Psoriasis Treatments from a GP

Moisturisers and Emollients

Moisturisers are widely available and can be bought from pharmacies, supermarkets and beauty stores. Some can be prescribed by your doctor.

Although there is little scientific research into the effects of moisturisers on psoriasis, our own experience - and the experience of healthcare professional bodies that we work with - shows that:

• Moisturisers make the skin much more comfortable – they decrease the dryness, scaling, cracking and soreness, and itching;

• Through decreasing the dryness and softening scale, moisturisers allow the other active treatments you use (e.g. coal tar, vitamin D) to be better absorbed, and therefore to work more effectively.

There are so many moisturisers to choose from that sometimes it can be difficult to know which is best. However, the best moisturiser is the one that you feel happiest with and that you can use easily on a regular basis. You may find that a combination of moisturisers work best for you, and that different moisturisers are more appropriate at different times of day. Even if you’ve been prescribed another treatment for your psoriasis, it is still recommended that you moisturise every day.

Click here for tips on moisturising, as well as more information on the different moisturisers that might be useful for people with psoriasis.

Vitamin D-based Topicals

Vitamin D derivatives come in gel, ointment, lotion and scalp solution applications. The vitamin D treatments act by encouraging normal skin cell growth and preventing the excessive growth rate that we see in psoriasis. Some of the ones most commonly used include Calcipotriol (Dovonex), Tacalcitol (Curatoderm) and Calcitriol (Silkis). They are not steroids and can therefore be more appropriate for longer-term use.

Click here for more information on Vitamin D treatments for psoriasis.

Topical Steroids

Topical steroids are one of the first treatment options for people whose psoriasis covers 5% or less of their body or is currently flaring. They are easy to apply and can have positive results in a short period of time. However, steroid treatments should not be used for too long a period of time, as they can cause side effects such as skin thinning, and can cause psoriasis to become ‘unstable’ (prone to flaring). Because of this, you should see your doctor regularly whilst using steroid treatment, so that they can keep your psoriasis under review and move you to a different treatment when necessary.

Commonly-used topical steroids include Eumovate/Betnovate/Dermovate, although many others are available. Dovobet is a commonly-used psoriasis treatment that is a combination of vitamin D derivative and topical steroid, betamethasone. Like other topical steroids, Dovobet should not be used permanently or for too long a period of time.

Some steroids may be used in sensitive areas, but some may not – you should always read the patient information leaflet or check with your doctor.

Click here for more information on topical steroid treatments for psoriasis.

Coal Tar Preparations

Coal tar has been used to treat psoriasis for many years, particularly scalp psoriasis. Creams and lotions such as Exorex or Psoriderm are available for the scalp and body, whilst there are many other specific scalp applications, shampoos and bath additives available from your pharmacy or GP. Modern tar preparations are less smelly and messy than the traditional unrefined products. Many applications can be purchased over the counter, although some products do require a prescription.

Click here for more information on coal tar treatments for psoriasis.

Dithranol Preparations

Dithranol has been used to treat psoriasis for many years, and was traditionally applied by nurses in a hospital ward. Modern dithranol preparations mean that people are able to use it themselves at home, although it can be time-consuming and messy.

Dithranol is most suitable for well-defined plaques of psoriasis as it needs to be applied carefully to avoid irritating non-affected skin. Because of this, it is usually not suitable for guttate psoriasis or psoriasis in sensitive areas such as the face, skin folds or the genitals.

At-home dithranol preparations such as Micanol and Dithrocream come as ointments or creams in different strengths, some of which need to be prescribed by a doctor, but some can be bought over-the-counter.

Click here for more information on dithranol treatments for psoriasis.

Calcineurin Inhibitors

Calcineurin inhibitors block the chemical calcineurin. This chemical ‘switches on’ inflammation in the skin; causing redness and itching. Calcineurin inhibitors are licensed for atopic eczema, but are sometimes used ‘off licence’ in other inflammatory skin conditions, such as psoriasis, because of their ability to reduce inflammation.

Calcineurin inhibitors do a similar job to topical steroids (reduce inflammation), but don’t have the same side effects, meaning they may be more appropriate for longer-term use, or in sensitive areas. Two commonly prescribed calcineurin inhibitors are Protopic and Elidel.

These are only available on prescription – ask your doctor for more information.

The Psoriasis Association is the UK's leading national charity and membership organisation for people affected by psoriasis – patients, families, carers and health professionals Read More >

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