How Does Light Therapy Work For Psoriasis
Light therapy, also known as phototherapy, is a treatment that focuses specific types of light onto the skin.
Your doctor may suggest one or more of the following phototherapy or combination therapy approaches:
Ultraviolet B This is an effective choice and can be delivered as either broadband UVB or narrowband UVB . UVB phototherapy is a good course of treatment for people with moderate to severe cases of psoriasis, patients with plaque psoriasis, those with thin plaques, and people who are generally responsive to natural sunlight.
PUVA For advanced cases of psoriasis, a physician might suggest combining exposure to ultraviolet A light with prescribing psoralen, a light-sensitizing medication that is most commonly administered orally. Taken shortly before light treatment, psoralen seems to boost the therapeutic effect of light on the immune system. People with moderate to severe cases of plaque psoriasis, guttate psoriasis, and psoriasis of the palms and soles are good candidates for PUVA.
The therapy is done in a doctor’s office, psoriasis clinic, or at home with a phototherapy unit. The FDA regulates medical devices used in the application of phototherapy. Laser treatments, using a device known as an excimer laser, can administer highly targeted beams of ultraviolet light to treat select areas of affected skin.
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Alternative Treatments For Psoriasis
If you have psoriasis, you might be wondering if theres more you can do to manage your condition. There are some alternative treatments you may be able to try, alongside the care you get from your doctor.
They may help symptoms like itching, scaling, and painful plaques. Before you try one, even an over-the-counter product, talk to your doctor.
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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.
Use Of Otc Emollients And Creams
Topical emollients and creams are agents that sooth and soften the skin. Emollients, such as lanolin, are rich in fats and oils. They work by moisturizing the skin and protecting it from drying.
Regular use of emollients may lessen the need for anti-inflammatories like corticosteroids in psoriasis.
Ask your dermatologist, family doctor, or pharmacist for their top recommendations.
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How A Dermatologist Can Help
With so many products, it can be difficult to know what to use. If you dont see the results you like with OTC treatment for psoriasis, you may want to see dermatologist. Dermatologists are the skin disease experts. They know how to tailor psoriasis treatment to the type of psoriasis you have. Sometimes, this requires combining treatments. You may also need one treatment plan to gain control over your psoriasis and another to maintain the results.
ImagesGetty Images
ReferencesMenter A, Korman NJ, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis. Section 3: Guidelines of care for the management and treatment of psoriasis with topical therapies. J Am Acad Dermatol. 2009 60:64359.
Paghdal KV, Schwartz RA. Coal tar: Back to the future. J Am Acad Dermatol. 2009 Aug 61:294-302.
All content solely developed by the American Academy of Dermatology
The American Academy of Dermatology gratefully acknowledges the support from Amgen and .
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Itchiness is one symptom of psoriasis, which is why this earns top points for helping to tamp down the itch. Plus, it also contains salicylic acidat a maximum, over-the-counter, 3% concentrationto help break down plaques and scale. And since it costs less than lunch, you can go ahead and slather it on with reckless abandon.
Specially formulated for extremely dry or even atopic skin, this a top pick for those who have to deal with both dryness and psoriasis. It offers a heavy hit of hydration immediately, but also has an exclusive complex that works to repair a damaged skin barrier. And psoriasis-sufferers will appreciate that it is formulated to ease itchiness.
How To Choose A Shampoo For Scalp Psoriasis
Still unsure how to pick the right shampoo for your hair and scalp? Heres what to consider:
- Severity of your symptoms. If youre experiencing a mild to medium case of scalp psoriasis, start with an OTC shampoo. If you have a severe case, or if OTC products dont seem to help, you may need to see your doctor for a prescription shampoo.
- Consider your hair type. Check the ingredients list before you make a purchase, especially if you have dry, curly, color treated, or fine hair. Some shampoos may contain drying ingredients, like sulfates, while others may be too heavy for fine hair.
- Do your research. If you didnt see a shampoo on this list you want to try, no worries! There are many shampoos out there that will work great for you. Just look for key ingredients, like salicylic acid or coal tar, and be sure to check reviews to see what others with scalp psoriasis have to say about it.
Clobetasol , triamcinolone , fluocinolone , and betamethasone are examples of commonly prescribed corticosteroids.
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
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What Are The Best Over
Most modern psoriasis treatments are available on prescription only from the doctor as they contain active, restricted, or biological altering ingredients. We wanted to answer the question: What are the best psoriasis treatments available without a doctors prescription?
