Psoriasis – treatment

Basic care – psoriasis

Optimal skin care forms the basis of psoriasis therapy. It should be applied consistently – not just during a push. Ideal are moisturizing oil baths, shower oils, fatty ointments or high-fat creams. They improve the body’s protective function of the skin. There are also ointments and creams containing urea or salicylic acid. They help the skin to retain moisture.

Mild psoriasis: treatment

In mild psoriasis, physicians usually rely on an external (topical) treatment of the symptoms. For this purpose, substances are used which slow down the excessive growth of skin cells, ie dandruff, and / or have an anti-inflammatory effect.

They are used in the form of creams, gels or lotions, as well as shampoos. They contain agents like

• Vitamin D3 (tacalcitol, calcitriol or calcipotriol)
• cortisone
• Dithranol / cignolin
• Vitamin A derivatives (tazarotene)

Calcineurin inhibitors: If psoriasis occurs on the face, between the fingers, around the genitals, or on the buttocks, calcineurin inhibitors such as tacrolimus and primecrolimus may help in some cases.

Moderate to severe psoriasis: treatment

If the treatment of the skin alone is not sufficient, further treatment options will come into play. From medicines to light and bath therapy to psychological help.

drugs

In the case of moderate to severe psoriasis, medicines are now available that specifically slow down or stop the inflammatory process in various ways. They are taken or administered by syringe. 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 inhibitors: Tumor necrosis factor-α is a messenger substance that enhances inflammatory processes. Tailored antibodies capture TNF-alpha and 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 that is involved in autoimmune reactions, as they also occur in psoriasis. Genetically engineered antibodies capture it and thus inhibit the autoimmune reaction. These include the active substances secukinomab and ixekizumab.

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

Light and bath therapies

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

Balneo-Photo-Therapy: In order to increase the effect of light in psoriasis treatment, doctors often combine them with bathing therapy. The irradiation takes place only after a saltwater bath.

PUVA therapy: Even creams that contain psoralen support the effect. Psoralen is an ingredient that is 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: The laser therapy is particularly suitable for smaller foci of psoriasis, for example on the knees or elbows. For this purpose laser light is focused on the affected skin areas. The targeted light beam can reach diseased skin surfaces without burning the healthy skin in the area.

Air Therapy: Sometimes psoriasis also helps with climate therapies. During a 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: Also brine baths can help with psoriasis. The brine from underground storage contains between 20 and 30 percent salt, especially common salt (sodium chloride), as well as other minerals. Studies have shown that brine removes inflammatory substances from the skin and so alleviates the symptoms of psoriasis.

Removal of the pharyngeal tonsils

There is sometimes a temporal relationship between the onset or reoccurrence of psoriasis symptoms and strep throat-induced tonsillitis or tonsillitis. In that case it may be useful to remove the pharyngeal tonsils. Often the symptoms of psoriasis improve over the long term. In some cases, psoriasis does not appear afterwards.

relaxation techniques

Since stress can provoke or intensify relapses, it makes sense for people with psoriasis to acquire a relaxation technique. examples are

• Autogenic training
• Progressive muscle relaxation according to Jacobson
• meditation
• mindfulness training
• Tai chi
• Qigong

Home remedies for psoriasis treatment

Patients with psoriasis use various home remedies to relieve their skin symptoms. Some treat the skin, for example, with cooking and healing oils such as almond oil, evening primrose oil and grape seed oil.

Quark wrap or rubbing the skin with shea butter to soothe the inflamed skin.

homeopathy

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

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

psychotherapy

The problem is that a psoriasis itself causes stress: In a push, the patients feel unattractive and uncomfortable in their skin. That beats your mind. The constant itching also generates stress.

Above all, however, stigmatization and exclusion by fellow human beings are a great emotional burden. In such cases, psychotherapeutic support may facilitate disease management. This is especially true when depression or anxiety disorders occur.