Treatment of psoriasis

Medical products (preparations, medicines, vitamins, medicines) are mentioned for informational purposes only. We do not recommend using them without a doctor's prescription. Recommended reading: " Why can't you take medications without a doctor's prescription?". The search for an effective cure for psoriasis has been going on for several centuries. Today, almost 2% of the entire population of the Earth is struggling with this disease, including both children and people of age. Dermatosis with a "calling card" in the form of a skin rash continues to exacerbate this indicator and affect an increasing number of people. In this regard, the question of effective means of combating psoriasis remains relevant. Methods of therapy for this disease are being improved every year, new drugs are entering the markets, and alternative procedures are being offered.

Among the entire medical arsenal, there is no such medicine that would help every patient or cure the disease forever. Despite this, doctors do not consider psoriasis a death sentence. For each individual case, you can find a method of treatment that will help the patient to enjoy a full life again.

Effective ointments for psoriasis

The true cause of psoriasis, or psoriasis, is still being clarified. To find an effective cure and treatment policy, scientists need to figure out exactly how and why this disease is born.

Among the confirmed causes are genetic predisposition, malfunctions of the immune system and metabolism. But in most cases, the picture of the disease in each case is individual, often doctors cannot establish a single factor that provoked the onset of the disease.

Doctors unequivocally agree on one opinion: psoriasis therapy requires an integrated approach. Today it is well established that psoriasis is not just a skin disease, but a chronic pathology, which is accompanied by malfunctions of many systems. It affects the central and peripheral nervous system, the cardiovascular system, affects the functioning of the liver and kidneys. Such a number of links in the pathological process greatly complicate the process of selecting the right treatment.

The first task of therapy is to stop the manifestation of the symptoms of the disease, for this purpose ointments and creams are used. But this is not enough for a stable regression of the disease, therefore, the therapeutic complex includes medical and climatic treatment, sometimes phototherapy is used. In severe cases, when the prescribed drugs and procedures are ineffective, alternative methods and experimental methods of treatment are used.

External stool therapy is an important part of all therapeutic measures. In this regard, therapeutic ointments for the treatment of psoriasis, which are divided into hormonal and non-hormonal, have proven themselves best. The first act quickly, but have a number of side effects. Non-hormonal formulations have a slow effect, but are safer. Depending on the manifestation of the disease, the doctor may recommend the use of one or another class of drugs.

Despite the side effects of hormonal formulations, dermatologists are often forced to use them because the patient may require urgent treatment.

According to the strength of the action, they are classified into:

  • weak;
  • with moderate activity;
  • strong.

However, such a gradation does not always mean that potent agents will be effective. In one case, the patient relies on an ointment with a weak effect, and in the other, a more active one. Attempts at self-treatment in this case are very dangerous for the patient, since the active substances in the composition of hormonal ointments, when used uncontrollably, only aggravate the symptoms.

When used occasionally under the supervision of a physician, such ointments cause minimal damage, but almost certainly help. The main task of the patient and the doctor is to support the effect obtained, but with the help of other means. Let's take a closer look at the list of hormonal ointments for psoriasis.

Hormonal ointments
Active substance Name drug Effect of the ointment and side effect
Based on fludcortonol Synoderm, Locasalen, Flucort, Ultralan, Flunolon, Sinaflan, Locacorten, Flucinar, Lorinden It is used against pustular psoriasis, reduces purulent processes in pustules, has antipruritic and anti-inflammatory effects.

Side effects: return of itching, burning, atrophy

Based on betamethasone Diprogent, Fucicort, Betasalik, Betazon, Celeston, Vipsogal, Akriderm, Belogent, Flosteron, Beloderm, Kuterid, Celestoderm, Betnovate, Betasalin, Diprospan, Belosalik Prevents cell growth at the site of injury, has anti-inflammatory effect, constricts blood vessels and increases their permeability.

Side effects: dry skin, possible secondary infection of papules, risk of allergic dermatitis and prickly heat. In especially severe cases, skin atrophy was observed

Based on triamcinolone Polcortolone, Phtoderm, Berlikort, Kenakort, Kenalog, Fluorocort, Triacort, Nazacort Relieves inflammation in the areas of psoriasis lesions, reduces itching, completely eliminates it if used correctly.

