Psoriasis Treatment Strategies

There are many psoriasis treatments that can be used alone or in combination. They include topical treatments, phototherapy (ultraviolet light therapy), and oral and injected medications.
Deciding on a treatment approach is something that you'll do with your doctor. Your decision will be based on a number of things: the severity of your psoriasis, any treatments that you've used before, whether you have other medical conditions, and finally, your own opinion about what sounds right to you.
Doctors have traditionally used a "1-2-3" approach to treating psoriasis. You start with topical creams and ointments. If they aren't enough, you might move on to phototherapy. If your psoriasis still isn't under control, you then might try systemic or biologic medications. However, this incremental approach is only a rule of thumb. Your doctor may suggest a different strategy in your case. Here's a brief outline of the major approaches to treatment.

What About Alternative Medicine for Psoriasis?

If you've looked around a bookstore or searched for psoriasis on the Internet, you may have already discovered some of the countless alternative methods for treating the condition. Almost every herb or pill or therapy has some supporters -- you'll find people who swear by vitamins, enemas, acupuncture, shark cartilage, or emu oil. There are even special spas in Turkey where people with psoriasis go to relax in a hot pool, breathe in the steam, and have the psoriatic plaques eaten off of their body by hungry, little fish.
You may be tempted to try a treatment that's out of the ordinary, especially if conventional medicine doesn't seem to be helping much. Just be cautious and remember that no alternative approach has ever been proven to help. Also, some alternative approaches may not be safe.
In general, you should check with your doctor before trying anything. Even some of the herbal supplements and over-the-counter treatments that you can get at the drug store are risky, especially when taken in combination with other treatments. One supposedly safe over-the-counter medication for psoriasis, Skin-Cap, was withdrawn from the U.S. market in 1997 when it was discovered to contain a powerful steroid. Always be suspicious of miracle cures, and never assume that a "natural" approach will be harmless.

Coping With Psoriasis Treatment

You have to strike a balance between the amount your psoriasis symptoms bother you and the difficulties imposed by treating them. While one medication may cause the fewest side effects, you may notice another one works better.
Psoriasis treatment takes commitment. It's important that you ask yourself what you're honestly willing to do. You may want to please your doctor when you're in the office by agreeing to whatever treatment he or she suggests. But don't agree to phototherapy sessions three times a week if you know that, realistically, you'll have to cancel half of them. Don't say that you'll take a drug twice a day if you'll probably forget most of the time. Don't agree to use coal tar in your hair each night if you know that you just can't take the mess.
Psoriasis is not the sort of condition where you can let your doctor make your choices for you. Only you know how far you're willing to go for treatment. You have to be involved in making the decision.
One of the terribly frustrating things about psoriasis is that effective treatments may not stay effective. Just when you finally feel like you've found a cream or medication that keeps your psoriasis symptoms under control, you may have another flare-up. It can be discouraging. You may be tempted to give up.
But don't despair. There are other treatments and combinations of treatments that you can use. It's important to keep trying.
"A lot of people who need treatment for psoriasis aren't getting it," says Bruce E. Strober, MD, PhD, co-director of the Psoriasis and Psoriatic Arthritis Center at New York University. "They may have lost faith in treatments for the condition. But we have a lot of good medications that they don't know about."