HAE SIVUSTOLTA:
Psoriasis is highly variable: the degree of symptoms typically varies from time to time and along the course of the year. It can be clear for months or even years, sometimes it never returns at all. In most cases, this life-long condition means alternating periods of flaring (the materialisation of psoriasis) and clearing (often referred to as remission).
The different types of psoriasis not only have different appearances, but also may require different types of treatment. Moreover, each person reacts differently to any therapy, so finding the most suitable therapy may take time and to some extent, is a case of trial and error.
There are four main classes of psoriasis therapies: topical treatments, phototherapy, systemic treatments and biological therapies.
Topical treatments
Topical treatments are applied directly to the affected areas. Examples include: anthralin, coal tar, retinoids, vitamin D3 analogues and corticosteroid cream Topical treatments are usually only prescribed for mild-to-moderate psoriasis; this is where the psoriasis affects 5% of the body surface area or less. Topical treatments are often used in combination with other types of therapy. They are effective; however, they can take time and/or be awkward to apply.
In addition to topical treatments, moisturisers or emollients are an important component of treatment of psoriasis, helping to reduce the flaking of the lesions. Some people with psoriasis find the use of moisturisers sufficient to treat their psoriasis.
Phototherapy
In phototherapy UV-light is utilised, which has long been known to help clear up psoriasis. UVA, UVB, and PUVA phototherapy are used to treat psoriasis in Finland. UVB uses ultraviolet B light, which is more intense than ultraviolet A, but does not penetrate as deeply. PUVA uses ultraviolet A light and a psoralen compound which makes the skin more sensitive to this wavelength of light. These therapies require a number of visits to the hospital a week.
Climate therapy
Climate therapy refers to treatment and rehabilitation journeys which are meant for people with severe psoriasis. Psoriasis is considered severe when lesions are resistant to care and continuous medical treatment is needed: hospital or open unit care, systemic drugs, phototherapy and topical medicines. Climate therapy offers a possibility for people with psoriasis to have a break from their intensive medication and treatment schedule. The main goal of the climate therapy is to relieve the symptoms of severe psoriasis- often attendees have no symptoms after the journey.
Climate therapy aims at enabling the clients to
- stop their heavy systemic and topical medication (both during the trip and after it)
- understand their own responsibility in their care
-alleviate the physical and psychological fatigue that many people with a chronic condition experience
-meet their peers and share experiences
-adopt a healthy life style and exercise practices
- improve their physical, psychological and social well-being
The effects of the climate therapy are based on the sunlight, sea water and relaxing rehabilitation environment. Psoriasisliitto arranges supervised climate therapy journeys during which clients will follow individual sun bathing plan and receive other supporting treatments. In addition, climate therapy journeys include activities and exercising; teaching and guiding self-care and healthy life style and peer support. During the journey each attendee participates in the lectures and discussion groups held by doctor and/or nurse. Each attendee will have an individual care plan and four doctor’s check-ups during the trip.
Systemic therapy
Systemic therapy is used in cases where the psoriasis is extensive or if the patient has not responded to other therapies. These are usually administered by a specialist and can be taken either orally or as an injection. Examples of systemic therapies are: methotrexate, cyclosporine, oral retinoids and fumaric acid esters. These compounds treat psoriasis by suppressing your entire immune system.
Biologics
Biologic therapies are new, injectable medications that are used to treat moderate-to-severe psoriasis. They are large protein molecules which are injected into the body. Biologics target a very specific part of the immune response. There are currently four biologics in development for the treatment of psoriasis: efalizumab, alefacept, etanercept and infliximab.
Find out about psoriasis and its treatment
The more you know about the therapies available and about what to expect, the better you will be able to control your psoriasis.