Side effects: skin irritation, return of itching, eczema. If used incorrectly, there is a risk of re-infection of the skin and skin atrophy

With hydrocortisone Cortef, Laticort, Hydrocortisone ointment, Hyoxysone, Dactacort, Sopolcort, Fucidin, Oxycort, Sibicort, Corteid, Sulfodecortem, Lokoid, Advantan Interferes with the development of cells (antiproliferative effect), inhibits the growth of connective tissue in areas of skin lesions. Not used to treat extensive plaque psoriasis.

Side effects: allergic reactions, striae, skin maceration, miliaria. Rarely - skin atrophy, folliculitis

With budesonide Apulein, Pulmicort (as an inhalation suspension) Relieves itching and burning on the affected areas, has anti-inflammatory and anti-allergic effects.

Side effects: dark striae, ecchymosis, itching, re-infection of the skin. Rarely - contact dermatitis, allergic exanthema

Based on clobetasol Powercourt, Dermovate, Skin Cap (not mentioned in the instructions, although the drug contains clobetasol propionate), Cloveit Stops the development of cells and connective tissue, relieves itching, prevents (reduces) purulent processes in pustules, has an anti-allergic effect.

Used for no more than five consecutive days, under the strict supervision of the attending physician.

Side effects: if used incorrectly, it can cause vasodilation and skin atrophy

We reviewed the list of hormonal ointments for psoriasis, but it is far from complete. Today, new drugs are licensed, however, just as often, due to severe side effects, such drugs lose their license. When prescribing such an ointment or cream to a patient, the doctor must warn the patient about all possible side effects from the treatment. The patient, for his part, must strictly observe the precautions and dosage of the drug. Hormonal ointments are absolutely contraindicated during pregnancy and for young children.

Topical steroid-based hormonal agents are needed because of their rapid and, in most cases, effective action. Unlike non-hormonal formulations, they relieve inflammation in a matter of days, eliminate the keratinized crust from papules, and reduce the affected area. In patient reviews, it is noted that itching disappears within a few minutes after applying the ointment with topical steroids. For cases of pustular psoriasis on the legs, arms and back, the purulent process slows down, the pustules are released from the exudative fluid.

In the European Union and the United States, such products are dispensed only by prescription, but in the CIS, most of these ointments can be purchased at a pharmacy without a prescription, which explains the frequent cases of side effects caused by overdose. As a result of the uncontrolled use of such drugs, the patient may develop Addison's disease, in which the adrenal glands cease to produce steroids on their own. A patient with such a disease has to take hormonal drugs for life.

Another significant drawback of such drugs is that with prolonged use of the ointment, resistance to the drug can develop in the body, which will manifest itself as an aggravation of side effects. At the same time, a patient who has already used a hormonal agent will almost certainly not be helped by non-hormonal drugs. Therefore, local external treatment on the skin begins with the simplest means.

Non-hormonal ointments
Active ingredient Name preparations Review of preparations
Solidol based Akrustal, Magnipsor, Cytopsor, Antipsoriasis, Kartalin, Antipsor This group is considered one of the most effective. In a therapeutic effect, they normalize metabolism in cells, eliminate inflammation and the development of new affected cells, contain natural extracts and vitamins. They are used exclusively as prescribed by a doctor
With tar Anthrasulfone ointment, Picladol cream, Super psori cream, Berestin, Antipsorin, Colloidin, Anthramin ointment, Alfozil (in the form of a lotion) Dry plaques, have a pronounced anti-inflammatory and bactericidal effect, accelerate the exfoliation of keratinized skin. The disadvantages include: pungent odor, increased phototoxicity. Application to large areas of skin is not recommended
C vitamin D Daivonex, Calcipotriol, Psorkutan, Dawn Cream They suppress the accelerated regeneration of keratocytes, reduce desquamation, and slow down pathological cell division. They are used, in most cases, against ordinary psoriasis. Can be used only on prescription and in the absence of allergic reactions
With oil Ichthyol-naftalan ointment, Losterin, Naftaderm, Naftalan ointment, Neftesan Produced on the basis of therapeutic naftalan. They disinfect the skin, relieve itching in the affected area, exfoliate the keratinized crust, and have a resolving and analgesic effect.