The challenge we faced here is that different countries have different restrictions on what is classed as an over-the-counter treatment. We have tried to include over-the-counter treatments in both the U.S. and Europe and any restrictions that apply to either geographical area.
Without further adieu, here are the best over-the-counter psoriasis treatments available today:
Ingredients In Otc Products
Some OTC medications may include active ingredients such as coal tar and mild corticosteroids. We explore more details about these products and their main ingredients below.
Coal tar
Manufacturers include coal tar in OTC and prescription products for psoriasis, including creams, shampoos, ointments, and bath solutions. Doctors and dermatologists have recommended it as a beneficial treatment for psoriasis for years, which can help:
- reduce swelling, scaling, and redness
- reduce itching and flaking
- slow overproduction of skin cells
Mild corticosteroids
Corticosteroids may help reduce inflammation and itching. A person can buy solutions, ointments, and creams containing mild corticosteroids, such as hydrocortisone, without a prescription. Hydrocortisone is effective in treating a few small patches of psoriasis, although individuals with more severe symptoms will probably need a prescription corticosteroid.
Moisturizers
These products may help with skin healing and relieve skin dryness. Some moisturizers may partially seal water onto the skin, helping people with mild or severe psoriasis. Dermatologists recommend applying moisturizer once a day, or more often in cases of very dry skin. People should choose a heavy, fragrance-free ointment or cream instead of lotion.
Scale softeners
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Buying Psoriasis Creams Over The Counter
You can readily buy emollients in a pharmacy, but medicated creams will typically require a conversation with the pharmacist or a prescription from your doctor.
Coal tar shampoos, including polytar shampoo, which are a treatment for scalp psoriasis, are usually available to buy without speaking to a pharmacist.
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Complementary And Alternative Treatments
Youll find plenty of these for treating psoriasis. The US Food and Drug Administration doesnt regulate these products. As such, few of these treatments have been studied. Those that have been studied were tested on small numbers of people, so we dont know how well these treatments work. We also dont know whether theyre safe.
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How Does Phototherapy Work
Despite many studies being performed it is impossible to say exactly how this treatment works. Much like psoriasis itself, there are many unknown factors that science has yet to work out. Studies have shown that in essence, phototherapy stops the overproduction of skin cells, one of the major symptoms of psoriasis. It is believed to suppress the bodys immune system, thus reducing the inflamed patches that psoriasis causes.
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The elbows are another common spot where psoriasis appears, says Miller. And for that particular area, this balm can’t be beaten. Its thick enough to address the thicker skin on your elbows credit a petroleum-jelly blend thats great for any type of super dry skin, psoriasis-prone included. Still, it absorbs quickly without feeling greasy, so you can even use it in the morning before getting dressed.
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Salicylic Acid: A Keratolytic
Salicylic acid is available in both over-the-counter and prescription strengths. It’s known as a “keratolytic”, which means it loosens dead skin from the psoriasis plaque to reduce scaling.
Salicylic acid is available in many different OTC formulations, such as lotions, gels, creams, foams, shampoos and others, to treat both skin and scalp psoriasis.
Salicylic acid can be used in combination with other treatments, like corticosteroid creams, anthralin, or coal tar to increase effectiveness.
- It may take up to several days before your symptoms improve.
- Common side effects of salicylic acid may include skin irritation, peeling, rash, or blanching of the skin area.
Heads Up: Anthralin For Scalp Psoriasis
Anthralin is a prescription topical cream or shampoo for the scalp that slows down the growth of skin cells.
- Anthralin, like coal tar, can be messy, stain fabrics, and has a strong odor.
- Anthralin can also stain the skin or hair with a temporary reddish brown color.
- Treatment may be applied for short periods to help lessen staining and irritation. Follow your healthcare providers instructions for use.
Like coal tar, anthralin may be used in combination with UV light to help with skin symptoms of psoriasis, including dryness, redness, flaking, scaling, and itching.
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Finding The Right Psoriasis Treatment:
Heres one of the challenging things about treating psoriasis: Your body can build up a tolerance to a certain medications, so something that seemed magical in its ability to bring you relief could suddenly stop working. On the other hand, a treatment that didnt work for you years ago could suddenly work wonders.
