Gary W. Cole, MD, FAAD
Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Psoriasis facts
- What is psoriasis?
- What are causes and risk factors of psoriasis?
- What are the different types of psoriasis?
- Can psoriasis affect my joints?
- Can psoriasis affect only my nails?
- What are psoriasis symptoms and signs? What does psoriasis look like?
- How do health-care professionals diagnose psoriasis?
- How many people have psoriasis?
- Is psoriasis contagious?
- Is there a cure for psoriasis?
- Is psoriasis hereditary?
- What kind of doctor treats psoriasis?
- What is the treatment for psoriasis?
- What creams, lotions, and home remedies are available for psoriasis?
- What oral medications are available for psoriasis?
- What injections or infusions are available for psoriasis?
- Is there a psoriasis diet?
- What about light therapy for psoriasis?
- What is the long-term prognosis with psoriasis? What are complications of psoriasis?
- Is it possible to prevent psoriasis?
- What does the future hold for psoriasis?
- Is there a national psoriasis support group?
- Where can people get more information on psoriasis?
- Pictures of Psoriasis - Slideshow
- Take the Psoriasis Quiz
- Psoriasis FAQs
- Find a local Dermatologist in your town
What is the treatment for psoriasis?
There are many effective treatment choices for psoriasis. The best treatment is individually determined by the treating physician and depends, in part, on the type of disease, the severity, and the total body area involved.
For mild disease that involves only small areas of the body (like less than 10% of the total skin surface), topical (skin applied) creams, lotions, and sprays may be very effective and safe to use. Occasionally, a small local injection of steroids directly into a tough or resistant isolated psoriatic plaque may be helpful.
For moderate to severe disease that involves much larger areas of the body (like 20% or more of the total skin surface), topical products may not be effective or practical to apply. This may require ultraviolet light treatments or systemic (total body treatments such as pills or injections) medications. Internal medications usually have greater risks. Because topical therapy has no effect on psoriatic arthritis, systemic medications are generally required to stop the progression to permanent joint destruction.
It is important to keep in mind that as with any medical condition, all medications carry possible side effects. No medication is 100% effective for everyone, and no medication is 100% safe. The decision to use any medication requires thorough consideration and discussion with your physician. The risks and potential benefit of medications have to be considered for each type of psoriasis and the individual patient. Of two patients with precisely the same amount of disease, one may tolerate it with very little treatment, while the other may be almost completely become incapacitated and require treatment internally.
A proposal to minimize the toxicity of some of these medicines has been commonly called "rotational" therapy. The idea is to change the anti-psoriasis drugs every six to 24 months in order to minimize the toxicity of one medication. Depending on the medications selected, this proposal can be an optimal option. An exception to this proposal is the use of the newer biologics medications as described below. A patient who has been using strong topical steroids over large areas of their body for prolonged periods may benefit from stopping the steroids for a while and rotating onto a different therapy, like calcitriol (Vectical), light therapy, or an injectable biologic.
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