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Psoriasis is a chronic skin disorder that causes areas of red, thickened, scaly skin.  Psoriasis is not an infection, and it is not contagious. The the exact cause of psoriasis is not known, but it is due to a combination of immune, genetic, and environmental factors. Children and adolescents can develop psoriasis, but it occurs primarily in adults. It may affect any area of skin including the scalp, nails and joints (psoriatic arthritis). The severity of psoriasis is determined by how much of the body's surface is covered and how much it affects a person's quality of life. Psoriasis is not curable, although many treatments are available to reduce the symptoms and appearance of the disease.

Psoriasis Overview

Dermatology Consultation

There is no cure for psoriasis, but there are medications which can help to control the symptoms.

  • Topical medications:

    • Corticosteroids: Medications such as clobetasol, triamcinolone, betamethasone are topical corticosteroids (sometimes called "steroids," but different from body building steroids) are applied to the skin to help reduce inflammation. Side effects can include thinning of the skin (particularly when applied to normal skin). These effects are most likely to occur when high-potency topical corticosteroids are used for long periods of time.

    • Calcipotriene:  Calcipotriene is a medication related to vitamin D which works by slowing the growth of skin cells. It can be used instead of or in addition to topical corticosteroids.

    • Retinoids: Medications such as tazarotene (Tazorac) are derived from vitamin A and work best on thick areas of psoriasis.

  • Oral medications:

    • Methotrexate: Methotrexate treats psoriasis by suppressing the immune response that triggers the disease. This drug is often used to treat moderate to severe psoriasis and/or psoriatic arthritis. Side effects including damaging lung and liver and lowering blood counts can occur, so close monitoring is required.

    • Apremilast (Otezla): is a newer oral medication for psoriasis and psoriatic arthritis that works by reducing inflammation. The benefit is that it does not suppress the immune system.

    • Acetretin (Soriatane): This an oral retinoid (deriviative of vitamin A) which is used for severe psoriasis.

  • Injectable biologic medications: This group of medications target components of the overactie immune system and are very effective for controlling psoriasis. They are given as a shot into the skin and dosing ranges from twice weekly to once every 90 days. Due to their effects on the immune system, they should not be used in patients with serious infections. These medications include

    • Etanercept (Enbrel)

    • Adalimumab (Humira)

    • Certolizumab pegol (Cimzia)

    • Ustekinumab (Stelara)

    • Secukinumab (Cosentyx)

    • Ixekizumab (Taltz)

    • Brodalumab (Siliq)

    • Guselkumab (Tremfya)

    • Tildrakizumab (Ilumya)

    • Risankizumab (Skyrizi)

  • Phototherapy: Exposure to ultraviolet light on a regular basis can improve psoriasis. Patients stand in front of a special light source, which helps to decrease inflammation.

  • XTRAC Laser: The XTRAC laser produces a highly effective, safe, and painless therapy by delivering a targeted, super-narrow UVB band of light to affected areas, resulting in effective and rapid improvement without the worry of harmful side effects of systemic agents. Theses services may be covered by your insurance. Multiple treatments are required and are performed twice weekly for 5 - 10 weeks.

Psoriasis Treatment