Thats why trial and error is a necessary part of psoriasis treatment. Finding the right treatment for psoriasis is much like finding the right partner. It may take some ‘dating’ until the right one finally comes along, says Dr. Gohara. Some may work for a bit, but then efficacy fizzles. Topical steroids are the most common culprit of this phenomenon, although it may happen with other topical or systemic medication as well.
Methotrexate : A Longer
Methotrexate , is a folic acid antagonist, meaning it blocks the action of folic acid. Methotrexate is often abbreviated “MTX”.
- Methotrexate comes as a once-weekly oral tablet or injection that suppresses the immune system and DNA synthesis to slow down skin cell turnover.
- MTX can be used long-term for moderate to severe psoriasis and for psoriatic arthritis, but results with MTX may not be seen for several months. Review MTX dosing here.
- Your doctor may also prescribe folic acid in addition to MTX to help lessen stomach and other side effects.
- MTX can be toxic to the liver and other organs lab monitoring will be needed.
MTX should NOT be used in women who are pregnant or planning a pregnancy men should also stop its use 3 months before conception. Use effective contraception during and after treatment with methotrexate.
- Effective birth control is recommended for females of reproductive potential during therapy and for at least 6 months after the final dose.
- Effective contraception is recommended for males with female partners of reproductive potential during therapy and for at least 3 months after the final dose of methotrexate.
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Treatment: Where To Start
The most common treatments for mild cases are medications that you put directly on your scalp. If you have a more severe case or have psoriasis elsewhere on your body, you may need a medication that treats your whole body. You can take these medications by mouth or injection.
If your psoriasis doesnt respond well after repeated use of one medication, your doctor may replace or combine it with another type of treatment.
One of the first steps is to soften and remove scales. This makes it easier for medications to do their job.
- Apply over-the-counter products to your scalp to help soften scales and make them easier to peel off. Look for products with the active ingredients salicylic acid, lactic acid, urea, zinc pyrithione, or selenium sulfide.
- Gently loosen the scales with a brush or fine-toothed comb.
- Shampoo your scalp to remove the scales, using a salicylic acid shampoo or soap.
- Apply thick creams to your scalp while its still damp to hold in the moisture.
To apply medication:
Topical Treatments For Psoriasis:
Some creams and lotions that can ease the dryness and itch are available over the counter with others, youll need a prescription from a doctor. It takes a bit of trial and error to find what topical treatment may work best for you. Here, some guidance to the most common types of creams and lotions for psoriasis.
Salicylic acid
This is the active ingredient in treatments that can help banish scales by softening them and making the outer layer of skin shed. You can find salicylic acid in many forms . These treatments are designed to work in combo with others, because getting rid of the scales can help other treatments do their work more efficiently. If its a strong version, salicylic acid can irritate the skin and make hair more likely to break off, and that can lead to temporary hair loss, says the NPF.
Topical steroids
The NPF advises not to use a topical steroid for longer than three weeks without consulting a doctor, as well as to avoid stopping the use of one suddenly because that can cause a flare-up of your psoriasis. Another reason to use these under the care of a physician: Topical steroids can be absorbed via the skin and have an impact on internal organs when used for a long period of time or over a wide area of skin.
Vitamin D3 treatments
Vitamin A treatments
Coal tar
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The Heartbreak: What Are The Causes Of Psoriasis
The exact causes of psoriasis are not fully known. Many researchers believe it is a combination of factors — including family history, a faulty immune system, and effects from the environment.
- In people with psoriasis, certain white blood cells that normally fight off infection instead attack healthy cells . It is the most prevalent autoimmune disease in the U.S.
- New skins cells are formed too quickly and result in a layer of dead, scaly skin and white blood cells that remain on the top layer of skin instead of sloughing off.
- These patches of skin and lesions are known as psoriatic lesions or plaque psoriasis.
- Psoriasis can lead to feelings of embarrasment, self-consciousness, and worry.
Tablets Capsules And Injections
If your psoriasis is severe or other treatments have not worked, you may be prescribed systemic treatments by a specialist. Systemic treatments work throughout the entire body.
These medications can be very effective in treating psoriasis, but they all have potentially serious side effects. All the systemic treatments for psoriasis have benefits and risks. Before starting treatment, talk to your doctor about your treatment options and any risks associated with them.
If you’re planning for a baby, become pregnant or are thinking of breastfeeding, you should also speak to your doctor first before taking any new medicine to check it’s suitable for use during pregnancy or breastfeeding.
There are 2 main types of systemic treatment, called non-biological and biological .
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