Treatments for psoriasis fall into four categories: topicals, phototherapy, systemics and complementary or integrative medicine, according to the NPF. The choice of therapy depends on the severity of the disease, says Dr. Green.
Topical treatments are creams applied directly to the affected area, slowing the rapid production of skin cells and reducing inflammation. The most common topical medications are topical steroids, which contain an anti-inflammatory ingredient to heal swelling and redness and usually require a prescription from your doctor. However, topical steroids cant be used in some areas because they may cause side effects like bruising, pigmentation and redness.
In 2022, the U.S. Food and Drug Administration (FDA) approved a new, nonsteroidal topical cream for adults for the first time in 25 years called tapinarof. Patients can use this treatment from head to toe without any limitations, which is great for those who have mild to moderate psoriasis, says Dr. Green.
The FDA has also approved several over-the-counter topical treatments for psoriasis, such as lotions, shampoos, tars and bath foams that often contain coal tar and salicylic acid.
Phototherapy is a type of light therapy that a dermatologist may prescribe if topical treatments are ineffective. This therapy involves regularly exposing the skin to ultraviolet (UV) light, particularly UVB light. UVB rays are found in natural sunlight and slow the growth of skin cells.
There are several types of phototherapy, and its most effective when patients receive therapy at least two to five times a week for several weeks, according to the American Academy of Dermatology Association (AAD). Phototherapy is not prescribed for patients with skin cancer or in the case of any condition or medication that makes them more sensitive to UV light.
Systemic treatments are prescription drugs taken orally or through an injection or infusion and are usually prescribed when topicals and phototherapy are unsuccessful. These drugs, known as biologics or biosimilars, work throughout the body to target specific molecules inside immune cells and correct the overactive immune response causing psoriasis flares.
Biologics and biosimilars include medicines that come from live organisms, including animal cells and microorganisms like yeast and bacteria. Both treatments are highly regulated by the FDA and deemed by the organization to be safe and effective.
The best way to prevent psoriasis flares is to follow your dermatologists treatment recommendations, moisturize well and avoid trauma to the skin. Lowering stress can also help, says Dr. Stevenson.
The AAD suggests practicing stress-relieving activities, such as yoga, meditation and attending support groups. Lifestyle changes like reducing alcohol consumption, quitting smoking, avoiding skin exposure to dry, cold weather, treating infections and avoiding cutting yourself while shaving can also help prevent flares. Dietary considerations, such as increasing fruits and vegetables and avoiding foods that are high in fat, sugars, sodium and meat as well as limiting processed foods, may play an important role in minimizing psoriasis symptoms, according to an article in Immunity.
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