Creams for the treatment of psoriasis

The treatment of psoriasis includes the use of various skin creams. Every patient with psoriasis should be given a basic care with creams containing salicylic acid and urea. These creams help to loosen the skin scales.

In addition, dry skin should be treated with moisturizing creams. Examples of such moisturizing creams are Dermalex or Physioderm®. In addition, various creams and ointments with different local active ingredients can be prescribed by the dermatologist.

Such creams contain the usual local therapeutic agents. Cortisone-like drugs, so-called corticoids, are used in the local therapy of psoriasis. Not only the anti-inflammatory effect of these drugs is used, but also their inhibitory effect on the growth of the upper layers of the skin.

As a cream, for example, the active agents mometasone furoate and betamethasone benzoate are applied locally to the affected skin areas. As a rule, the active agents are applied up to 3 times a day. A first therapeutic success can already be seen after 1 to 2 weeks.

Up to 50% of patients experience a satisfactory result. However, the therapy should be limited to a few weeks, as otherwise skin changes, such as atrophy of the skin (thinning), may occur. Cortisone-type drugs are usually used in combination with other active ingredients.

So-called vitamin D analogues are an important component of the local therapy of psoriasis. The active agents calcipotriol and tacalcitol are derivatives of vitamin D and are applied to psoriasis in the form of ointments, creams and emulsions. The preparations are applied 1 to 2 times a day.

Healing success can be expected after 2 to 3 weeks at the earliest. The very well tolerated drugs are, unlike cortisone-like active substances, also suitable for long-term therapy over 12 to 18 months. They can be used well in combination with corticoids or UV therapy.

When applied over a large area, they can have an effect on the calcium balance, especially in children. Therefore, they should not be used on large areas. Some time ago vitamin B12 ointments and creams came on the market which were recommended by the respective manufacturers for the treatment of psoriasis.

However, these preparations cannot be recommended by conventional medicine. Their effectiveness is highly doubted. In theory, vitamin B-12 ointments are supposed to “intercept” inflammatory processes of the skin and thus alleviate the inflammatory reaction. However, there is no conclusive evidence for this effectiveness, so that the use of vitamin B-12 ointments is not recommended in the current guideline for the treatment of psoriasis.

Light therapy

Light therapy is a common and very effective treatment option for psoriasis. This form of therapy makes use of 2 effects of UV light in particular. Firstly, the cell growth of the upper skin layers is inhibited and secondly, the immune system is downregulated.

This can lead to an improvement in the symptoms of psoriasis. The common light therapy uses UV-B light with a wavelength of 311 nanometers. Irradiation is performed approximately 3 to 5 times a week.

After about 2 to 3 weeks the first treatment successes are achieved. After about six weeks of therapy, 75% of patients are free of symptoms. The therapy causes side effects in some patients, such as reddening of the skin, itching and irritation, which are however only of a temporary nature.

During the therapy one should avoid additional sunlight. A modification of the light therapy is the PUVA. This therapy consists of an irradiation of the skin with UV-A light and an additional application of the active substance psoralen. This is either applied to the skin or taken as a tablet and increases the skin’s sensitivity to UV light. Here, even 90% of the patients are free of symptoms.