How Bad is Your Psoriasis – A Review of Treatment Options?
The powerful anti-psoriasis drug ustekinemab (Stelara – Janssen) has been approved for the treatment of psoriatic arthritis. This drug is a member of the biological family – a group of specially designed antibodies that target super-specific areas of the inflammatory pathway in psoriasis.
Other biological drugs that are licensed for treatment of psoriasis and arthritis include etanercept (Enbrel), adalimumab (Humira) and infliximab (Remicade).
If your psoriasis is inadequately controlled, ask your dermatologist to discuss the biological treatments available.
How bad is your psoriasis – a review of treatment options?
Treatment for psoriasis comprise three main approaches: Creams, ultraviolet therapy and ‘systemic’ medicines.
- Moisturisers, soap substitutes and bath oils
- Steroid creams
- Vitamin D analogues – calcipotriol (Dovonex)
- Combinations creams (mixtures of the above)
- Tacrolimus (Protopic) – a non-steroid anti inflammatory cream
Ultraviolet (UV) therapy:
Ultraviolet therapy comprises 2 usable wavelengths – UV A and B. Both are very good at suppressing the inflammation in psoriasis (and other inflammatory skin disease).
UVB: the tanning rays of sunlight and are less penetrating than UVA, so in theory, give less risk of sun damage and skin cancer.
UVA: deeper penetrating, so dermatologists will prescribe a sensitising medication called psoralen in order that patients require less UVA to achieve the same effect. This Psoralen-UVA combination therapy is abbreviated to PUVA.
There are many systemic options to treat psoriasis ranging from drugs that reduce the turnover rate of skin cells, through mild suppressants of the immune system on to powerful immunosuppressants. These drugs include acitretin, hydroxycarbamide, fumaric acid, methotrexate, ciclosporin and the biological drugs. All can be effective treatments for psoriasis, but all have potential side effects that need to be taken into account in discussion with your dermatologist. For further information on the drug treatment for moderate to severe psoriasis, please see the British Association of Dermatologists