Not suitable for the treatment of exacerbations, during the progressive stage, in renal failure

Mustard compounds Psoriasin, Antipsoriaticum Ointments interact with proteins, have an irritating and blistering effect, accelerate exfoliation. Used only on small areas of the body and only under the supervision of a doctor
Mixed Salicylo-zinc paste, Vishnevsky's ointment They are the most common means due to their availability. They have antifungal, anti-inflammatory, antibacterial reactions. They dry the skin and form a barrier to protect against external irritants

Solidol-based ointments are considered the most effective. Despite the fact that non-hormonal ointments have fewer side effects, they also have disadvantages. The main disadvantage is selective efficiency, they do not always help. At the same time, the first positive results sometimes have to wait a very long time. The disadvantages of such drugs include the risk of an allergic reaction that develops with prolonged use.

Among the advantages of non-hormonal ointments, relative cheapness is noted, especially in comparison with hormonal formulations. There are many ointments and creams with a completely natural composition on the domestic market, which ensures a low likelihood of side effects and a small list of contraindications. Compared to steroid drugs, such formulations are relatively safe and do not cause such an aggressive response from the body.

In addition to the two classifications considered, dermatologists note the effectiveness of mixed ointments. These include Xamiol, Daivobet, Akriderm - preparations based on steroids and vitamin D. They are distinguished by a quick effect against itching, inflammation, cell proliferation, but are limited to a wide list of contraindications. For local therapy are presented: Inderma spray, cartoline ointment, Elokom (hormonal).

Despite the many recommended remedies for local use, doctors often resort to traditional medicine. Psoriasis is a disease with an unknown etiology, which justifies all, sometimes even extraordinary, methods of therapy. In addition to external effects on the skin, the patient needs to maintain the intake of vitamins, strengthen the immune system and normalize metabolism, which is ensured only with drug therapy.

Innovative Chinese medicine is sometimes used for topical therapy, often with positive results. One such remedy is considered to be a patch for psoriasis, which acts as a compress.

Drug treatment

The drug systemic treatment regimen is based on many factors associated with psoriasis (lichen scaly). Among these factors, the severity of the disease and the area of ​​​​damage, the age of the patient, the presence of other concomitant diseases of the stage of psoriasis in the patient are distinguished. Basically, active systemic treatment is resorted to in severe cases, when plaques actively grow and cover large areas of the body. But even with small lesions, the patient is prescribed maintenance drugs. If the disease is in a latent stage, medications are often not prescribed.

Dietary supplements against psoriasis

In patients with psoriasis, metabolism and the balance of vitamins in the body are often disturbed. Doctors consider this fact as one of the reasons for the exacerbation of scaly lichen in a patient. Therefore, therapeutic strategies often include dietary supplements. They help to remove harmful substances from the body and replenish the reserves of useful components. In this practice, compounds are used that only provoke the natural cleansing process. Dietary supplements are also widely used to support the functioning of the kidneys and liver.

List of psoriasis supplements:

  • Sagrada;
  • Green Star;
  • Acidobac;
  • Calcimax;
  • Grapeine;
  • Pax;
  • Chelated.

Each dietary supplement has a place in treatment only in the appropriate situation. For example, Sagrada and Acidobak support digestion, which is often disturbed in psoriasis. Pax performs an important function in such therapy - it normalizes the functioning of the nervous system.

You can not use any supplement you like, it must be prescribed by a doctor.

Lichen scaly in children and adults is very sensitive to incorrect treatment, and the same applies to nutritional supplements. Even taking vitamins can be detrimental to the patient: since the balance in the body is already disturbed, hypervitaminosis can occur, which will provoke the progression of the disease.

Biologically active supplements are designed only to support the body, increase its chances of recovery. It is believed that the use of such funds well prepares the ground for further treatment, but should not be used as monotherapy.

Drugs

Stronger drugs are used to treat squamous lichen when mild and topical therapy fails. Several types of drugs are used in drug therapy:

  • immunosuppressants;
  • antihistamine formulations;
  • sorbents and prebiotics;
  • hepatoprotectors;
  • immunomodulators;
  • non-steroidal anti-inflammatory drugs (NSAIDs or NSAIDs);
  • hormonal pills.

