Model Monday's: Diana Moldovan

Topical Treatments For Psoriasis

The dry patches of skin you get with psoriasis can be itchy and uncomfortable, but the right treatment plan can help.

Your doctor will likely suggest creams, lotions, foams, sprays, solutions, and ointments. These are called topical treatments – meaning you put them directly on your skin or scalp.

You can get some over the counter (OTC) at the drugstore, but you'll need a prescription for others. It may take time to find what works best for you.

Moisturizers and emollients you buy without a prescription can help control flare-ups. In general, thick, greasy lotions, creams, and ointments that trap moisture in your skin work best.

Salicylic acid gets rid of scales that show up on patches of psoriasis. It comes in lotions, creams, ointments, foams, gels, soaps, shampoos, liquids, cloth pads, and patches. It's especially helpful when it's used with other skin treatments. Removing flakes of dead skin lets other medications work better.

Coal tar can help slow the growth of skin cells and make your skin look better. It also comes in many forms, including shampoo to treat scalp psoriasis. The weaker products are available OTC. Your doctor can prescribe a stronger version if you need it.

But coal tar doesn't smell good, and it can irritate your skin and stain your clothes. And you'll need to follow the directions carefully. Some studies show that chemicals in coal tar can lead to cancer , but only at very high doses. It's safe to use these products if you follow your doctor's instructions.

Mild steroids (corticosteroids) help with inflammation and slow the growth of skin cells so they don't build up. They come in different strengths. Weaker formulas may work for sensitive areas like your face or neck or skin-fold areas like your groin or armpit. Stronger corticosteroids require a doctor's prescription.

Stronger steroids (corticosteroids) work better if you have more than a few small patches of psoriasis, especially in areas that are harder to treat, like knees and elbows.

Steroids sometimes work better when they're used along with other medications.

Non-steroid topicals include roflumilast (Zoryve) and tapinarof (Vtama). 

Your doctor probably will recommend that you use these once a day. They may suggest that you wrap the area with tape or plastic after you treat it. This is called occlusion. It can help some treatments work better, but it may also make side effects stronger.

The side effects include:

Make sure you follow your doctor's directions. Using steroids too often has been linked to serious health problems, including certain kinds of cancer.

Vitamin D analogue topicals have lab-made vitamin D in them. These ointments, gels, creams, lotions, foams, and solutions make your skin cells grow more slowly. Over the long term, they may be safer for you than steroids, but they can irritate your skin.

Your doctor will probably suggest you use small amounts twice a day. Be careful not to get it on your healthy skin.

Some of these medications can make you sick if you swallow them, so keep them away from children and pets. And make sure your doctor knows what other medicines you take. Some can stop vitamin D products from working.

Vitamin D analogues include:

Your doctor also may recommend that you use vitamin D along with a steroid. Two combination medications, Enstilar and Taclonex, each contain both calcipotriene (vitamin D) and betamethasone dipropionate (a steroid).

Retinoids, like tazarotene (Tazorac), can help speed up the growth and shedding of skin cells. These foams, gels, or creams are made with vitamin A and come in different strengths. Typically, you put a small dab on the inflamed area and rub it in before bed. (There are OTC retinoids, but not generally for psoriasis.) Tazorac plus a topical corticosteroid is more effective than Tazorac alone.

Tapinarof (Vtama) is a new steroid-free topical cream that is an aryl hydrocarbon receptor (ARH) agonist approved to treat moderate to severe plaque psoriasis in adults. Applied once a day, it can be used on sensitive areas of the body and is safe for long-term use. A similar treatment is roflumilast (Zoryve). 

Doctors usually don't recommend these for women who are pregnant or might get pregnant.

Anthralin slows the growth of skin cells and eases inflammation. It doesn't have any serious side effects, but it can irritate your skin and stain clothes, sheets, and skin. It's often used with other medications.

Pimecrolimus (Elidel) and tacrolimus (Protopic) can also help with inflammation. Your doctor may call these drugs calcineurin inhibitors. They're sometimes used to treat psoriasis when other medications don't work.

Be sure to read the FDA warning on the label. There may be a link between calcineurin inhibitors and lymphoma (cancer of the lymphatic system) and skin cancer.

Tapinarof (Vtama) is the first aryl hydrocarbon receptor (AHR) agonist to be approved by the FDA. It's a 1% cream formulation for adults with plaque psoriasis. 

Many topical treatments can bother your skin. So over time, your doctor may suggest that you switch to different types of creams. You may also use them along with other kinds of treatments, like phototherapy or medications you take by mouth or with shots.

