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Psoriasis is a skin condition that can make parts or all of your skin red, thick, and flaky. In people with dark skin tones, the psoriasis spots might look purple, dark brown, or dark gray. The flakes on top of psoriasis are usually silver or white and thick, which can look like these:
All images credit to CPG Management of Psoriasis Vulgaris 2013
While the world lacks accurate incidence data on psoriasis, published data on the prevalence of psoriasis in countries vary between 0.09% and 11.4%, and there’s evidence that the prevalence of psoriasis is increasing over time.
Psoriasis is more than just a skin condition — it’s an immune and inflammatory disorder that affects skin as well as other organs, which puts psoriasis patients at risk for other medical conditions as well, such as psoriatic arthritis. Read about psoriasis in-depth in our article here.
In conjunction with World Psoriasis Day 2021, we would like to give you an overview on psoriasis treatment. If you’re a psoriasis patient, we hope this article could empower you to understand your treatment more and even explore better ways of managing your psoriasis with your doctor.
Topical corticosteroids are colloquially known as steroid creams— they’re the most widely used treatment for various skin conditions, including psoriasis. These preparations reduce skin inflammation by affecting the underlying genetic activities. Topical corticosteroids are typically classified and used according to their potencies.
Note: Contraindications are conditions of which the medication should not be used because it may result in harm to the person.
Pregnant and breastfeeding women should consult their doctors before using topical corticosteroids.
Examples of topical corticosteroids:
Tar-based preparations are commonly used for mild cases of psoriasis. However, some patients may find tar-based preparations tricky to use because it may cause staining and irritation.
While the exact mechanism is still unknown, vitamin D analogue is a group of established treatments for psoriasis. They work by suppressing the overgrowing of skin cells, which is a hallmark of psoriasis.
Calcipotriol, the only topical vitamin D analogue available in Malaysia, is available in various dosage forms, such as cream and scalp solution. Some of which are combined with a topical corticosteroid to confer better control of psoriasis symptoms.
Other commonly used treatment for psoriasis also include:
Salicylic acid ointment, available in various strengths (2% to 20%)
Acitretin (oral medication)—Acitretin is also used in the treatment of severe acne. One of the most common side effects is dry and cracked lip (cheilitis), and it can be managed with applying vaseline on the lip regularly. Acitretin should not be used in pregnant women as it can cause birth defects and miscarriage. For women with childbearing potential, they should avoid pregnancy for at least 1 month before, during, and for at least 3 years after treatment with acitretin.
Immunosuppressants such as cyclosporine and methotrexate. Both are also commonly used for other medical conditions such as to suppress organ rejection after organ transplant. Cyclosporine can be used in pregnant women under medical supervision whereas methotrexate should not be used in pregnant women.
Biologics such as adalimumab, etanercept, infliximab, secukinumab and ustekinumab. These biologics are newer treatments, only available in injections and are very expensive. Their use is limited to psoriasis cases that are resistant to the treatments we’ve discussed thus far.
Regularly moisturizing skin with emollients or substitute soaps with emollients can improve skin moisture, strengthen skin barrier and reduce the need for more topical corticosteroids. Consult a pharmacist to gain insight on the appropriate emollients you should use.
As with other chronic diseases, psoriasis may affect areas of your life other than your physical health. Psoriasis may affect your emotional health, your relationships, and how you handle stress. It could even affect areas of your life that you wouldn’t expect, such as the clothes that you choose to wear. For some people, living with psoriasis can be a challenge. However, there are ways to handle those challenges so you can thrive with psoriasis. Read more here.
If you have any questions related to psoriasis, you can consult our professional doctors and healthcare professionals on DOC2US. DOC2US is a mobile application that allows you to talk to a doctor or any healthcare professionals via text chat at any time and from anywhere. For better communication, you can even send our online doctor images or voice messages related to your medical inquiry.
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Disclaimer: As a service to our users and general public, DOC2US provides health education contents. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
Specific references have been linked in its relevant part of the article.
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