Preventive Services Covered by Private Health Plans under the Affordable Care Act
Psoriasis Treatments
There's no cure for psoriasis , but treatment can help you feel better. You may need topical, oral, or body-wide (systemic) treatments. Even if you have severe psoriasis, there are good ways to manage your flare-ups. You may be able to get rid of your symptoms completely.
Many treatments are available today to relieve psoriasis symptoms like itching and dryness. You can get these treatments over-the-counter, and you may only need to use those you apply to your skin. In more serious cases, your dermatologist may recommend prescription options. Some home remedies, like apple cider vinegar, may also be effective, but talk to your doctor before trying at-home treatment options. (Photo Credit: iStock/Getty Images)
Scalp psoriasis treatment
If you have scalp psoriasis, your doctor may start your treatment with products you can apply on your scalp, such as shampoos, creams, lotions, or gels. These products may contain active ingredients such as corticosteroids, salicylic acid, coal tar, clobetasol propionate, tazarotene, and anthralin.
If your case is severe or stubborn, your doctor may prescribe stronger medicines you take by mouth, such as acitretin (Soriatane), cyclosporine (Gengraf), or methotrexate (Rheumatrex, Trexall). You may also get injection medicines such as adalimumab (Humira), etanercept (Enbrel), or ustekinumab (Stelara).
Sometimes, your doctor may recommend phototherapy, a treatment using ultraviolet (UV) light to treat your symptoms.
Nail psoriasis treatment
Nail psoriasis can be hard to treat because standard psoriasis treatments don't often work or could take time to work. For example, treatments applied to your nails may require at least six months of regular use, once or twice a day, to work.
You and your doctor may have to try different treatments before identifying a regimen that works for you.
Some treatments you might undergo include:
Inverse psoriasis treatment
For inverse psoriasis, your dermatologist will suggest mild treatment because the folds of skin in your genital area, under your breasts, or armpits are sensitive. These treatments will manage or relieve symptoms such as itching, pain, and burning. They can also improve the look of the affected skin.
Medicines you may need to treat inverse psoriasis include:
Plaque psoriasis treatment
Many of the standard psoriasis treatments work for plaque psoriasis, too, as this is the most common type of psoriasis. Depending on your case, your dermatologist may recommend treatments to apply to your skin. These medicines may have active ingredients like anthralin, coal tar, corticosteroids, synthetic vitamin D, and salicylic acid. You'll likely use these medicines only if your case is mild.
In more severe cases, your doctor may recommend injection medicines like adalimumab and etanercept, drugs you take by mouth like apremilast and cyclosporine, and phototherapy.
Other psoriasis types and treatment
To treat other types of psoriasis, including guttate psoriasis, pustular psoriasis, and erythrodermic psoriasis, your doctor will consider a few things, including:
Based on the answers to the above questions as well as your preferences and lifestyle, you and your doctor will work together to find a treatment plan that works for you.
Some treatment options your doctor will explore with you may include:
The most common psoriasis treatments are medications you rub directly on your skin. Along with a good moisturizer, they're usually the first thing your doctor will suggest, especially for mild to moderate psoriasis. There are over-the-counter (OTC) and prescription options.
Topical treatments for psoriasis come as ointments, creams, solutions, or foam and include:
Psoriasis treatment creams
Steroid creams slow down immune cells in your skin. They can ease swelling and redness. Mild steroid creams are available OTC, but you'll need a prescription from your doctor for something stronger. Steroids come with side effects and should be used with caution on sensitive areas like your face or genitals. They can burn or thin the skin. Use them exactly the way your doctor tells you.
Other topical psoriasis treatments
Salicylic acid. This can soften and thin scaly skin but can also irritate your skin if left for too long. It might weaken your hair follicles and cause temporary hair loss, too. The body can absorb salicylic acid if you put it on large patches of skin.
Calcipotriol (calcipotriene). This is a strong form of synthetic vitamin D and is known to control overactive skin cells. Your doctor might pair it with a steroid cream.
