New Treatment Options for Psoriasis

There’s good news for the 7.5 million Americans who suffer from psoriasis – the autoimmune disease that causes raised, red, scaly patches to appear on the skin. Rather than treat flare-ups with a gradual approach, many doctors take a more proactive approach to make the most of long-term treatment from the first visit, reports the U.S. Food and Drug Administration (FDA).

“More treatment options are becoming available for people with moderate-to-severe psoriasis,” said Patricia Feito, M.D., a family medicine specialist affiliated with Baptist Health. “There is ample evidence showing therapies that target specific aspects of a person’s immune system can be effective for many patients.”

The first step in treating the disease is properly diagnosing it in its early stages, says Dr. Feito. In most cases, doctors can make a psoriasis diagnosis by considering the location, appearance and symptoms of the rash. Psoriasis usually is found on the outside of knees and elbows, the scalp, lower back, face, palms and the soles of feet. The symptoms of psoriasis – pain, swelling, burning, itching and redness – can create significant physical and emotional discomfort for people who have the disease.

Your doctor also will consider your family history. About one-third of those with psoriasis have a family member with the disease, according to the National Psoriasis Foundation ^[1]. These genes, say researchers, can combine with various external factors to “trigger” the disease. Psoriasis triggers vary by individual and can include stress, medication, injury to skin and infection.

Psoriasis and Other Chronic Conditions

People with psoriasis are at risk for developing or exacerbating associated diseases, including lymphoma, heart disease, diabetes, inflammatory bowel disease, depression and metabolic syndrome – a combination of obesity, high blood pressure, high cholesterol and diabetes. With this in mind, Dr. Feito recommends patients adopt a team approach to treatment by partnering with their primary care physician and a dermatologist experienced with psoriasis.

Treatment Options

Since there is no cure for psoriasis, the main goals of treatment are to reduce inflammation and stop the rapid reproduction of skin cells. Depending on the severity of the disease and associated diseases, doctors may recommend a combination of therapies, including:   

Lifestyle changes. Healthy habits such as reducing or limiting tobacco use and alcohol consumption, maintaining a healthy weight, eating a healthy diet, addressing vitamin deficiencies, reducing stress and getting plenty of exercise may help patients manage the disease, Dr. Feito says.   

Topical medicines. Emollients and topical corticosteroids are the most frequently used treatment for psoriasis and usually are the first line of defense in a treatment plan. “They not only are cost-effective; they are effective at slowing down cell reproduction, reducing inflammation and minimizing symptoms,” Dr. Feito said.

Phototherapy or light therapy.  Exposing the skin to ultraviolet light on a regular basis and under medical supervision in a doctor’s office, clinic or at home with phototherapy unit is an effective treatment for moderate-to-severe psoriasis.

Systemic therapy.  Medications taken by mouth or injection work throughout the body to reduce symptoms of moderate-to-severe psoriasis.   

Biologic drugs.  These medications are given by injection or intravenously and contain an antibody designed to target different pathways in the immune system that lead to inflammation. “It’s important to screen patients for underlying conditions before starting any immune modulator treatment,” Dr. Feito added.

Although psoriasis is a chronic disease with no cure, there are more patient-specific treatments options available today than ever before. A combination of these treatments can help many people avoid the downside of ineffective therapies and increase the number of symptom-free days.