Treatment:

The goal of treatment is to control your symptoms and prevent infections.

In general, three treatment options are used for patients with psoriasis:

• Topical medications such as lotions, ointments, creams, and shampoos
• Body-wide (systemic) medications, which are pills or injections that affect the whole body, not just the skin
• Phototherapy, which uses light to treat psoriasis

Most cases of psoriasis are treated with medications that are placed directly on the skin or scalp:

• Cortisone creams and ointments
• Creams or ointments that contain coal tar or anthralin
• Creams to remove the scaling (usually salicylic acid or lactic acid)
• Dandruff shampoos (over-the-counter or prescription)
• Moisturizers
• Prescription medicines containing vitamin D or vitamin A (retinoids)

If you have an infection, your doctor will prescribe antibiotics.

You may try the following self-care at home:

• Oatmeal baths may be soothing and may help to loosen scales. You can use over-the-counter oatmeal bath products. Or, you can mix 1 cup of oatmeal into a tub of warm water.
• Sunlight may help your symptoms go away. Be careful not to get sunburned.
• Relaxation and antistress techniques may be helpful. The link between stress and flares of psoriasis is not well understood, however.

Some people may choose to have phototherapy.

• Phototherapy is a medical treatment in which your skin is carefully exposed to ultraviolet light.
• Phototherapy may be given alone or after you take a drug that makes the skin sensitive to light.
• Phototherapy for psoriasis can be given as ultraviolet A (UVA) or ultraviolet B (UVB) light.

Persons with very severe psoriasis may receive medicines to suppress the body's immune response. These medicines include methotrexate or cyclosporine. (Persons who have psoriatic arthritis may also receive these drugs.) Retinoids such as acitretin can also be used.

Newer drugs called biologics specifically target the body's immune response, which is thought to play a role in psoriasis. These drugs are used when other treatments do not work. Biologics approved for the treatment of psoriasis include:

• Adalimumab (Humira)
• Alefacept (Amevive)
• Etanercept (Enbrel)
• Infliximab (Remicade)
• Stelara

Support Groups:

See: Psoriasis support group

Expectations (prognosis):

Psoriasis is a life-long condition that can be controlled with treatment. It may go away for a long time and then return. With appropriate treatment, it usually does not affect your general physical health.

Complications:

• Arthritis
• Pain
• Severe itching
• Secondary skin infections
• Side effects from medicines used to treat psoriasis
• Skin cancer from light therapy

Calling your health care provider:

Call your health care provider if you have symptoms of psoriasis or if the skin irritation continues despite treatment.

Tell your doctor if you have joint pain or fever with your psoriasis attacks.

If you have symptoms of arthritis, talk to your dermatologist or rheumatologist.

Go to the emergency room or call the local emergency number (such as 911) if you have a severe outbreak that covers all or most of your body.