Roflumilast (Zoryve). It's a steroid-free cream that can be used once daily to relieve plaques. Because it is a PDE-4 inhibitor, it can block the enzyme that causes inflammation.
Tapinarof (Vtama). It's a new steroid-free topical cream that is an aryl hydrocarbon receptor agonist. It is approved to treat plaque psoriasis in adults. You apply it once a day. It can be used on sensitive body areas and is safe for long-term use.
Tazorac (Tazarotene). It's available in gel, cream, or foam and is applied once or twice daily. It is not recommended for people who are pregnant, breastfeeding, or intending to become pregnant.
Immunomodulators. These aren't steroids, but they change how your immune cells work. Options include pimecrolimus and tacrolimus. Your doctor might give you these to use on sensitive areas such as your face, groin, or skin folds.
Coal tar ointment and shampoo. Coal tar is known to ease psoriasis-related inflammation, itching, and scales. But it can cause side effects such as skin redness and dryness. It can also make your skin more sensitive to UV light. Coal tar is not recommended for pregnant and breastfeeding people. Ask your doctor how to use it.
Prescription retinoid. These are ointments made with synthetic vitamin A. Your doctor might tell you to take them along with a steroid. That can lower your odds of skin irritation caused by the retinoid.
Over-the-counter psoriasis treatment
If your psoriasis is mild, you can use OTC treatments, which you can get without a prescription at drug stores, pharmacies, grocery stores, convenience stores, or online retailers.
Treatments with active ingredients. These OTC psoriasis treatments usually contain ingredients that help improve your symptoms. Examples include coal tar or corticosteroids like hydrocortisone. These ingredients help:
Moisturizers. Regardless of how severe your psoriasis is, you may benefit from regularly using a moisturizer, which you can get over the counter. It helps reduce dryness and scaling and promotes skin healing. You can use the moisturizer once daily or more if your skin is drier than usual. When choosing a moisturizer, look for thicker options such as a heavy cream, ointment, or oil. Also, choose one without fragrance and one you can be sure you'll stick with.
Scale softeners. Scale softeners that contain salicylic acid, lactic acid, or urea can also be purchased over the counter. These products can soften and remove scaling and reduce swelling. They may be great for you, especially if you have plaque psoriasis. But be sure to follow the instructions on the product. Otherwise, they might not work well or cause more skin problems such as itching, redness, and dryness.
Anti-itch treatments. Many anti-itch treatments for psoriasis are also available over the counter. These products often contain calamine, camphor, hydrocortisone, or menthol. Though they help relieve psoriasis itching, they can also make your skin irritated and dry. To help with this, look for moisturizing options or use a moisturizer along with the anti-itch treatment.
Sunlight has been used to treat skin conditions for thousands of years. Now doctors use machines to shine UV rays directly on your skin.
Light therapy can slow down fast-growing skin cells in people who have psoriasis. It's usually something a dermatologist will do in their office a few times a week. But there are some at-home kits you can use. Ask your doctor about them.
Types of phototherapy for psoriasis include:
Narrowband UVB therapy. This is a targeted form of ultraviolet B (UVB) light. You stand in a light box or your doctor passes a brush or comb over the affected areas. It's safe for children, people who are pregnant or breastfeeding, and those with a weakened immune system or ongoing illness.
Broadband UVB therapy. This sends out a wider range of UVB light. It's not used as much as narrowband UVB therapy because it's not as effective.
Excimer laser therapy (XTRAC laser). Excimer laser therapy helps get rid of the red patches by exposing them to targeted UVB rays.
Psoralen + UVA (PUVA). This mixes a drug called psoralen with ultraviolet A (UVA) light. You can take psoralen by mouth or sit in a bath. It makes your skin more sensitive to light, which boosts the amount of UVA light your skin can absorb. This combo works well for psoriasis. But it's an older treatment that's not used as much as narrowband UVB therapy.
