Medications Used To Treat Psoriasis

How Is Psoriasis Treated

Overview – Stelara a Prescription Medication Used to Treat Adults with Psoriasis

Most psoriasis therapies aim to stop skin cells from growing so quickly, reduce inflammation, and smooth out the skin.

Proper psoriasis treatments can help clear the condition and improve your quality of life.

What works for one person might not work for another, so keep trying therapies until you find one thats effective for you.

Doctors typically start with the mildest approach and move on from there.

What Complementary And Alternative Treatments Help Psoriasis

Complementary and alternative therapies are sometimes used to improve symptoms of psoriasis.

Although most of these approaches are safe, you should talk to your doctor before trying any new treatment or technique.

Examples of complementary and alternative methods commonly used to treat psoriasis include:

Diet and Nutrition Some people report improved symptoms by altering their diets or taking certain supplements. You can also try avoiding specific dietary triggers that may increase inflammation and worsen your symptoms.11

Sunlight Exposure to small amounts of sunlight can reduce some symptoms of psoriasis. But too much sun can worsen outbreaks and increase your risk of skin cancer. Talk to your doctor about how much sunlight exposure is safe for your situation.

Daily Baths Soaking in mineral water baths may help hydrate and soften the skin. You can add colloidal oatmeal, Epsom salts, or Dead Sea salts to bathwater to help calm inflamed skin. But stay away from hot water and harsh soaps, which can worsen your symptoms.

Moisturizer Some people report fewer symptoms when they apply moisturizer to affected areas. Ointments can help lock in moisture better than creams.

Yoga and Meditation These practices can clear your mind and reduce stress, which may ease symptoms of psoriasis.

Exercise Physical activity increases the production of chemicals known as endorphins, which improve mood and energy. Exercise can also help you sleep better and reduce anxiety.

What Are The Risk Factors For Psoriasis

While anyone can develop psoriasis, the following factors can increase your risk:

Family History Having one parent with psoriasis increases your risk, and having two parents with the condition puts you at greater risk.

Infections People with HIV are more likely to develop psoriasis. Additionally, strep throat has been linked with the development of a certain type of psoriasis, called guttate psoriasis. This causes small, round, scaly rashes to develop, usually on the trunk and arms. Kids and young adults with this type of recurring infection may be at increased risk.

Stress Since stress can impact your immune system by causing inflammation, high stress levels may increase your risk of psoriasis.

Obesity Being overweight or obese increases your risk, and psoriasis often develops in the creases and folds of skin.

Smoking Smoking tobacco increases your risk and the severity of psoriasis, and may initiate the development of the disease.

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Newer Drug Treatments For Psoriatic Arthritis

Get more information about the medications, ustekimumab, apremilast and abatacept that were approved by the FDA as options for treating PsA.

Psoriatic arthritis is a chronic, autoimmune, inflammatory form of arthritis that causes painful, swollen joints, as well as the skin symptoms associated with psoriasis. Approximately 30 percent of people with psoriasis develop PsA in addition to their skin condition. The goal of treatment is to improve both joint and skin symptoms and prevent or minimize permanent joint damage.. While there are a variety of treatments available, many PsA patients are undertreated, making newer drug approvals important to give doctors and patients more options. Depending on its severity, psoriatic arthritis is typically treated with nonsteroidal anti-inflammatory drugs , corticosteroids and conventional disease-modifying anti-rheumatic drugs such as methotrexate. Biologics such as adalimumab , etanercept , golimumab and infliximab are used when other treatments fail to bring relief or as part of an aggressive treatment strategy. The U.S. Food and Drug Administration approved three new drugs between 2013 and 2017 for use in psoriatic arthritis:

Topical Medications For Psoriasis

Clobetasol , triamcinolone , fluocinolone , and betamethasone are examples of commonly prescribed corticosteroids.

How corticosteroids work: Corticosteroids decrease skin inflammation and itching.
Who should not use these medications: Individuals with corticosteroid allergy or skin infections should not use corticosteroids.
Use: Apply a thin film to affected skin areas. These creams or ointments are usually applied two times a day, but dosage depends on severity of the psoriasis.
Drug or food interactions: No interactions have been reported with topical use.
Adverse effects: Corticosteroids may cause adverse effects to the body if used over large areas. They can also cause local thinning of the skin. Do not use for long periods of time. It is best not to put bandages over the treated skin unless directed by the physician because too much of the medicine may be absorbed into the body.

Creams and Ointments Related to Vitamin D

Calcipotriene is a relative of vitamin D-3 that is used to treat moderate psoriasis.

How vitamin D medications work: Calcipotriene slows the production of excess skin cells.
Who should not use these medications: Individuals with the following conditions should not take calcipotriene:
Allergy to calcipotriene cream
Vitamin D toxicity

Use: Apply to affected skin area two times a day. This medication is available as a cream, ointment, or solution.

Tar-Containing Preparations

Drug or food interactions: No interactions have been reported.

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Understand The Differences In Injectable Medications

Is the injection a good move or a bad one? asked one MyPsoriasisTeam member.