The introduction of immunosuppressants in the treatment of psoriasis is considered one of the most important advances in medicine in this field. Suppression of immunity in this case is necessary to block the growth of new cells. It has been established that psoriasis is partly autoimmune in nature, so the suppression of too aggressive behavior of the immune system often becomes the key to successful treatment. A positive result after the use of immunosuppressants is possible with careful, short-term and complex therapy.

Antihistamines are needed by the patient to relieve itching and inflammation. Today, doctors turn to such remedies, in most cases, only at the first sign of a relapse. The antipruritic effect is very important in the treatment of psoriasis, since the constant burning sensation often introduces the patient into a depressive state, and this significantly slows down the treatment.

Among the drugs in this category, experts prefer the III generation of drugs, they have fewer side effects and more effective action. A good therapeutic effect was shown by:

  • Erius;
  • Cetirizine;
  • Telfast;
  • Fexofast;
  • Xizal;
  • Desal.

Taking antihistamines should also be under the strict supervision of the attending physician.

Hepatoprotectors are prescribed to patients to support liver function. In the course of observations of patients with psoriasis, it turned out that the liver often suffers from the disease no less than the skin itself. In addition, it has an additional burden from complex therapy, so the use of hepatoprotectors is no less important than medications for psoriasis itself.

Immunomodulators, sorbents and prebiotics perform a supporting function. Any infectious process in the body can lead to a new outbreak of the disease or its exacerbation. Doctors focus on cleansing the intestines and blood to minimize possible complications. In this niche, the effectiveness of Polysorb is noted. On the other hand folic acid has lost popularity in such therapy, as it does not give the expected results.

NSAIDs are the mainstay of drug treatment. Their action is aimed at alleviating the symptoms of the disease: reducing inflammation, itching, pain. They are prescribed only in severe stages, such as psoriatic arthritis, erythroderma. In crisis situations, when no medicine works, hormonal pills are used.

In complex therapy, good results were shown by: Neotigazon, Psorilom, Methotrexate (antineoplastic), Metipred (hormonal), calcium gluconate. Doctors especially highlight Likopid, which has been successfully used for 20 years.

It is important not to self-medicate. Psoriasis can progress and worsen from completely harmless factors, especially the wrong medications. Also, the patient should not rely on the reviews of other patients: what helps one may harm another. Even traditional medicine should be discussed with your doctor.

Injectables for the treatment of psoriasis

Injectable formulations for the treatment of psoriasis are used only when other agents have failed. In particular, they are indicated for joint damage (psoriatic arthritis), erythrodermic psoriasis. The list of drugs is identical to tablets. In fact, doctors use the same drugs, but in a different form, in order to act on the foci of the disease faster and more efficiently. Among these drugs, the same classification applies (NSAIDs, immunosuppressants, hepatoprotectors, etc.). Also use general strengthening formulations in the form of injections and infusions (sodium thiosulfate).

The need for injections occurs when a patient needs urgent help. This often happens with drug overdoses with incorrect self-medication. Like psoriasis pills, injectables are hormonal and non-hormonal.

Their use should be prescribed by a physician and under his strict supervision.

For the relief of symptoms, use: Chloropyramine, Remicade, Stelara, Pyrogenal, Heptral, Tavegil. Drug injection therapy is used only for a short period of time, followed by less "aggressive" methods. The transition from systemic to local therapy is considered an excellent achievement in every picture of the disease.

A separate niche in therapy is occupied by strengthening and sterilizing drops of ASD - Dorogov's antiseptic stimulator fraction 2 and ASD 3. They are prescribed for a very weakened body for oral administration.

Proper nutrition

The text is for reference only. We urge you not to use diets, do not resort to any medical menus and fasting without medical supervision. Recommended reading: " Why you can't go on a diet on your own". The patient's diet has no less effect on the course of the disease than drug treatment. One of the factors that cause outbreaks of psoriasis is metabolic disorders, moreover, proper nutrition will cleanse the body and become the key to successful therapy. The remission of the disease or progression depends on what is included in the menu for each day.

There is currently no recommended diet in the treatment of psoriasis. Each picture of the disease is individual and requires a different set of ingredients and dishes. The food table should be drawn up in detail with the attending physician, since what is useful in one case may provoke an outbreak of psoriasis in another. The Pegano diet is widely used, designed to maintain the body.

