Psoriasis - Different forms of therapy

Skin care for psoriasis

Proper skin care is extremely important as a basic treatment for psoriasis. Refatting oil baths, shower oils, fatty ointments or fatty creams improve the body's own protective function. Also beneficial are urea, glycerol or hyaluronic acid, which protect the skin from dehydration.

Medication for application

In the acute disease, the scaly layer is first replaced with ointment dressings (salicylic acid, lactic acid). Only then can the active ingredients of certain pharmaceutical ointments penetrate to the skin cells. Substances are used which slow down the excessive growth of skin cells, ie dandruff, and have an anti-inflammatory effect. For example, coal tar, dithranol or cignoline, vitamin D derivatives such as calcipotriol and tacalcitol, vitamin A derivatives such as tazarotene and fumaric acid are used.

Cortisone preparations have an anti-inflammatory effect and reduce itching, but should only be used for a short time. Some doctors have also achieved good results with the newer alternatives tacrolimus and pimecrolimus - however, these are not officially approved for the treatment of psoriasis. They are also suspected of long-term carcinogenicity.

Light and electricity

Another treatment method is the irradiation with high-energy UV radiation, possibly combined with active ingredients or salt baths. These include PUVA, a combination of UV-A radiation with the active ingredient psoralen. This increases the photosensitivity of the skin, whereby the UV-A light can develop its full effectiveness. Stays in the marine or high mountain climate (especially at the Dead Sea) are often very effective, but the effect usually disappears quickly after the end of the treatment.

In psoriasis on the hands and feet, the side-effect-free treatment with alternating currents of medium frequency (interference therapy) is sometimes successful. Presumably, the division activity of the cells is inhibited; possibly additionally increases the pain threshold. In some patients, laser therapy works with a so-called Ecximer laser; however, this treatment has not yet been scientifically proven.

Internal medications for psoriasis

In the case of more severe illnesses, systemic drugs are used which suppress the immune system but may also have corresponding side effects. However, conventional substances such as ciclosporin A, methotrexate, or fumaric acid esters do not work in all patients.

If itching is severe, antihistamines may also be taken as tablets.

Biologics for the treatment of psoriasis

New hope is in the case of plaque psoriasis, a newer class of drugs from the group of biological therapies known as "biologics" or "biologics". The first generation of these biologics are TNF-a inhibitors, ie biologically or genetically engineered proteins that block the body's own messenger TNF-alpha, which triggers and amplifies inflammation.

The second generation of biologics, on the other hand, blocks various interleukins (ILs), which are messengers that affect, among other things, cell division and growth. This group includes, for example, the active substances ustekinumab, secukinumab or ixekizumab. The agents are administered at intervals of several weeks in the form of syringes or pens.

self-treatment

Some medicinal plants have a positive effect - including mahonia, witch hazel (hamamelis) and aloe vera. They are available as ointments or extracts in the pharmacy, in addition, the witch hazel can be prepared as a tea for envelopes and baths.

There are also countless tips that help individuals who have not been scientifically proven. These include, for example:

  • Bathing with sea salt or with "doctor fish" from Kangal
  • Rubbing with St. John's wort or bread drink
  • Taking apple cider vinegar, vitamin supplements or capsules with evening primrose, borage, linseed, soy or fish oil

In some cases, certain foods also worsen the appearance of the skin or, conversely, it is improved by a change in diet.

Even with alternative medicine methods successes are repeatedly achieved, such as the homeopathic constitutional therapy (possibly in combination with a self-blood therapy), the bowel rehabilitation and microbiological therapy (because the intestine is an important part of the immune system) or acupuncture. Relaxation methods help to reduce stress; psychological support as well as an exchange in self-help groups support those affected.

Treatment with nibbling fish

From Turkey, a very different way of treatment has become known. There swim in the river near the small town of Kangal in eastern Anatolia fish in a river that feed on dead human dander as a plankton replacement. Two species of fish share the work: one species constantly hits the skin, loosening the dander, the other species then shed the scales. Further scientific research on this "animal" treatment is pending, but the reports of some patients are impressive.

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