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Psoriasis – treatment: ointments, tablets, light

by Josephine Andrews
Published: Last Updated on 352 views

Psoriasis is an autoimmune disease that currently has no cure. However, the typical symptoms can be significantly alleviated or even made to disappear with modern medication. Therapy is currently considered successful if the original skin symptoms improve by at least 75 percent. Read about the treatment options for psoriasis here.

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.

L41 M07 L40

Basic care – psoriasis

Optimal skin care forms the basis of psoriasis therapy. It should be used consistently – not just during a flare-up. Moisturizing oil baths, shower oils, fatty ointments or high-fat creams are ideal. They improve the body’s protective function of the skin . There are also ointments and creams that contain urea or salicylic acid . They help the skin to store moisture.

Mild psoriasis: treatment

In the case of mild psoriasis, doctors usually use external (topical) treatment of the symptoms. For this purpose, substances are used that slow down the excessive growth of the skin cells, ie the formation of scales, and/or have an anti-inflammatory effect.

They are used in the form of creams, gels or lotions, but also shampoos. They contain active ingredients such as

  • Vitamin D3 (Tacalcitol, Calcitriol or Calcipotriol)
  • cortisone
  • Dithranol/Cignolin
  • Vitamin A derivatives (tazarotene)

Calcineurin inhibitors: If psoriasis occurs on the face, between the fingers, in the area of ​​​​the genitals or on the buttocks, calcineurin inhibitors such as tacrolimus and primecrolimus can also help in some cases.

Moderate to severe psoriasis: treatment

If the treatment of the skin alone is not sufficient, other treatment options come into play. From medication to light and bath therapy to psychological support.

medication

In the case of moderate to severe psoriasis, there are now drugs available that specifically slow down or stop the inflammatory process in various ways. They are taken orally or given by injection. This treatment approach is called systemic therapy.

Immunomodulators: Immunomodulators can regulate the overreaction of the immune system. These include acitretin, ciclosporin, fumaric acid esters and methotrexate (MTX).

TNF-alpha inhibitor: The tumor necrosis factor-α is a messenger substance that increases inflammatory processes. Tailor-made antibodies intercept TNF-alpha and thus down-regulate the inflammatory process. They are therefore called TNF-alpha inhibitors. These include the active ingredients 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 ingredients secukinomab and ixekizumab.

Ustekinumab is an antibody against the cytokines interleukin-12 and interleukin-23, which are also involved in the inflammatory processes in the skin.

Light and bath therapies

In phototherapy for psoriasis, the skin is treated with light. In addition to natural sunlight (heliotherapy), special emitters that emit light rays with a wavelength of 311 nanometers are also used. These have proven to be particularly effective in the treatment of psoriasis.

Balneo-Photo-Therapy: Doctors often combine it with bath therapy to increase the effect of light during psoriasis treatment. The irradiation takes place only 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 called PUVA therapy (P+UV-A).

Laser therapy: Laser therapy is particularly suitable for smaller areas of psoriasis, for example on the knees or elbows . For this purpose, laser light is focused on the affected skin areas. The targeted beam of light can reach diseased skin areas without burning the surrounding healthy skin.

Climate therapy: Sometimes climate therapy also 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.

Psoriasis therapy with brine: brine baths can also help with psoriasis. The brine from underground storage contains between 20 and 30 percent salt, mainly table salt (sodium chloride), as well as other minerals. Studies have shown that brine releases inflammatory substances from the skin and thus alleviates the symptoms of psoriasis.

Removal of the adenoids

Sometimes there is a temporal relationship between the onset or recurrence of psoriasis symptoms and a strep throat or tonsillitis. In this case, it may make sense to remove the adenoids. This often improves the symptoms of psoriasis in the long term. In some cases, the psoriasis does not appear at all afterwards.

relaxation techniques

Since stress can provoke or exacerbate flare-ups, it makes sense for people with psoriasis to learn a relaxation technique. examples are

  • autogenic training
  • Jacobson’s progressive muscle relaxation
  • meditation
  • mindfulness training
  • tai chi
  • qigong

Home remedies for psoriasis treatment

Many psoriasis sufferers use home remedies to relieve their skin symptoms. Some treat the skin, for example, with almond oil, evening primrose oil and grape seed oil or salt baths.

Curd wraps or rubbing shea butter into the skin are also said to soothe inflamed skin.

Home remedies can at best complement conventional medical treatment of psoriasis, but cannot replace it. Talk to your doctor about how you can best support the therapy yourself.

homeopathy

Many people try to get their psoriasis under control homeopathically. For example, globules based on Hydrocotyle asiatica, Mahonia aquifolium and sulfur should help.

Since the effectiveness of homeopathy has not yet been scientifically proven in general, the chances of success of homeopathic psoriasis treatment are unclear.

psychotherapy

The problem is that psoriasis itself creates stress: when it flares up, patients feel unattractive and uncomfortable in their own skin. That hits the heart. The constant itching also creates stress.

Above all, however, stigmatization and exclusion by fellow human beings are a great psychological burden. In such cases, psychotherapeutic support can make it easier to cope with the illness. This is especially true when depression or anxiety disorders occur.

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