Re-evaluating Treatment Options For Psoriasis Patients
Prevention and Treatment Treatment innovations should motivate Psoriasis patients to find their optimal treatment with their dermatologist.
Each year, on October 27, people worldwide raise awareness of a severe, painful inflammatory disease that affects about 125 million people worldwide — psoriasis.
It’s normal for skin cells to mature and shed over the course of a month. But in a person who has psoriasis, autoimmune signals cause skin cells to form in three to four days — piling up on the skin and causing thick, red, and scaly patches of varying sizes. During a flare-up, which can be triggered by stress and cold weather, the skin can be itchy, painful, and tender.
Noticeable symptoms of a chronic skin condition like psoriasis can often lead to some patients suffering from social isolation and even clinical depression. “Just imagine what it would be like to see someone cross the street to avoid interacting with you,” says Dr. Lyn Guenther, a professor of dermatology at Western University in London, ON.
Topical therapy, which includes creams, gels and foams, is viewed as a frontline therapy to treat psoriasis. Almost all patients use a topical treatment either on its own or, in more severe cases, in combination with treatments such as phototherapy, oral, or injectable medications.
The various topical treatments work by slowing down or normalizing cell reproduction and reducing inflammation of the psoriasis patch or plaque. The most commonly used contain a steroid or synthetic forms of vitamin D, or a combination of both. Steroids reduce inflammation and vitamin D slows the growth of skin cells that build up in psoriasis patients.
Other topical therapies include coal tar, which helps slow the growth of skin cells, and salicylic acid, which smoothes the skin by promoting the shedding of psoriatic scales. There are also products that contain aloe vera, jojoba, and other ingredients that help remove psoriatic scales as well as moisturize, soothe, and relieve itching.
There is an effective treatment for almost every psoriasis patient. “If older therapies have not been effective previously ask about new ones,” says Dr. Chih-ho Hong, a board-certified dermatologist and founder of SkinFitMD, a cosmetic dermatology clinic in Surrey, BC. “There are a lot of options out there.”
Advances in treatments
Although topical formulations can be effective, they can be inconvenient to apply. But thanks to continued efforts to develop effective, safe, and convenient therapies, new topical treatments have recently been introduced. Foam preparations of corticosteroids, for instance, are well accepted by patients, and may lead to improved adherence to therapy.
One such addition to the available topical treatments for psoriasis is a spray foam formulation that combines a steroid and vitamin D. This treatment provides good penetration of the active ingredients into the skin, and improved control of psoriasis symptoms, compared to the same ingredients in other formulations. The foam delivery system provides a patient-friendly and convenient application; it works in much the same way a spray sunscreen does.
There are also other new approaches to topical psoriasis medication in development, including the use of nanostructured lipid carriers loaded with the psoriasis medication, methotrexate, to deliver the medication right to the skin.
Dr. Ron Vender, a dermatologist based in Hamilton, ON, anticipates the options for psoriasis patients will continue to grow. “I predict, down the road, we’ll see a variety of new, safer, and more effective therapies.”
Finding the right therapy through conversation
To find the best treatment, patients should schedule an appointment with a board-certified dermatologist and ask him or her informed questions. Finding the best medication can be a matter of trial and error for someone with psoriasis, but it’s well worth the effort to improve quality of life.