Treatment

There are many creams, ointments, lotions, and pills are available for the treatment of psoriasis. Many patients require only over-the-counter treatment or even none at all during relapses. About a third of patients with psoriasis, however, do not respond to over-the-counter remedies and lifestyle changes and require aggressive treatments. In some cases, such treatments need to be lifelong.

Treatment Options

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In general, the following three treatment options are used for psoriasis, from least to greatest potency:

• Topical Medications. Options include lotions, ointments, creams, and shampoos. These may be useful for mild-to-moderate psoriasis. Topical medicines rarely produce complete clearance, however.
• Phototherapy. Options include light-wave radiation treatments using broad- or narrow band ultraviolet B (UVB) or psoralen with ultraviolet A (PUVA). This therapy is effective for moderate-to-severe psoriasis. Phototherapies are more effective than drugs and have fewer side effects than most systemic agents. Even more promising, in a 2000 analysis comparing a number of psoriasis treatments, an advanced phototherapy called narrow band UVB achieved the highest complete clearance rate (86% of patients).
• Body-Wide (Systemic) Agents. This treatment employs various pills that affect the whole body system, not just the skin. These agents have significant side effects and are generally reserved for severe psoriasis.
• Controlled comparison studies are needed to determine the safest and most effective treatments. In any case, individual requirements vary widely and treatment selection must be carefully discussed with the doctor.

Treatment Sequences