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HealthInfo Canterbury

Psoriasis treatments

Although there is no cure for psoriasis, treatments aim to keep it under control

Treatments include soap substitutes, creams, ointments, and lotions, some of which are especially for your face or scalp. If these don't control your psoriasis, then you may try UV treatments (light therapy) and some medications that work on your skin or immune system.

Many psoriasis treatments are only available on prescription from your doctor, and some are available only through a specialist.

Soap substitutes

Doctors often recommend you use a product called aqueous cream instead of soap or body wash. You can buy aqueous cream from pharmacies, but it will be cheaper if prescribed by your doctor. Doctors no longer recommend using aqueous cream as a moisturiser.

You can also get pine tar or coal tar washes from a pharmacy or on prescription. These may be worth trying, but they don't work well for everyone, and they also stain bedding and clothing.

Creams and medications

For psoriasis on your body, the most common starting treatment is an ingredient called calcipotriol (trade name Daivonex), which is available as a cream, ointment, or scalp lotion.

Calcipotriol is what's called a vitamin D analogue, which means it's a lot like vitamin D. It helps to slow down the speed at which you make skin and also reduces inflammation. However, it can also make your skin extra sensitive to sunlight, so you do have to be careful when you are outside.

This is a prescription medicine, so you can only get it through your doctor. Your doctor will provide advice on how to use this treatment. Read Medsafe information about Daivonex

Important!

Do not use calcipotriol products on your face or sensitive areas, such as inside your elbows or other skin folds, as it can irritate your skin.

Your doctor may also prescribe a steroid cream, especially for psoriasis on your face or sensitive areas.

FTU-squareSteroid creams work by reducing skin inflammation, redness, and itching. Make sure you use them as instructed, because you can damage your skin if you use them incorrectly. Your doctor may prescribe a topical steroid for you to try, and will give you specific instructions on how to use it.

Topical steroids are identified by their strength (also called potency), and they range from low potency, for example, 0.5 to 1% hydrocortisone, right up to very potent creams.

You should only apply a thin layer of a steroid cream. A useful measurement is the finger-tip unit. One finger-tip unit (FTU) is measured as a thin line of cream from the last joint of your index (second) finger to your finger tip. Use this amount of cream to cover an area that is double the size of the palm of your hand.

How much steroid cream to use

Body part

Number of finger-tip units

Face and neck

2.5

Trunk

7 for front

7 for back

Arm

3 each

Hand

1 each

Leg

6 each

Foot

2 each

An average-sized man would use 20 g a day for one whole body treatment, or around 140 g a week.

 

If you are using a moisturiser, apply this first, wait a few minutes, and then apply the steroid cream.

psoriasis-earUse the steroid cream when your skin is red and inflamed, and stop using it once the redness settles down.

Treatments for psoriasis on your scalp

You can buy tar shampoos from the supermarket or pharmacy to help with psoriasis on your scalp. If this is not working, your doctor may suggest you try a product containing betamethasone valerate (Beta Scalp). This is a steroid medication and is only available on prescription. You can also get a calcipotriol scalp lotion.

For thicker scaling, a product called Coco-scalp may help. Use as directed on the packaging.

Other treatments for psoriasis

If you psoriasis is very bad and not getting better with creams and lotions, your doctor may consider stronger medications, or refer you to the Christchurch Hospital Dermatology Department.

If you are referred to a hospital or private specialist, they might prescribe ultraviolet treatment and oral medication (tablets). These are available from specialists only, not from your GP.

Ultraviolet treatment, which is also called phototherapy, is not the same as a sunbed. Sunbeds give off the wrong type of light to help psoriasis, and they increase your chances of getting skin cancer.

If you have ultraviolet therapy, you will have it at hospital. You may also be prescribed tablets to help settle down your psoriasis.

Oral medicines

Another treatment is called acitretin. It is a type of medicine called a retinoid, which means that it's similar to vitamin A.

Acitretin works by slowing down skin production. You must not take it if you are pregnant or trying to get pregnant, as it can cause serious damage to a developing baby. You can't donate blood while taking this medication, or for two years afterwards.

Other medications work by suppressing your immune system. Methotrexate is one of these types of medicine. It controls psoriasis well, but it can have serious side effects, such as causing liver damage and increasing your chances of getting infections.

Written by HealthInfo clinical advisers. Updated March 2017.

Sources

See also:

Immunosuppression

Page reference: 37442

Review key: HIPSO-20776