How can psoriasis be treated?
Psoriasis cannot be cured. However, there are various ways to treat it. The treatment options depend, among other things, on how severe the psoriasis is, where it manifests itself, but also whether there is an acute flare-up or the symptoms are dormant.
Basic care for psoriasis
Optimal skin care forms the basis of psoriasis therapy. It is used throughout – not just during a flare-up. Moisturizing oil baths, shower oils, fatty ointments or creams rich in fat are ideal. They improve the body’s own protective function of the skin.
Ointments and creams containing urea or salicylic acid are also recommended. They help the skin to retain moisture.
External medication for psoriasis
In the case of mild psoriasis, doctors generally rely on external (topical) treatment of the symptoms. This involves the use of substances that slow down the excessive growth of skin cells, i.e. the formation of scales, and/or have an anti-inflammatory effect.
They are used in the form of creams, gels, lotions and shampoos and contain active ingredients such as
- Vitamin D3 (tacalcitol, calcitriol or calcipotriol)
- cortisone
- dithranol/cignolin
- Vitamin A derivatives (tazarotene)
What helps against psoriasis on the head? Read more about the symptoms and treatment of psoriasis on the scalp here: Psoriasis – scalp.
Tablets and other systemic medication for psoriasis
For moderate to severe psoriasis, medicines are available that specifically slow down or stop the inflammatory process in various ways. They are taken or administered by injection. This treatment approach is called systemic therapy.
- Immunomodulators: Immunomodulators regulate the excessive reaction of the immune system. These include acitretin, ciclosporin, fumaric acid esters and methotrexate (MTX).
- TNF-alpha inhibitors: Tumor necrosis factor-α is a messenger substance that intensifies inflammatory processes. Customized antibodies intercept TNF-alpha and thus downregulate the inflammatory process. They are therefore called TNF-alpha inhibitors. These include the active substances adalimumab, etanercept and infliximab.
- Interleukin antibodies: Interleukin-17 is a messenger substance that is involved in autoimmune reactions, such as those that occur in psoriasis. Genetically engineered antibodies intercept it and thus inhibit the autoimmune reaction. These include the active substances secukinomab and ixekizumab.
Light and bath therapies
Photo-therapy for psoriasis involves treating the skin with light. In addition to natural sunlight (helio-therapy), special lamps are used that emit light rays with a wavelength of 311 nanometers. These have proven to be particularly effective in the treatment of psoriasis.
- Balneo-photo therapy: To enhance the effect of the light in psoriasis treatment, doctors often combine it with bath therapy. Irradiation only takes place after a salt water bath.
- PUVA therapy: Creams containing psoralen also support the effect. Psoralen is an active ingredient found in the essential oils of some plants. It sensitizes the skin to UV light. This combination is known as PUVA therapy (P+UV-A).
- Laser therapy: Laser therapy is particularly suitable for smaller foci of psoriasis, for example on the knees or elbows. Laser light is focused onto the affected areas of skin. The targeted beam of light reaches diseased areas of skin without burning the surrounding healthy skin.
- Climate therapy: Sometimes climate therapy helps with psoriasis. During a spa stay at the Dead Sea, for example, the sun and the extremely salty water have a positive effect on the skin.
Psychotherapy and patient education
The problem is that psoriasis itself causes stress: during an attack, patients feel unattractive and uncomfortable in their skin. This affects their mood. The constant itching also causes stress.
Above all, however, stigmatization and exclusion by fellow human beings are a major psychological burden. In such cases, psychotherapeutic support makes it easier to cope with the illness. This is particularly true when depression or anxiety disorders occur.
Patient training is also part of psoriasis treatment. Here, those affected receive information about the disease as well as practical advice on therapies, skin care and ways to reduce stress. The aim is to improve the patient’s quality of life.
Relaxation techniques
As stress provokes or exacerbates flare-ups in many people, it is useful for people with psoriasis to learn relaxation techniques that reduce stress. Examples of this are
- Autogenic training
- Progressive muscle relaxation according to Jacobson
- meditation
- Mindfulness training
- Tai Chi
- Qigong
Psoriasis: What home remedies can be used?
Many patients with psoriasis rely on home remedies to alleviate their skin symptoms. Some treat the skin with almond oil, evening primrose oil and grape seed oil or salt baths, for example.
Home remedies have their limits. If the symptoms persist over a longer period of time, do not improve or even get worse, you should always consult a doctor.
Homeopathy
Many people try to get their psoriasis under control with homeopathic remedies. For example, they use globules based on Hydrocotyle asiatica, Mahonia aquifolium and sulphur.
As the effectiveness of homeopathy in general has not yet been scientifically proven, the chances of success of homeopathic psoriasis treatment are unclear.
