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By taking into account how your psoriasis affects you physically, emotionally, and socially, your dermatologist may be able to offer you a greater variety of treatment options.
Treatments
Before your dermatologist can decide on a treatment approach, he or she must first determine the severity of your psoriasis. Classifying psoriasis as mild, moderate or severe typically involves assessing the percent of body surface area (BSA) affected, location of your lesions, the type of psoriasis, as well as the impact of psoriasis on your quality of life.
Since everyone reacts differently to his or her condition, quality of life measurements can be tricky. For example, someone with only a few small patches of psoriasis may be more bothered, especially if it occurs on a more vulnerable part of the body. On the other hand, someone whose psoriasis covers over 50% of his or her body may not be bothered by it and is able to lead a normal life.
Assessing disease severity and how it affects your treatment options
You and your dermatologist should consider how psoriasis affects your life when developing a treatment plan. That’s why it’s important to tell your dermatologist about your physical symptoms as well as how your psoriasis affects you emotionally and socially. By taking all of these aspects into account, your dermatologist may be able to offer you a greater variety of treatment options.
Back to topWhere do you fit into this newer treatment approach?
After a recent evaluation of the current severity criteria of mild, moderate, and severe psoriasis, the National Psoriasis Foundation (NPF) recommended using a broader classification system that focuses on how people with psoriasis should be treated, rather than on the severity of their disease. This two-tiered approach categorizes patients based on whether they are candidates for localized therapies or candidates for systemic and/or phototherapy.
- Candidates for localized therapy have plaque psoriasis that is limited to a small area and affects less than 5% of the body surface area (BSA).
- Candidates for systemic and/or phototherapy have plaque psoriasis that affects 5% or more of their BSA. Some may have less than 5% but the lesions are present on the face, genitals, hands or feet or other vulnerable areas. People who are not adequately controlled using localized therapies, or who are significantly impaired physically or mentally by their disease, are also potential candidates for systemic and/or phototherapy.
- Over-the-counter topicals
- anthralin
- coal tar preparations
- keratolytics (salicylic acid)
- moisturizers
- Prescription topicals
- topical retinoids (tazarotene)
- topical steroids (corticosteroids)
- vitamin D analogs (calcipotriene)
- Oral prescription medications
- cyclosporine
- methotrexate
- oral retinoids (acitretin)
- Injectable systemic medications:
- Biologic medicines
- adalimumab
- alefacept
- etanercept
- infliximab
- ustekinumab
- Biologic medicines
- Phototherapy: artificial ultraviolet light, or a combination of ultraviolet light and medications
- UVB broadband and narrowband
- PUVA (UVA + psoralen)
- Laser treatments
Your dermatologist may prescribe localized treatments in combination or in sequence with systemic therapies, or phototherapy. In addition to these therapies, you may wish to explore non-conventional treatment approaches, such as meditation or acupuncture.
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