Phototherapy can cause short- and long-term side effects. It may make you feel like you have sunburn and raise your risk of getting skin cancer. It's not recommended if:
Immunosuppressants. If other treatments don't work or if you have moderate to severe psoriasis, your doctor might give you drugs to slow down your entire immune system. You'll take them by mouth or get them via an injection. They can make it harder to fight off infections and cause other unwanted side effects.
Some immunosuppressants used to treat psoriasis include:
Oral retinoids are often used to treat pustular psoriasis. But they can cause unwanted side effects, including hair loss and liver or bone problems. Your doctor may lower your dose once your symptoms get better.
It's not safe to take acitretin if you're allergic to retinoids. Oral retinoids can also lead to birth defects. Don't take these drugs if:
Systemic biologic psoriasis treatments
These are newer drugs made from living organisms. Biologics are divided into groups: tumor necrosis factor (TNF) inhibitors, interleukin (IL)-23 inhibitors, IL-17 inhibitors, and IL-12/23 inhibitors. Each type targets specific immune cells or proteins that cause psoriasis. Unlike immunosuppressants, they don't affect your whole immune system.
You'll likely get this treatment through a shot or IV.
Biologics work best for moderate to serious psoriasis and psoriatic arthritis. But they can be expensive. These drugs are generally considered safe, but more research is needed on their long-term effects. Your doctor will help you decide if they're right for you.
Biologics used to treat psoriasis include:
Many people try herbs, vitamins, or other at-home remedies to ease symptoms. Just remember what works for someone else might not work for you. It's best to talk to your doctor before you change or add something to your treatment plan. They'll let you know what's safe.
Here are some commonly used natural psoriasis treatments:
Salt baths. These might lift some of your scales and help you itch less. Add Dead Sea or Epsom salts to warm water. Soak for 15 minutes. Apply moisturizer after your bath so your skin doesn't get too dry.
Colloidal oatmeal. Some people say their skin is less red and itchy when they soak in an oatmeal bath or apply a paste to their skin. There's not much evidence to show it treats psoriasis.
Aloe vera. A cream with 0.5% aloe might lessen your scales and ease redness for a short time. You can use it up to three times a day.
Apple cider vinegar. This is sometimes used to ease itching from scalp psoriasis. You can use it a few times a week. Make sure you mix more parts water than vinegar. Otherwise, the vinegar can burn your skin. Avoid any open wounds.
Healthy diet. There's no meal plan specifically for psoriasis. But if you're overweight or obese, your symptoms might get better if you lose excess weight. Experts think that's because certain cells, such as the ones in your belly, worsen inflammation. That makes it harder for the immune cells in your skin and body to work the right way.
Keep your doctor in the loop about your condition. They may need to update your care plan over time. That might mean switching to a different topical drug or trying a mix of psoriasis treatments.
Psoriasis has no cure, but many treatments are available today to relieve symptoms such as itching and dryness and improve the look of your skin. You can get these treatments over the counter, and you may only need to use those you apply to your skin. In moderate-to-severe cases, your dermatologist may recommend prescription options. You might also have to be on more than one treatment for the best result. You may have to experiment for a while before you find a treatment plan that works for you. Talk to your doctor before considering home remedies such as apple cider vinegar as a long-term way to manage your psoriasis.
Can I live a normal life with psoriasis?
Yes, you can live a normal life with psoriasis, especially if you consistently use a treatment that works for your symptoms.
Can I marry a person with psoriasis?
Yes, you can marry a person with psoriasis. The condition isn't contagious.
Which treatment is best for psoriasis?
The best treatment for psoriasis depends on the type you have, how serious it is, and your symptoms. You'll likely start with topical treatments with corticosteroids.
Is psoriasis 100% curable?
No, psoriasis isn't fully curable, but treatment can help manage symptoms such as itching, redness, swelling, and scaling.
How does psoriasis start?