And don't be surprised if something that was working stops – or something that's never helped before starts to do some good. Let your doctor know what makes a difference and what doesn't. Together, you can find the treatment that's right for you.

Before using topical treatments, make sure you understand the directions and the side effects they can cause. And stick with your treatment plan once you start. If you don't use your medication regularly, your psoriasis could get worse.

Find out how to tell if your psoriasis treatment is working.

What Do Corticosteroids Do And When Do You Need Them?

Corticosteroids are important, sometimes life-saving therapies and the most widely prescribed drugs worldwide. They play a role in treating a variety of inflammatory medical conditions, including inflammatory bowel disease, asthma, psoriasis, multiple sclerosis, and rheumatoid arthritis, among many others. However, they can have significant side effects at high doses or when prescribed long-term.

Technically speaking the term "corticosteroids" refers to a group of hormones produced by your adrenal glands (the glands at the top of each kidney) as well as closely related substances made in a lab. However, the term is commonly used to refer to a subset of corticosteroids called "glucocorticoids." Sometimes people also just refer to corticosteroids as "steroids." However, that can be confusing, as these steroids aren't the same as the steroids that people sometimes use to build muscle ("anabolic steroids" such as synthetic testosterone). 

Depending on the clinical situation, you might take a corticosteroid orally or in many other ways, such as eye drops. Most are only available through a prescription, but you can purchase some versions applied to the skin over the counter (OTC).