There isnt a simple answer to that question. There are various injectable medications used for different types of psoriatic disease. Your doctor may have to run some medical tests before determining which injectable medication is appropriate for you. Injectable medications for psoriasis may include corticosteroids, immunomodulators, or biologics.

A corticosteroid like Kenalog can be delivered into the joint of a person to treat psoriatic arthritis. It can also be locally injected subcutaneously under the skin. Immunomodulators like methotrexate can be injected subcutaneously. Biologics may be prescribed in conjunction with methotrexate or as stand-alone treatment. Humira is one of the most popular biologics, and it is also injected subcutaneously. Other biologics, such as Remicade , are delivered through an IV.

Treatment With Topical Corticosteroids

Corticosteroids reduce inflammation and slow the rapid production of skin cells. They are applied to the skin in the form of a cream, solution, ointment or for the treatment of psoriasis on the scalp a foam or shampoo.

There are big differences between corticosteroids in terms of the strength of their effect . In Germany and other countries they are divided up into four groups based on their potency:

Low-potency corticosteroids
High-potency corticosteroids
Ultra-high-potency corticosteroids

Ultra-high-potency corticosteroids are often needed for the treatment of very scaly areas of skin and psoriasis on hair-covered areas of the scalp. Weaker corticosteroids or other drugs are used on sensitive areas of the body, such as the face or in skin folds. The symptoms usually improve within one to two weeks of starting treatment.

Psoriasis flare-ups are often treated with stronger medications such as mometasone. These medications are generally applied to the affected areas of skin once or twice a day for the first three weeks. After that they are gradually applied less frequently for instance, every other day in the fourth week, and every three days in the fifth week. Treatment with topical steroids is stopped gradually because an abrupt stop can make psoriasis come back again.

Studies have shown high-potency corticosteroids to be effective. They found the following after a few weeks:

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Can Biosimilars Be Used With Other Treatments

It is important to tell your health care provider about all treatments, medicines, vitamins or supplements that you are taking.

Like all biologics, biosimilars can be used with other treatment options including topicals and phototherapy. The biologics Enbrel, Humira and Remicade are shown to be safe and effective when taken with methotrexate. This means that their biosimilars, including Erelzi, Amjevita, and Inflectra, may be safe and effective when taken with methotrexate.

With Inflectra being the biosimilar to Remicade, its use in combination with phototherapy may increase the risk for skin cancer.
No drugs that interact with biologics should be combined with their respective biosimilars.

What’s The Best Way To Control Psoriasis

Everyones case of psoriasis is different, which means treatment will be different for every person. However, some of the best treatments for psoriasis seem to include a combination of lifestyle changes, home remedies, and prescription medications. This article contains information on treatments and medications. Using this article in combination with a consultation from your doctor can help you find the best way to control psoriasis.

Which Medications Are Used To Treat Psoriasis

Many drugs that affect the rate of skin cell production are used in psoriasis therapy alone or in combination with light therapy, stress reduction, and climatotherapy. Adjuncts to treatment include sunshine, moisturizers, and salicylic acid as a scale-removing agent. Generally, these therapies are used for patients with less than 20% of body surface area involved, unless the lesions are physically, socially, or economically disabling.

Treatments for more advanced psoriasis include narrowband ultraviolet B light, psoralen with ultraviolet A light retinoids , methotrexate , cyclosporine , infliximab , etanercept , adalimumab , apremilast , and secukinumab . Decreased effectiveness of infliximab or adalimumab in a patient previously well controlled on the medication may mean that antibodies to the medication are being produced.

In a study of ustekinumab in patients with moderate-to-severe psoriasis, investigators did not observe an increased trend in dose-related or cumulative toxicity with the duration of ustekinumab treatment. The investigators also reported rates of adverse events generally comparable to those of other biologics approved for managing moderate-to-severe psoriasis. It is approved in two dosages, administered subcutaneously, with the higher dose given to those weighing 100 kg or more. It has been suggested that 91 kg might be a better cutoff for the higher dose for optimal control.

References

Should You Take A Biologic

It depends on 5 things:

1. How much of your skin is affected by psoriasis

Doctors often use biologic drugs on people with moderate to severe psoriasis.

Moderate psoriasis means that 3% to 10% of your body is covered with red, scaly patches.
Severe psoriasis means that more than 10% of your body is covered.

You may also want to take a biologic drug if you have mild psoriasis but it really bothers you.

2. How much psoriasis affects your life

If your psoriasis doesnât really bother you, the doctor may tell you that a biologic drug isn’t worth the risks. Biologics suppress your immune system. That means they can make you more likely to get an infection.
They may not be worth the cost, either. Biologic drugs are expensive. Depending on the drug and the dose, they can cost $10,000 to $30,000 or more a year.

3. Your health

The doctor will take a careful look at your health history. Biologic drugs may not be best for people with certain health conditions, including:

A history of infections such as tuberculosis
A history of cancer
A weak immune system because of a disease like HIV or cancer

Biologics may cause a recurrence of some chronic diseases that are in remission. Also, because biologics suppress the immune system, they could make serious infections more likely.

