What’s the best way to treat and manage psoriasis?Skin, Hair & Nails
I’m hearing a lot of different opinions from friends and family about diets, medicines, etc for treating psoriasis. What’s your take on the best way to treat and manage psoriasis?
Thanks for the D2D.
Firstly, I think it is important to try to lead a healthy and stress-free lifestyle. Stress is hard to avoid in stressful Singapore but it is a well-know trigger of psoriasis, so do not forget to minimize stress in your life.
For mild psoriasis, this is usually treated with topical medications. Topical steroids, coal tar and vitamin D analogues creams are commonly prescribed. They are effective for controlling psoriasis when there is a limited area of involvement.
If your psoriasis is more extensive, it can be difficult to apply the creams as it can be time consuming and messy, and often the adherence to treatment is low.
Phototherapy is good treatment option if your psoriasis is more extensive or if you fail topical treatment. This involves the use of ultraviolet light and it is like going for a medical tanning session in a light booth, but you have to attend treatment 2 to 3 times a week.
In severe cases of psoriasis, oral medications like methotrexate, acitretin and cyclosporine can also be used. These medications are effective in treating psoriasis, although they do suppress the immune system and affect the liver, kidneys and blood counts. However, with careful monitoring, they can be used safely to treat psoriasis.
There are now new treatments for psoriasis which are highly effective. These are the biologic agents and they are given by injections. They have been developed through advances in biotechnology and target specific immune pathways that cause psoriasis. They have changed the landscape of psoriasis treatment with the latest biologics achieving clear or almost clear in up to 80% of patients. I have many patients who were once covered in psoriasis, having failed all the traditional treatments, who are now completely clear of psoriasis. The biologic agents do suppress the immune system but have minimal impact on the liver and kidneys, unlike the traditional oral therapies.
Dr Colin Theng
MBBS, MRCP, MMED (Fam. Med), FAMS
Mount Alvernia Medical Centre D
820 Thomson Road #07-61
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