Psoriasis is a chronic skin condition that affects millions worldwide. If you’re seeking information on How To Cure Psoriasis Permanently, it’s important to understand the realities of this condition and the most effective ways to manage it. While there’s currently no known permanent cure for psoriasis, numerous treatments are available to help control symptoms, reduce flare-ups, and improve your quality of life.
This comprehensive guide, based on the latest medical understanding, will explore the various treatment options for psoriasis, from topical remedies to advanced therapies. We will delve into how these treatments work, their benefits, and what you can expect on your journey to managing psoriasis effectively.
Understanding Psoriasis and Treatment Goals
Before diving into specific treatments, it’s crucial to recognize that psoriasis is a long-term condition. The goal of psoriasis treatment isn’t a permanent cure, but rather to:
- Reduce inflammation and itching: Alleviate the uncomfortable symptoms associated with psoriasis.
- Clear skin: Minimize or eliminate psoriasis plaques for clearer skin appearance.
- Slow skin cell growth: Target the underlying cause of psoriasis plaques – the rapid overproduction of skin cells.
- Prevent flare-ups: Extend periods of remission and reduce the frequency and severity of psoriasis outbreaks.
- Improve quality of life: Help individuals live more comfortably and confidently with psoriasis.
Treatment approaches are tailored to the individual, considering the type and severity of psoriasis, affected areas, overall health, and personal preferences. Doctors typically start with milder treatments and escalate to stronger options if needed.
Topical Treatments: First-Line Therapy for Mild to Moderate Psoriasis
Topical treatments are creams and ointments applied directly to the skin. They are often the first line of defense for mild to moderate psoriasis. For many, these treatments alone can effectively manage their condition. It may take several weeks to see noticeable improvement with topical treatments.
Emollients: Moisturizing Relief
Emollients are moisturizing treatments that are fundamental in psoriasis management. They work by:
- Hydrating the skin: Reducing water loss and preventing dryness, a common issue with psoriasis.
- Protecting the skin: Creating a protective barrier against irritants and environmental factors.
- Reducing itching and scaling: Soothing irritated skin and minimizing the buildup of scales.
Emollients are available in various forms, including creams, ointments, lotions, and bath oils. They can be purchased over the counter and should be applied liberally and frequently, especially after bathing. Emollients enhance the effectiveness of other topical treatments by ensuring the skin is well-hydrated. It’s generally recommended to wait at least 30 minutes after applying an emollient before using another topical medication.
Topical Corticosteroids: Reducing Inflammation
Topical corticosteroids, also known as steroid creams or ointments, are a mainstay in psoriasis treatment. They work by:
- Reducing inflammation: Suppressing the immune response that causes psoriasis plaques.
- Slowing skin cell production: Helping to normalize the accelerated skin cell growth.
- Relieving itching: Providing relief from the discomfort of itchy psoriasis patches.
Corticosteroids come in varying strengths, from mild to very potent. Your doctor will prescribe the appropriate strength based on the severity and location of your psoriasis. Stronger corticosteroids are typically used for thicker plaques or resistant areas and should be used cautiously and for limited periods due to potential side effects like skin thinning. It’s crucial to use topical corticosteroids as directed by your healthcare provider.
Vitamin D Analogues: Slowing Skin Cell Growth
Vitamin D analogue creams are another common topical treatment, often used in conjunction with or as an alternative to corticosteroids. They function by:
- Slowing down skin cell production: Regulating the abnormal growth of skin cells in psoriasis.
- Reducing inflammation: Contributing to the overall reduction of inflammation in psoriasis plaques.
Examples of vitamin D analogues include calcipotriol, calcitriol, and tacalcitol. These treatments generally have fewer side effects than corticosteroids when used as directed. They are particularly useful for psoriasis on the limbs, trunk, and scalp.
Calcineurin Inhibitors: For Sensitive Areas
Calcineurin inhibitors, such as tacrolimus and pimecrolimus, are topical ointments or creams that work by:
- Suppressing the immune system: Reducing the immune activity specifically in the treated skin area.
- Reducing inflammation: Helping to calm inflammation in sensitive skin areas.
These are often used for psoriasis in delicate areas like the face, genitals, and skin folds where strong corticosteroids might be unsuitable due to the risk of skin thinning. While they may cause initial burning or itching, this usually subsides within a week of use.
