Psoriasis

Encyclopedia of Alternative Medicine, Apr 06, 2001 by Maureen Haggerty

Administered under medical supervision, ultraviolet light B (UVB) is used to control psoriasis that covers many areas of the body or that has not responded to other treatment. Doctors combine UVB treatments with topical medications to treat some patients and sometimes prescribe home phototherapy, in which the patient administers his own UVB treatments.

Photochemotherapy (PUVA) is a medically supervised procedure that combines medication with exposure to ultraviolet light (UVA) to treat localized or widespread psoriasis. An individual with wide-spread psoriasis that has not responded to treatment may enroll in one of the day treatment programs conducted at special facilities throughout the United States. Psoriasis patients who participate in these intensive sessions are exposed to UVB and given other treatments for six to eight hours a day for two to four weeks.

Methotrexate (MTX) can be given as a pill or as an injection to alleviate symptoms of severe psoriasis or psoriatic arthritis. Patients who take MTX must be carefully monitored by a doctor who checks blood liver enzymes to prevent liver damage.

Psoriatic arthritis can also be treated with nonsteroidal anti-inflammatory drugs (NSAIDS), like acetaminophen (Tylenol) or aspirin. Hot compresses and warm water soaks may also provide some relief for painful joints.

Other medications used to treat severe psoriasis include etrentinate (Tegison) and isotretinoin (Accutane), whose chemical properties are similar to those of Vitamin A. Most effective in treating pustular or erythrodermic psoriasis, Tegison also relieves some symptoms of plaque psoriasis. Tegison can enhance the effectiveness of UVB or PUVA treatments and reduce the amount of exposure necessary.

Accutane is a less effective psoriasis treatment than Tegison, but can cause many of the same side effects, including nosebleeds, inflammation of the eyes and lips, bone spurs , hair loss , and birth defects. Tegison is stored in the body for an unknown length of time, and should not be taken by a woman who is pregnant or planning to become pregnant. A woman should use reliable birth control while taking Accutane and for at least one month before and after her course of treatment.

Cyclosporin emulsion (Neoral) is used to treat stubborn cases of severe psoriasis. Cyclosporin is also used to prevent rejection of transplanted organs, and Neoral, approved by the FDA in 1997, should be particularly beneficial to psoriasis patients who are young children or African Americans, or those who have diabetes.

Other conventional treatments for psoriasis include:

• Capsaicin (Capsicum frutecens), an ointment that can stop production of the chemical that causes the skin to become inflamed and halts the runaway production of new skin cells. Capsaicin is available without a prescription, but should be used under a doctor's supervision to prevent burns and skin damage.
• Hydrocortisone creams, topical ointments containing a form of vitamin D called calcitriol, and coal-tar shampoos and ointments can relieve symptoms but may cause such side effects as folliculitis (inflammation of hair follicles) and heightened risk of skin cancer.