries and thus infections.

Salicylic acid and urea also have a slight anti-inflammatory effect and, as a desirable side effect, have a slight effect against bacteria and fungi.

Basic therapy generally includes good skin care, even outside of flare-ups.

Other active ingredients that are suitable for external use include:

Treatment with nail polish

If psoriasis also affects the nails on the hands and feet, a special psoriasis nail polish can also help.

The water-soluble psoriasis nail polish contains the active ingredient hydroxypropyl chitosan and has proven itself in various studies. An application period of at least six months is recommended for psoriatic nails.

Involvement of the finger and toenails in psoriasis is often not just a cosmetic problem for those affected. Many patients experience nail disease as painful and feel that their quality of life is severely impaired as a result.

Psoriasis: treatment with medication

If ointments and creams are not enough to eliminate the symptoms of psoriasis, various internally administered remedies can be used. They are taken orally or administered with injections.

This also includes so-called biologics, which suppress the immune system. You can read more about biologics for psoriasis here.

The following active ingredients are the first choice:

  • Acitretin: From the group of retinoids, it must not be taken by pregnant or breastfeeding women.

  • Cyclosporine: Calcineurin inhibitor, which is used for severe psoriasis vulgaris that cannot be adequately treated with other active ingredients. Inhibits inflammation as an immunosuppressant.

  • Fumaric acid ester: Inhibits inflammatory cells (lymphocytes) and influences the release of inflammation-regulating cell messengers (cytokines). An effect usually occurs after three to five weeks. Good effectiveness, but also often side effects.

  • Adalimumab (is one of the biologics)

  • Secukinumab (is one of the biologics)

This systemic therapy is usually combined with external applications and/or light therapies (phototherapy).

Treat psoriasis with home remedies?

In addition to medical therapy, there are some home remedies that can be helpful. This includes:

  • Aloe vera: The plant’s gel has skin-soothing properties and can reduce itching and redness. High-quality ointments and lotions with aloe vera can be purchased at the pharmacy.

  • turmeric: The golden yellow root contains curcumin, which has anti-inflammatory properties. Corresponding agents are available in capsule form.

  • Coconut oil: Ointments and creams with pure coconut oil moisturize the skin and relieve inflammation. It is important to choose products that do not contain chemical fragrances.

  • sea-salt: Many sufferers find baths with sea salt to be soothing. The salt water removes dead skin cells and cleanses the pores. Dead Sea salt is particularly recommended.

  • baking powder: Baking soda or baking powder are said to help especially with acute itching. Dissolve the home remedy in water, dip a cloth into the mixture and place it on the affected skin.

  • wrap: Moist compresses, compresses and curd wraps are also used as home remedies.

Please note: Treatment with home remedies alone is not recommended from a medical perspective. Some home remedies also lead to allergic reactions. In any case, those affected should contact a dermatologist to receive appropriate therapy.

Phototherapy for psoriasis

Phototherapies include ultraviolet light (UV) radiation and PUVA therapy.

With PUVA, the active ingredient psoralen is used as a tablet, cream or gel before light therapy. It increases the skin’s sensitivity to light and thereby increases the effectiveness of the UV-A treatment.

Phototherapy with ultraviolet radiation can be combined with most medications used to treat psoriasis. Bathing light therapy (balneophototherapy) can also take place. In photosoletherapy, for example, Dead Sea salt is added to the bath water.

In addition to phototherapy, many people with psoriasis also benefit from a stay at the Dead Sea, where photosoletherapy occurs naturally.

Other active ingredients for the treatment of psoriasis

If these therapies and active ingredients cannot be administered due to intolerances or contraindications or if they do not have a sufficient effect, the following medications are also available according to the guidelines for psoriasis vulgaris:

  • Apremilast (for moderate to severe psoriasis)

  • Etanercept (is one of the biologics)

  • Infliximab (is one of the biologics)

  • Ustekinumab (is one of the biologics)

  • Methotrexate

Choice of therapy for psoriasis

Therapy for psoriasis is often started with cortisone preparations for external use, as these generally relieve the acute symptoms well and are at the same time well tolerated as long as they are used for a short period of time.

With long-term use, possible side effects should be taken into account. Another topical agent such as calcipotriol, which is a vitamin D3 derivative and promotes the formation of healthy skin, comes into question.

If external application – even in combination with phototherapy – is not sufficient, a risk-benefit assessment must be carried out together with the treating doctor and a suitable active ingredient must be selected for internal use.

This depends on the severity of the psoriasis, possible comorbidities and the impairment of quality of life caused by the psoriasis.

However, for many of those affected, a good result can be achieved with external remedies in combination with light therapy and good skin care.

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