Coal Tar: A Traditional Remedy
Coal tar is one of the oldest treatments for psoriasis. Its exact mechanism is not fully understood, but it is believed to work by:
- Reducing scaling: Helping to soften and remove the thick scales of psoriasis plaques.
- Decreasing inflammation: Contributing to the reduction of inflammation.
- Relieving itchiness: Providing symptomatic relief from itching.
Coal tar is available in various forms, including creams, ointments, shampoos, and bath solutions. It can be used for psoriasis on the limbs, trunk, and scalp when other topical treatments are insufficient. However, coal tar has a strong odor and can stain clothes and bedding, which can be drawbacks for some individuals.
Dithranol: Short-Term Intensive Treatment
Dithranol is a potent topical treatment used for short periods, often under hospital supervision. It works by:
- Suppressing skin cell production: Effectively slowing down the rapid growth of skin cells.
Dithranol is typically used for psoriasis on the limbs or trunk. Due to its potential to stain skin, clothes, and surfaces, it is usually applied in a controlled setting and left on for a short duration (10-60 minutes) before being washed off.
Phototherapy: Light Treatment for Psoriasis
Phototherapy, also known as light therapy, uses ultraviolet (UV) light to treat psoriasis. It’s administered in hospitals or specialized centers under the guidance of a dermatologist. It’s important to distinguish phototherapy from sunbeds, as it uses specific wavelengths of UV light in a controlled medical setting.
Ultraviolet B (UVB) Phototherapy: Targeting Skin Cell Growth
UVB phototherapy utilizes a specific wavelength of UV light that is invisible to the naked eye. It works by:
- Slowing down skin cell production: Reducing the overproduction of skin cells in psoriasis plaques.
UVB phototherapy is effective for various types of psoriasis that haven’t responded adequately to topical treatments. Treatment sessions are brief, typically lasting only a few minutes, but require multiple visits per week (usually 2-3 times) for several weeks (6-8 weeks) to achieve optimal results.
Psoralen plus Ultraviolet A (PUVA): Deeper Penetration
Psoralen plus ultraviolet A (PUVA) therapy is a more intensive form of phototherapy. It involves:
- Psoralen administration: Taking a medication called psoralen, either orally or topically, which makes the skin more sensitive to UV light.
- UVA exposure: Exposing the skin to ultraviolet A (UVA) light, which penetrates deeper into the skin than UVB light.
PUVA therapy is typically reserved for severe psoriasis that has not responded to other treatments. It can be more effective than UVB for certain types of psoriasis. However, PUVA therapy has potential side effects, including nausea, headaches, burning, and itching. Long-term PUVA treatment is not recommended due to an increased risk of skin cancer. Patients undergoing PUVA therapy need to wear special glasses for 24 hours after psoralen intake to protect their eyes from cataracts.
Combination Light Therapy: Enhancing Effectiveness
Topical treatments can be combined with phototherapy to enhance treatment effectiveness. This approach is considered when:
- Psoriasis is not responding to light therapy alone.
- Patients are unable or unwilling to take systemic medications.
Combining treatments can often lead to better outcomes and may allow for lower doses of each individual therapy.
Systemic Treatments: Addressing Psoriasis Throughout the Body
Systemic treatments are medications that work throughout the entire body. They are usually prescribed by a specialist for severe psoriasis or when other treatments have failed. Systemic treatments can be highly effective but also carry a risk of more significant side effects. It’s crucial to discuss the benefits and risks of systemic treatments with your doctor before starting therapy.
Systemic treatments fall into two main categories: non-biological and biological medications.
Non-Biological Systemic Medications
These are typically oral medications (tablets or capsules) that broadly affect the immune system or skin cell growth.
Methotrexate: Slowing Skin Cell Production and Inflammation
Methotrexate is a commonly used systemic medication for psoriasis. It works by:
- Slowing down skin cell production: Inhibiting the rapid growth of skin cells.
- Suppressing inflammation: Reducing the overall inflammatory response in psoriasis.
Methotrexate is usually taken once a week. Potential side effects include nausea and impacts on blood cell production. Long-term use can pose a risk of liver damage. It’s contraindicated for individuals with liver disease, and alcohol consumption should be avoided while taking methotrexate. Methotrexate is teratogenic, meaning it can harm a developing fetus. Strict contraception is necessary for both women and men taking methotrexate, and pregnancy should be avoided for a period after stopping the medication.