4. Insurance coverage

5. Your preferences

Causes And Treatment Of Psoriasis

Psoriasis Treatment Kit of Natural Ointment & Healing Cream Psor ...

Psoriasis is not contagious and cant be spread through contact or exchange of bodily fluids.

While the exact cause of psoriasis is unknown, it’s an autoimmune condition in which a faulty immune system changes the life cycle of skin cells in the body.

This change causes the cells to build up rapidly on the surface of the skin in just a few days.

These extra skin cells form thick, itchy, dry, discolored patches, called plaques, on the skin’s surface.

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So What Are My Psoriasis Medication Options

As we mentioned, there are several different types of psoriasis: plaque psoriasis , scalp psoriasis, guttate, pustular, inverse, erythrodermic, and even psoriatic arthritis, which is a combo of psoriasis and arthritis. The medication youre prescribed is often determined by your type, and may include topical treatments, drugs taken orally, and injections. Let’s start by taking a look at topical medications for psoriasis.

Skin irritation at the application site
Skin thinning
Stretch marks
Discoloration

Acrodermatitis Continua Of Hallopeau

This type of pustular psoriasis is rare. It causes pus-filled bumps on the fingertips, toes, or both. The disease can also develop underneath the nails.

Often beginning on one finger or toe, new pus-filled bumps may continue to appear. When this happens, new pustules can develop on more than the fingers and toes. In rare cases, the pus-filled bumps can slowly spread up the arms or legs.

Anyone who has pus-filled bumps over much of the skin needs immediate medical care. When widespread, pustular psoriasis can be life-threatening.

The first choice for treating this type of pustular psoriasis often includes the following.

Synthetic vitamin D combined with a strong corticosteroid: This combination is applied to the skin.
PUVA: This is a type of light treatment that involves taking a medication called psoralen before getting UVA light treatments on the affected skin.

While the above describes what treatment may be used for each type of pustular psoriasis, your treatment plan may include different medications. Your age, other medical conditions , and general health also play key role in determining which treatment is best for you.

ImageGetty Images

ReferencesFitzpatrick JE. Pustular eruptions. In: Fitzpatrick JE and Aeling JL. Dermatology Secrets. Hanley & Belfus, Inc., Philadelphia, 1996:66-7.

Jeon C, Nakamura M, et al. Generalized pustular psoriasis treated with apremilast in a patient with multiple medical comorbidities. JAAD Case Rep. 2017 3: 495-7.

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Psoriasis Drugs: Biologic Medication

Biologic drugs are protein-based medicines that are derived from living cells cultured in a laboratory.

These medicines are administered through an injection or IV and target parts of the immune system.

Biologics work by blocking the action of a specific type of immune cell and proteins in the immune system that play a major role in the development of psoriasis.

The following medicines are examples of biologics:

Azulfidine

How Biologics Will Affect Your Psoriasis

Treating Psoriasis

Whether you start with a biologic drug or turn to one after trying other therapies, you should see dramatic results. But you need to follow your doctor’s instructions for any treatment carefully. And youâll need to go in for regular follow-up visits to make sure your treatment is still working. At your visits, talk about any problems or side effects you are having.

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Other Systemic Agents For Psoriasis

Antimetabolites, Immunosuppressives, and Biologic Response Modifiers

These agents are potent drugs given by mouth or injection. They block inflammation and have effects on the immune system. The effect on skin is probably secondary to the effect on white blood cells.

Adalimumab , etanercept , infliximab , ustekinumab , secukinumab , ixekizumab , methotrexate , cyclosporine , and apremilast are in this group of systemic drugs. They may be prescribed for moderate to severe psoriasis.

How these drugs work: These medications can block inflammation. They are used to treat people with severe disabling psoriasis who have not responded to or tolerated other treatments.

Drug or food interactions: The safety and efficacy of these medications in patients receiving other immunosuppressive drugs have not been evaluated. Patients receiving these medications may receive concurrent vaccinations, except for live vaccines, such as the MMR and yellow fever vaccines.

Adverse effects: Serious infections may develop and the therapy should be discontinued if they occur. Possible adverse effects include injection-site pain, redness and swelling at injection site, and headaches. Rarely, lupus-like symptoms, lymphoma, reactivation of tuberculosis, and heart failure have been reported .

Methotrexate : This drug is used to treat plaque psoriasis and psoriatic arthritis. However, it is sometimes not effective.

Methotrexate allergy

Low blood cell levels

Cyclosporine

Cyclosporine allergy

How Do You Treat Mild To Moderate Psoriasis 7 Treatment Options

How Do You Treat Mild to Moderate Psoriasis? 7 Treatment Options Center

Psoriasis is a chronic autoimmune skin disorder that has periods of flare-ups and periods of remission. Mild to moderate psoriasis is typically treated with medications and therapies that aim to reduce inflammation and slow the rapid skin cell growth associated with the condition.

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