Many creams, ointments, lotions, and pills are available for the treatment of psoriasis. Many patients require only over-the-counter treatment, or even none at all during relapses.
About a third of patients with psoriasis, however, do not respond to over-the-counter remedies and lifestyle changes, and require aggressive treatments. In some cases, such treatments need to be lifelong.
In general, there are three treatment options for patients with psoriasis:
Individual needs vary widely, and treatment selection must be carefully discussed with the doctor.
Giving treatment in a particular order can help provide both quick relief of symptoms and long-term maintenance. It involves three main steps:
Choices for transitional or maintenance treatments depend on the severity of the condition. Some examples are described in the following sections.
In severe chronic cases, a doctor may recommend rotational therapy. This approach alternates treatments. The goal is to prevent severe side effects or build-up of resistance from long-term use of a single medicine. An example of a rotational schedule may be the following:
Some doctors use the Koo-Menter Psoriasis Instrument (KMPI) to decide which patients should receive a pill or an injection. The KMPI's questions include:
If the answer to these questions is "yes," three additional questions are considered:
If the answer to these questions is "yes," a doctor may decide to prescribe a pill or injected drugs.
Doctors increasingly use combinations of pills, creams, ointments, and phototherapy instead of single medications. Combinations of oral treatments are particularly useful, because the doses of each drug can be reduced. This lowers the risk of severe side effects. Thousands of combinations are possible, and patients should discuss with their doctors the best treatment for their individual needs.
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