Psoriasis can start at any time. It starts when your immune cells become too active, causing rapid production of skin cells. Triggers can include infections, medicines for treating conditions such as heart disease or malaria, taking too much alcohol, stress, smoking, and obesity.
FDA Expands Approval Of Vtama To Include Atopic Dermatitis
HealthDay News — The U.S. Food and Drug Administration has approved Vtama (tapinarof) 1 percent cream for an additional indication — the topical treatment of atopic dermatitis in adult and pediatric patients aged 2 years and older.
The cream, an aryl hydrocarbon receptor agonist, was previously approved as a topical, nonsteroidal treatment for plaque psoriasis.
The approval was based on results from the ADORING 1 and ADORING 2 trials, in which a statistically significant difference in the proportion of patients achieving a score of clear (0) or almost clear (1) and a minimum two-grade improvement from baseline at week 8 on the Validated Investigator Global Assessment for AD (vIGA-AD) was seen for Vtama compared with vehicle (ADORING 1: 45.4 versus 13.9 percent; ADORING 2: 46.4 versus 18.0 percent). Statistically significant benefits were seen for secondary end points, including an Eczema Area and Severity Index score improvement of at least 75 percent from baseline at week 8 and achievement of a ≥4-point improvement in the patient-reported Peak Pruritus Numerical Rating Scale from baseline at week 8 in patients aged 12 years and older.
Upper respiratory tract infection (12 percent), folliculitis (9 percent), lower respiratory tract infection (5 percent), headache (4 percent), asthma (2 percent), vomiting (2 percent), ear infection (2 percent), pain in extremity (2 percent), and abdominal pain (1 percent) were the most common adverse reactions reported.
"With the FDA's approval of Vtama cream in atopic dermatitis for adults and children as young as 2 years old, there is now a therapy that offers the potential for powerful skin clearance with no label warnings or precautions, contraindications, and no restrictions on duration of use or percentage of body surface area affected," Kevin Ali, the CEO of Organon, said in a statement.
Approval of Vtama was granted to Organon.
More Information
Tildrakizumab Demonstrates Long-term Benefits In Scalp Psoriasis Treatment
Photo Credit: Mysticfalcon
The following is a summary of "Efficacy and Safety of Tildrakizumab for the Treatment of Moderate-to-Severe Plaque Psoriasis of the Scalp: Week 52 Results From a Phase 3b, Randomized, Double-Blind, Placebo-Controlled Trial," published in the December 2024 issue of Dermatology by Sofen et al.
A Phase 3b, randomized, double-blind, placebo-controlled study (NCT03897088) previously demonstrated that tildrakizumab, an anti–interleukin-23 p19 antibody, met the primary efficacy endpoint at Week (W) 16 in patients with moderate-to-severe plaque psoriasis affecting the scalp.
Researchers conducted a retrospective study to assess the maintenance of tildrakizumab efficacy and safety for treating scalp psoriasis from the W 52 full analysis.
They randomized patients to continue receiving tildrakizumab 100 mg every 12 weeks or, for those on placebo (analyzed separately), switch to tildrakizumab 100 mg at W16. Efficacy endpoints included an Investigator Global Assessment modified 2011 (IGA mod 2011; scalp) score of 0 or 1 with a ≥2-grade improvement and ≥90% improvement in Psoriasis Scalp Severity Index score (PSSI 90) from baseline. Safety was evaluated based on adverse events.
The results showed that in patients initially randomized to tildrakizumab vs placebo, the IGA mod 2011 (scalp) and PSSI 90 response rates improved from 49.4% vs 7.3% and 60.7% vs 4.9% at W16 to 62.9% vs 56.1% and 65.2% vs 57.3% at W52, respectively. More than 80% of responders at W16 to tildrakizumab maintained the response. No serious adverse events related to treatment were reported.
Investigators concluded that tildrakizumab demonstrated sustained long-term efficacy and safety in treating scalp psoriasis.
Source: jaad.Org/article/S0190-9622(24)03393-0/fulltext
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