Corticosteroids can help tone down your body's natural immune response if it is triggering excess inflammation, which generally occurs in people with an autoimmune condition or during some allergic responses. Corticosteroids help regulate your immune system through a variety of complicated processes.  Less commonly, you might need to take corticosteroids if your body isn't able to make them in normal amounts. Corticosteroids are used to treat many different medical conditions that can involve excess inflammation or abnormal immune system responses. Some examples include: Rheumatology: Rheumatoid arthritis and other kinds of inflammatory arthritis, lupus, vasculitis (inflamed blood vessels), osteoarthritis Allergy and pulmonology: Asthma, COPD (chronic obstructive pulmonary disease), allergic rhinitis (hay fever), anaphylaxis, prenatal lung maturation Dermatology: Contact dermatitis, atopic dermatitis, psoriasis Gastroenterology and kidney disease: Crohn's disease, ulcerative colitis, autoimmune hepatitis affecting the liver, nephrotic syndrome affecting the kidneys Hematology: Hemolytic anemia, leukemia, lymphoma Neurology: Multiple sclerosis, other autoimmune conditions affecting the brain Ophthalmology: Uveitis (inflammation of the eye's uvea) or conjunctivitis Infectious disease: Pneumonia, septic shock (very low blood pressure due to an infection) Endocrinology (to replace missing corticosteroid): Adrenal insufficiency and Addison's disease Corticosteroids may take three to eight hours or so before they start to take effect. However, depending on the situation, you might not get the full results for a few days or longer.  Cortisol is the name of the corticosteroid hormone that your body naturally makes. People don't usually receive cortisol itself as a treatment, but there are closely related corticosteroids (which have many similar characteristics) that can be used if your body doesn't produce enough cortisol naturally. Some corticosteroids are more potent than others, so you could take a smaller dose of one to have the same effects as another. These drugs also differ a bit in how much they affect factors like salt and water levels in the body, which can affect your blood pressure. Generally, corticosteroids are categorized by how long they work and how they are taken. The categories and some of their most commonly prescribed brands include: Short-acting glucocorticoids: These affect the body for about 8-12 hours. Some important examples are Hydrocort (hydrocortisone) and Cortone (cortisone acetate). Intermediate-acting corticosteroids: These work for about 18 to 36 hours. Examples include Rayos and Omnipred (both prednisone) and Solumedrol (methylprednisolone). Long-acting corticosteroids: The corticosteroids in this group work for 36 hours or longer. Decadron (dexamethasone) is a key example, as is Celestone (betamethasone). Both are also very potent glucocorticoids.  Inhaled corticosteroids: Scientists developed certain corticosteroids because their properties made them better suited for being inhaled. Some key examples are Pulmicort (budesonide) and Flonase (fluticasone). Keep in mind that many corticosteroids have multiple brand names and most are referred to by their generic names. Corticosteroids can be taken through many different routes: orally, intravenously, inhalation, topically, or via your eyes, nose, rectum, ears, joints, or spine. These differences can also affect how long the drug is effective and how quickly it works. Your dose and treatment duration will vary based on the medical situation and the specific corticosteroid prescribed.  For example, intravenous steroids might make more sense if you can't take oral medicine, or if you need the steroid to get into your body as quickly as possible. Suppositories are also an option for young children who can't reliably swallow medicines, or for certain kinds of rectal problems. For mild skin conditions, you might take an over-the-counter preparation, such as one with hydrocortisone. For others, you might need a prescription-strength version, like Diprolene (betamethasone dipropionate), but for only a limited time (e.G., a few weeks). These are available as foams, gels, ointments, creams, lotions, etc. Some people get occasional corticosteroid injections into their joints for conditions like osteoarthritis or rheumatoid arthritis, to help relieve pain.  Inhaled corticosteroids are another important route, especially for conditions like asthma, COPD, or allergic rhinitis. They may especially be important for people whose disease can't be controlled with alternative methods. The steroids can be given through nebulizers, mouth inhalers, or nasal inhalers. Prescription corticosteroid eye drops can also be helpful for inflammation of the outer layer of the eye. For problems related to inflammation deeper within the eye, you might receive a corticosteroid injection into the eye itself from an ophthalmologist, if needed.  The following are some examples of corticosteroids taken using different methods:  Deltasone (prednisone pills) Decadron (pill form of dexamethasone) Pediapred (prednisolone liquid) Anusol-HC (hydrocortisone acetate suppository) Solu-medrol (methylprednisolone given via injection or intravenously) Cortizone-10 (hydrocortisone cream) Pulmicort (budesonide inhaled into the lungs) Flonase (fluticasone inhaled into the nose) Pred Forte (prednisolone eye drops) Minimizing Use Corticosteroid treatment usually works better as a short-term therapy. For example, someone having a flare of rheumatoid arthritis might need to take a short course of corticosteroids to help get their disease under control.  However, when taken long-term, corticosteroids have the increased potential to cause unpleasant side effects. Ideally, the affected person can take different medications long-term to help prevent future flares. If needed long-term, the lowest effective dose should be used. Although corticosteroids are very important treatments, they come with a wide range of potential side effects. Side effects are more likely if you are taking larger doses. Taking corticosteroids for a long period of time, even if at a low dose, also increases your chance of experiencing side effects. Some of these potential side effects include: Musculoskeletal: Osteonecrosis, death of bone tissue (at high and prolonged doses); muscle breakdown (myopathy) leading to weakness; osteoporosis, weakened bones increasing the risk of bone breaks, especially if taken for long periods Metabolism and growth: Worsened or new-onset diabetes; increased appetite; redistribution of fat to the abdomen and face; growth impairment in children Heart: Fluid retention, causing swelling and weight gain; increased risk of high blood pressure and heart attack Gastrointestinal: Upset stomach; stomach ulcer; bleeding in the gastrointestinal tract; fatty liver disease Skin: Increased bruising; skin thinning; acne; excess hair growth; skin coloration changes Eye: Increased risk of cataracts and glaucoma Immune effects: Slowed wound healing; increased risk of infections which goes up with higher doses; possible allergy in a small minority of people, which in some can be severe (e.G., with difficulty breathing) Psychiatric: Insomnia; increased anxiety; in some, initial sense of well-being or mania which may be followed by depression Most side effects will quickly resolve when you are able to stop taking the corticosteroid. However, some side effects, like osteoporosis that has developed over months or years, may not fully resolve without additional treatment.   Differences in Side Effects Corticosteroids that you take orally or through your veins tend to cause more side effects compared to those directly applied (e.G., to the skin, inhaled, into the joint). That's because you can get the medical effect at lower doses. However, additional side effects can occur due to these other applications. For example, you might experience nerve tingling and a little pain from a steroid injection, skin color changes from a steroid cream, or irritation of your gums from an inhaled steroid. Some factors that also increase your risk of side effects include the following: Older age Other medical conditions like diabetes or some infections Severe disease that's being treated Poor nutrition Use of other agents that suppress the immune system It's important that you and your healthcare provider weigh these and other factors when considering glucocorticoid therapy, especially if you need to take it long-term. Some people may need monitoring if they take these agents for a long time, such as bone scans to check for osteoporosis or blood tests to check for diabetes.  Adrenal Insufficiency and Tapering Doses When you take corticosteroids, it can cause your body to start making smaller amounts of the natural compound cortisol. This is especially the case for people who take large doses over a long period of time Therefore, if you stop taking a corticosteroid abruptly, it can cause symptoms of something called adrenal insufficiency. Symptoms are often relatively mild but might cause issues like fatigue, nausea, headache, and poor mood. However, in certain situations, coming off corticosteroids abruptly might be much more serious. This can cause symptoms like very low blood pressure, decreased consciousness, and seizures. This may be more likely if another trigger is also present, like surgery or illness.  You may need to have your corticosteroid dose slowly lowered as a result. For example, if you'd been taking 60 milligrams of prednisone for three weeks, you might slowly lower your dosage by 10 milligrams to 5 milligrams each day, with the guidance of a healthcare professional. It's common to notice some side effects from corticosteroids, like changes to your energy level or some mild skin changes. You can check in about these, and potentially about lowering your dose, at a follow-up appointment.  Call your healthcare provider promptly for issues that might be more serious, like changes in your vision, increased urination, yellowish skin or whites of the eyes, swelling, or signs of infection such as fever. For any urgent, potentially life-threatening problem, like sudden severe chest pain or difficulty breathing, call 911.   Corticosteroids are an important class of drugs for treating a wide variety of medical problems, including many inflammatory and autoimmune conditions. Sometimes they are life-saving therapies.  These treatments are available in a variety of formulations, including pills, liquids, intravenous preparations, lotions, injections, inhaled products, suppositories, and eye drops. The mode of administration and strength will depend on the specific medical situation. Corticosteroids come with a long list of potential side effects. However, these are more of a concern if you need to take them orally or intravenously, particularly at high doses or over a long period. Ideally. You'll likely only need to take corticosteroids for a brief time. In some cases, you may need to taper your dose after you stop taking them.

