From the Pharmacist: Managing psoriasis flares
There are several options for treating this common skin condition.
When an itchy rash doesn’t go away — and instead becomes raised, inflamed and painful — chances are it may be developing into psoriasis. According to the National Institutes of Health, over 6.7 million adults have been diagnosed with this disease.
It occurs when the immune system sends faulty signals telling skin cells to grow abnormally fast and pile up on the surface before they mature. Affected skin appears thick and red, is covered in silvery scales (plaque) and feels itchy or sore.
There are several different forms that can occur, including psoriatic arthritis, where joints become inflamed in addition to the development of skin lesions. Psoriasis patients are prone to “flares” — times when the disease is particularly active. These flares can be caused by stress, changes in the weather (resulting in dry skin) or infections.
The treatment goal is to reduce the number of lesions and provide symptom relief. The National Psoriasis Foundation has established guidelines to reduce the amount of the body affected to less than 1 percent — about the size of the palm, fingers and thumb of one hand. Treatments can take several months to become completely effective, even though they may provide some symptom relief sooner. Not all treatments work for all patients, and often multiple treatments are needed.
Ointments or creams including corticosteroids, vitamin D3, coal tar and anthralin are often prescribed. Bath solutions and lotions are also used to soothe the skin, but these are mild-acting agents and not very strong.
These are prescribed and include both natural and artificial types. This type of therapy should be under a doctor’s supervision since it needs to be safely done to minimize cancer-causing ultraviolet light.
Drugs like retinoids, cyclosporine and methotrexate are intended to reduce joint tenderness and swelling. Because these drugs can have side effects, patients are usually closely and frequently monitored through blood tests and office visits.
A class of drugs called biologics are available for treatment. Some of these include Humira®, Enbrel®, Taltz®, Orencia® and others. Biologics are an option for patients with moderate to severe cases of plaque psoriasis and psoriatic arthritis.
A patient who suffers with psoriasis is challenged to maintain a high quality of life. It is important that treatment options are discussed with a healthcare provider so the best one can be chosen. Your pharmacist can also help you understand costs, side effects and safety.
Psoriasis quick facts
- It can affect both men and women of any age+ Psoriasis is not contagious
- Typically, the lesions are not infectious
- In some cases, the disease is triggered by genetics
- Common disease zones include the scalp, face, hands, feet, nails and skin folds