Doctors have compiled a list of products prohibited in any case:

  • chocolate ​​, ready-made confectionery (cakes, bars);
  • alcohol and nicotine;
  • citruses;
  • red vegetables and fruits ( watermelon, tomatoes, peppers, etc.);
  • honey and nuts (with the permission of the doctor, you can eat in limited quantities);
  • junk food and drinks (sweetened soda, fast food, synthetic flavors);
  • fatty and smoked.

You should also limit the consumption of spicy, pickled, acidic foods. In a word, everything allergenic and those ingredients that irritate digestion and the central nervous system should be avoided. Patients with psoriasis are advised to reduce the amount of salt and refined sugar. Patient reviews note that this is the most difficult part of the diet, but taste buds quickly get used to unsalted and unsweetened food.

A mandatory requirement of the diet is a complete rejection of alcohol. Observations in this area have shown that alcohol (even in small quantities) leads to a rapid progression of psoriasis in absolutely all patients.

At the beginning of treatment, it is better to plan the menu for the week with the doctor. Based on the tests, he will be able to exclude all unwanted products and recommend those that the patient needs at the time of the examination. Even fortified food is not always useful for scaly lichen, since hypervitaminosis is often observed in such patients. The diet should consist of completely natural and fresh ingredients that do not cause allergies or indigestion.

Since complex treatment includes mandatory cleansing of the body, fasting is often prescribed to patients. Such practices are used 1-2 times a week, on the day of detox you need to drink only purified water. Any changes in the patient's menu should be notified to the doctor, including changes in diet, supplementation of vitamins, etc.

Features of the treatment of psoriasis in different parts of the body

Psoriasis It can appear at any age and anywhere on the body. It is believed that it is more dangerous for women than for men, because the weaker sex suffers from it almost twice as often. From the places of localization, this disease mainly “chooses” the knees and elbows. But there are frequent cases of its appearance on the face, palms, genitals.

Each type of psoriasis has its own specific treatment.

Scaling on the head

Therapy for this type of disease is also multicomponent, it consists of scalp care and medication. With a moderate and severe degree, tablets or injections are prescribed, in the initial stage there are enough vitamins or dietary supplements. The situation is especially difficult when the disease affects the face.

Scalp psoriasis may initially be similar to common dandruff: the skin becomes dry and rough with white scales. But over time, psoriasis covers an increasing area, the scalp resembles a dense crust. If you suspect such a problem, it is better not to compare photos on the Internet, but immediately contact a dermatologist or trichologist.

The methods of his treatment are not much different from general therapy. They include topical products, light therapy, folk remedies, proper nutrition. Of the medicines, shampoos received good reviews: Nizoral, Friderm, Psorilom, Fufan lotion (China). Cosmetic formulations are also used, Vichy has proven itself best. Prices for these treatments start at $40. Of the more affordable, ordinary tar shampoo is used, which also dries plaques well and sterilizes the skin. To remove psoriasis on the head, folk remedies recommend linseed oil and coconut.

Nails

Half of all patients with skin psoriasis experience psoriatic onychodystrophy, a lesion of the nail plate. Also, almost all patients with psoriatic arthritis face this problem. The extreme degree of this disease is the loss of the nail, so the treatment should be accurate.

For the treatment of onychodystrophy, the same ointments are prescribed that we considered earlier. Hormonal formulations are used only in very severe cases. In addition to ointments, the patient may be prescribed healing baths with celandine, aloe, thistle, sage, sea salt. When psoriasis appears on the nails, it is important to refuse to apply varnishes, to avoid mechanical damage.

For housework, it is recommended to use thick gloves, in winter it is good to warm hands and feet. Manicures and pedicures are best done on your own, with sterile instruments. The experience of treatment shows the good effectiveness of propolis compresses, Loma Lux, Lecithin cream.

On the hands and feet

Hands and feet are most commonly affected by palmoplantar psoriasis, and the nails may remain intact. Treatment of scaly lichen on the palms and legs will allow you to get rid of the symptoms of the disease, and at the same time to prevent onychodystrophy.

For therapy use:

  • ichthyol ointment;
  • salicylic ointment;
  • homemade ointments;
  • herbal baths;
  • compresses;
  • systemic tablet therapy;
  • phototherapy.