Keylika Launches NistuHeal Skin Cream Solution In India, With Plans To Expand To The US

San Francisco, United States - October 28, 2023 —

Biotech startup Keylika has launched NistuHeal™, a steroid-free, medicated skin cream formulated to provide relief from eczema, in India, with plans to expand to the United States. 30 million people in the United States suffer from at least one form of eczema, affecting roughly 10% of the population.

To address the lack of effective, steroid-free, natural treatments for eczema, particularly mild-to-moderate cases, Keylika co-founders Dr. Buddha Chaudhuri and Dr. Frederik Ceyssens developed NistuHeal. NistuHeal, originally developed in the U.S., is now available over-the-counter in India through e-commerce platforms.

Chaudhuri, Keylika's CEO, was inspired to create NistuHeal based on his personal struggles with eczema. "For over a decade I battled frustrating eczema flare-ups and the perpetual itch-scratch cycle," said Chaudhuri. "The standard topical steroid treatments only provided temporary relief before the uncontrollable itch would return. I knew there had to be a better solution."

Drawing on their combined 30+ years of expertise in drug delivery and biotechnology, Chaudhuri and Ceyssens carefully selected 11 plant-based active ingredients known to benefit eczematous skin. NistuHeal's proprietary blend includes hydrolyzed colloidal oatmeal, zinc and magnesium complexes, amino acids and botanical extracts chosen for their anti-inflammatory, anti-itch, antimicrobial, and wound healing properties.

After extensive in-house testing and iterations, Chaudhuri managed the complex regulatory process to register NistuHeal as an over-the-counter drug in India. Local partner Streem Bio oversaw cGMP-compliant manufacturing and launched sales and marketing efforts.

"The response from dermatologists has been tremendous," said Chaudhuri. "Clinicians recognize the need for a natural, steroid-free alternative for mild-to-moderate eczema." To validate NistuHeal's safety and efficacy, Keylika conducted a 28-day clinical study on patients with mild-to-moderate atopic dermatitis. Results demonstrated that NistuHeal significantly reduced eczema symptoms and itching, with over half of subjects reporting major improvements in their skin conditions, without any adverse side effects.

NistuHeal's successful launch in India has proven there is strong demand for effective natural eczema therapies in the over-the-counter market. Keylika plans to expand availability to other regions in the coming months, starting with the U.S.

About Keylika

Keylika is a young biotechnology startup developing innovative medicines using cutting edge drug delivery systems. The company, based out of the San Francisco Bay Area, was accepted into Y Combinator, S22 cohort and won a Golden Ticket at MBC BioLabs sponsored by Nitto Denko. Keylika employs 30+ years of research experience across top universities to engineer drug delivery solutions for enhanced drug efficacy and safety. Learn more at www.Keylika.Com.

Contact Info:Name: Buddhadev ChaudhuriEmail: Send EmailOrganization: KeylikaWebsite: https://www.Keylika.Com/

Release ID: 89111678

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