Treatments

A new look at assessing disease severity
and how it affects your treatment options

Both the American Academy of Dermatology (AAD) and the National Psoriasis Foundation recommend that dermatologists also consider quality of life issues when determining disease severity and when developing a treatment plan. That's why it's important to tell your dermatologist about your physical symptoms as well as how your psoriasis affects you emotionally and socially. By taking all of these aspects into account, your dermatologist may be able to offer you a greater variety of treatment options.

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Where do you fit into this newer treatment approach?

After a recent evaluation of the current severity criteria of mild, moderate, and severe psoriasis, the National Psoriasis Foundation recommended using a classification system that focuses on how people with psoriasis should be treated. This two-tiered approach categorizes patients based on whether they are candidates for localized therapies or candidates for systemic and/or phototherapy.

• Candidates for localized therapy have plaque psoriasis that is limited to a small area and affects less than 5% of the Body Surface Area (BSA).
• Candidates for systemic and/or phototherapy have plaque psoriasis that affects 5% or more of the BSA. Some may have less than 5% but the lesions are present on vulnerable areas such as the face, genitals, hands or feet. People who are not adequately controlled using localized therapies, or who are significantly impaired physically or mentally by their disease, are also potential candidates for systemic and/or phototherapy.

Systemic and/or Phototherapies

Traditional systemics: oral prescription medications

• Acitretin
• Cyclosporine
• Methotrexate

Biologics: a different kind of systemic psoriasis medication that works in a targeted way on the immune system

Phototherapy: artificial ultraviolet light, or a combination of ultraviolet light and medications

• UVB broadband and narrowband
• PUVA
• UVA plus psoralen

Localized Therapies

Topicals: creams, lotions, and ointments that are applied to the surface of the skin

• Over-the-counter topicals
  • Moisturizers
  • Salicylic acid
  • Coal tar preparations
• Prescription topicals
  • Topical steroids
  • Vitamin D analogs
  • Topical retinoids
  • Anthralin

UVB laser treatments

Your dermatologist may prescribe localized treatments in combination or in sequence with systemic therapies or phototherapy. You may also be prescribed a biologic medicine, which is a different way to treat psoriasis.

In addition to these more traditional therapies, you may wish to explore alternative treatment approaches, such as meditation or acupuncture.