Creams showed good efficacy against disease on the hands: Psoriasis Cream, Zorka, Chinese ointment King of the Skin (the latter refers to hormonal ones!). Traditional medicine uses coconut oil, propolis, soda and salt compresses, fish oil, hirudotherapy.

On the genitals

The appearance of symptoms of psoriasis on the genitals often causes a depressed, depressed state in patients. This greatly hinders the treatment, since its basis is a positive attitude. Stress and mood swings often become the root cause of an exacerbation of the disease.

Male and female genital organs are affected by vulgar, inverse and pustular psoriasis. In men, it most often appears on the head of the penis and pubis, for a woman the problem area is the labia. Treatment begins with local therapy with creams and ointments to eliminate itching and inflammation. In this regard, the Zdorov wax cream, the Chinese herbal preparation Iganerzhing (yiganerjing), Psoricontrol oil, and the antifungal cream Clotrimazole performed well.

Systemic and hormonal treatments for genital psoriasis are generally avoided. But in severe cases, tablets, hormonal ointments, and ultrasound are used. Salt baths, bathing with herbs also help well. Also, the patient needs to wear loose underwear to reduce the mechanical impact. It is forbidden to use synthetic materials, you need to abandon intimate soap.

Treatment of the disease in sanatoriums and resorts

The lifestyle of the patient also plays an important role. Dermatologists note that psoriasis is extremely rare in patients with overall life satisfaction. Therefore, it is important for patients to avoid stressful situations. In this regard, modern treatment at spa resorts performs several functions at once: the patient receives therapeutic assistance, physically relaxes and gains positive emotions.

For the treatment of scaly lichen, spas and sanatoriums with mineral springs are best suited:

  • Kyustendil (Bulgaria);
  • Moravske Toplice (Slovenia);
  • Harkany (Hungary);
  • Smrdaky (Slovakia).

The best place to get rid of skin problems is Harkan with thermal springs. In Russia, many sanatoriums offer mud treatment, you can do this in Anapa, Sochi, Gelendzhik, Altai. In Ukraine, the most popular for the treatment of diseases of this kind are Kuyalnik, Podolia, Truskavets. Patients also note positive changes after visiting resorts in the Crimea, the medical tourism center in Saki.

Well-known resorts on the Dead Sea remain no less popular for both recreation and treatment. Here, almost every clinic offers a cycle of therapeutic measures: hirudotherapy (leeches), laser treatment, plasmapheresis (blood purification), ultraviolet treatment.

Visiting resorts significantly accelerates the relief of symptoms, prevents new exacerbations, and relieves stress. Special attention is paid to climatotherapy by Israeli scientists, who note that this is the most important part of the treatment.

New treatments for the disease

Among the latest medical advances in the treatment of psoriasis are the use of immunosuppressants and the introduction of ultraviolet radiation. PUVA therapy promotes normal skin regeneration and metabolism in the epidermis, stable cell division. Scientists have noted that simultaneous systemic therapy with tablets and ultraviolet light gives a more effective result and a long-term remission.

This technique is gaining popularity as home setups become available. Darsonval is considered its predecessor. Like any other technique, self-medication is dangerous for this and side effects are possible. But with the correct use of such procedures, the chances of success are greatly increased.

Another pride of modern pharmaceuticals is biologics. Unlike drugs and procedures that eliminate the symptoms, these are designed to work on the causes. Biological drugs block the cells that provoke inflammation in psoriasis (T-lymphocytes). Compared to other immunosuppressive drugs, the new methods have fewer side effects.

Good therapeutic effect and relatively few disadvantages make biologics an important achievement of science. Today, the Food and Drug Administration approved the following brands: Remicade, Ameviv, Humira, Enbrel.

Despite the fact that medicine does not have a panacea for psoriasis, it certainly cannot be called helpless. All that the patient needs to cure the symptoms is to follow the doctor's recommendations, do not self-medicate and try to enjoy more often.

Sources
  1. Rassvet Clinic. - A dermatologist, trichologist deals with the treatment of psoriasis.
  2. Medical center "SM-Clinic". – All about psoriasis.
  3. Dermatologist prof. Janis Kisis. – Treatment of psoriasis.