Psoriasis sufferers much like any other individual with a disease, should consult with their doctor and be an active participant in the treatment plan. It is after all he/she who have to follow the plan in order for the treatment to have a chance at working. The treatments are typically done in steps that are focused on the type of psoriasis that the individual has and based on the severity of the particular case. Severity can change from one flare-up to another in the same individual, so treatment plans do change as time goes on. The steps for treatment are implemented in a 3 phase process. The first step is to apply topical medications, the second step is to use therapy such as phototherapy and the third step usually involves oral medications that are designed to systemically treat the individual. Step 3 medications are usually oral but can also be by injection or intravenously (IV). The delivery method will depend on the medication used and the severity of the particular flare-up.
The treatment plan not only changes over time because of type of psoriasis and severity but also because medications tend to not work as well as time and usage progresses. The approach most doctors and dermatologists use when designing the treatment plan is a "trial and error" one. In order to minimize the possibility of medication resistance, most doctors will use a particular treatment for 12 to 24 months and then switch to a different medication.
Topical medications are those that are applied directly to the skin's surface. These have been shown to be very effective in treating psoriasis. The treatments that have been shown over time to respond well have included: anthralin, coal tar, medications made using vitamin D3, steroid ointments and sunlight.
There are treatments that are designed to be soothing for the individual but are not for the purpose of clearing up the psoriasis. These soothing treatments can include: bath solutions and moisturizers.
Exploring some of the treatments further:
Anthralin: This ointment cream or paste is typically applied for 15 to 30 minutes and is used to treat chronic psoriasis lesions. It is known to irritate the skin and does not have a very good track record for clearing up the lesions. The medication is also known for staining the skin and clothing a brown or purple color which when you have a skin condition that already reddens your skin; who wants to also add brown or purple to the mix? Anthralin is not suitable to be used on lesions that are actively inflamed or in acute cases.
Coal Tar: There are 3 ways to use coal tar - applied directly to the affected skin area, as a bath, or as a shampoo for when the scalp area is involved. There are different strengths of coal tar available with the most impotent form being irritating to the skin. It has also been known to make the skin sensitive to ultraviolet (UV) light; the doctor usually prescribes it in conjunction with ultraviolet B (UVB) phototherapy. Coal tar has fewer side effects than steroids but is messier and less effective than steroids are. Coal tar also stains skin and clothing, and it has a strong odor.