Ciclosporin: Suppressing the Immune System
Ciclosporin is an immunosuppressant medication that effectively treats psoriasis by:
- Suppressing the immune system: Reducing the overactive immune response that drives psoriasis.
Ciclosporin is typically taken daily. It can increase the risk of kidney disease and high blood pressure, requiring regular monitoring of kidney function and blood pressure.
Acitretin: Reducing Skin Cell Production (Oral Retinoid)
Acitretin is an oral retinoid (a vitamin A derivative) used for severe psoriasis. It works by:
- Reducing skin cell production: Slowing down the rate of skin cell turnover.
Acitretin has a range of potential side effects, including dryness and cracking of the lips, dry nasal passages, and, rarely, hepatitis. Like methotrexate, acitretin is highly teratogenic, and women must avoid pregnancy during and for three years after stopping acitretin treatment.
Apremilast and Dimethyl Fumarate: Reducing Inflammation
Apremilast and dimethyl fumarate are newer oral medications that help manage psoriasis by:
- Reducing inflammation: Targeting inflammatory pathways involved in psoriasis.
These are typically prescribed for severe psoriasis that hasn’t responded to other non-biological systemic treatments. They are taken as daily tablets.
Biological Systemic Treatments (Biologics)
Biological treatments, or biologics, are injectable medications that precisely target specific parts of the immune system involved in psoriasis. They are usually reserved for severe psoriasis when other treatments have been ineffective or are unsuitable.
TNF-alpha Inhibitors: Etanercept, Adalimumab, Infliximab
Etanercept, adalimumab, and infliximab are TNF-alpha inhibitors. They work by:
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Blocking tumor necrosis factor-alpha (TNF-alpha): A key inflammatory protein involved in psoriasis.
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Etanercept: Injected twice weekly.
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Adalimumab: Injected every two weeks.
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Infliximab: Administered as an infusion at a hospital initially, then less frequently.
Common side effects include injection site reactions and headaches. Because they suppress the immune system, there is an increased risk of serious infections, including tuberculosis reactivation. Regular monitoring for side effects is essential during treatment.
Interleukin Inhibitors: Ustekinumab, Guselkumab, Secukinumab, Ixekizumab, Brodalumab, Bimekizumab, Risankizumab
This growing class of biologics targets specific interleukins, which are signaling molecules that play a key role in the inflammation of psoriasis.
- Ustekinumab: Targets IL-12 and IL-23. Injected initially, then every 12 weeks.
- Guselkumab, Secukinumab, Ixekizumab, Brodalumab, Bimekizumab, Risankizumab: Target IL-17 or IL-23. Varying injection frequencies.
These medications are generally recommended for severe psoriasis that hasn’t improved with other treatments. Side effects can include injection site reactions and throat infections. As with other biologics, there is a risk of serious infections due to immune system modulation.
Living with Psoriasis: Management and Long-Term Strategies
While a permanent cure for psoriasis remains elusive, effective management is absolutely achievable. Working closely with your dermatologist is key to developing a personalized treatment plan that addresses your specific needs and helps you live well with psoriasis.
Key strategies for long-term psoriasis management include:
- Adherence to treatment: Following your prescribed treatment plan consistently is crucial for achieving and maintaining control.
- Regular follow-up appointments: Your dermatologist will monitor your progress, adjust treatments as needed, and address any concerns.
- Lifestyle modifications: Certain lifestyle factors can influence psoriasis. These include:
- Stress management: Stress can trigger flare-ups. Techniques like yoga, meditation, or exercise can be helpful.
- Healthy diet: While diet doesn’t cure psoriasis, a balanced diet rich in anti-inflammatory foods may be beneficial.
- Avoiding triggers: Identifying and avoiding personal triggers, such as certain medications, infections, or skin injuries, can help prevent flare-ups.
- Gentle skin care: Using mild soaps, moisturizers, and avoiding harsh scrubbing can protect your skin.
- Support and education: Connecting with support groups and reliable online resources can provide valuable information, emotional support, and coping strategies.
In conclusion, while the question of “how to cure psoriasis permanently” currently has no definitive answer, hope and effective management are within reach. By understanding your treatment options, working closely with your healthcare provider, and adopting healthy lifestyle habits, you can effectively manage your psoriasis and achieve clearer skin and an improved quality of life.
Page last reviewed: 08 April 2022
Next review due: 08 April 2025
