Psoriasis Treatments

Can I get prescription psoriasis treatments online?

The Online Clinic can prescribe a variety of treatments for psoriasis online for next day delivery. Just click on the free consultation button to get started.

What is psoriasis?

Psoriasis is an autoimmune disease that affects the skin. Psoriasis causes a more rapid rate of skin cell growth (turnover), causing the cells to accumulate in patches on the skin's surface. The disease is not contagious (you cannot get it by touching the psoriasis patches) and symptoms may come and go as they improve and worsen.

Plaque psoriasis is the most common form of psoriasis, appearing on the elbows, knees, lower back and scalp as red patches that are often itchy, thick, and covered with silver-white scales, and may crack and bleed. However, there are four other different types of psoriasis: guttate psoriasis (small red spots usually on the body, arms and legs), pustular psoriasis (red swollen skin, usually with painful, pus-containing bumps on the hands and feet), inverse psoriasis (red, smooth, sore, skin patches where there is skin-to-skin contact, such as armpits and groin), and erythrodermic psoriasis (bright red, burned-looking skin all over the body that is very itchy, painful; rarely seen).

How common is psoriasis?

Psoriasis occurs in 1.5% of people in the UK, appearing in people of all ages. Psoriasis appears to occur at a younger age in females but in adulthood occurs in more men than women. Most often, psoriasis begins between 15 and 30 years of age, and its occurrence decreases in older people.

What are the causes and risk factors for psoriasis?

Psoriasis is thought to run in families. However, psoriasis is more complex than this and requires the interaction between environmental factors or triggers and inherited genes. Psoriasis is often reported following stressful situations, cold dry weather, and skin injuries (e.g. cuts, scratches, and sunburn). It may also be triggered by infections, particularly those caused by Streptococcus (e.g. Strep throat), and occurs at a higher rate in people infected with HIV.

Some medicines also appear to induce or worsen psoriasis, such as lithium (for bipolar disorder), beta adrenergic blockers (for high blood pressure and heart diseases), anti-malarial agents (for malaria), antibiotics (e.g. tetracyclines and penicillin) and corticosteroids. There may also be an association between smoking and alcohol consumption and the development of psoriasis.

Psoriasis and other diseases

Other diseases have been associated with psoriasis but it is not known for sure if it is the psoriasis itself, psoriasis medicines, or lifestyle of the individual with psoriasis that causes these conditions. Such diseases include psoriatic arthritis, cardiovascular disease (heart disease and stroke), diabetes, depression, cancer (e.g. skin cancer and lymphoma), obesity, and other autoimmune diseases (e.g. Crohn's disease).

How is psoriasis treated?

Psoriasis cannot be cured but there are treatments to reduce the rate of skin cell turnover (thus reducing skin inflammation and plaques) and remove the scaly skin cells (thus improving the skin texture and appearance).

Topical treatments (creams, ointments, lotions and shampoos) include moisturisers, coal tar, salicylic acid, corticosteroids, vitamin D analogues, retinoids, immunomodulators, and anthralin. Moisturisers, coal tar and salicylic acid reduce dryness, itch and scaling. Corticosteroids that work by slowing skin cell turnover thereby reducing inflammation, tend to be used when psoriasis flares-up and stopped when patches improve. The vitamin D analogue, calcitriol, has an advantage over corticosteroids in that it does not cause skin thinning. Immunomodulators (e.g. tacrolimus and pimecrolimus) also do not thin the skin but their use is limited as the risk of skin cancer and lymphoma may be increased.

Light therapy or phototherapy involves exposure of the skin to ultraviolet light from natural sunlight or artificial light sources such as ultraviolet B (UVB), narrow-band UVB, and psoralen (a light-sensitising medication) plus ultraviolet A (known as PUVA). A little sunlight exposure can improve psoriasis but severe exposure can make it worse.

Oral treatments for psoriasis include retinoids (e.g. acitretin), methotrexate, cyclosporine, and mycophenolate mofetil that control psoriasis by suppressing the body's immune (defence) system and reducing inflammation. These medicines are used for more difficult cases of psoriasis and can have severe side effects. For example, methotrexate is associated with blood disorders; cyclosporine with high blood pressure; mycophenolate mofetil with infection; and women should not get pregnant when or for three years after using acitretin due to the risk to the baby. Generally, oral corticosteroids are not used as they can make psoriasis worse. We only prescribe topical treatments online.

‘Biologics’ or immunomodulator drugs, so-called because they modulate the immune system to prevent inflammation, are received by intravenous infusion or injection into a muscle or beneath the skin. Biologics (alefacept, adalimumab, etanercept, infliximab and ustekinumab) are used to treat moderate to severe psoriasis, and individuals who have psoriatic arthritis or who have not responded to other treatments. Because these drugs interfere with our immune system, there is an increased risk of infection and some cancers.

How can I help myself?

There are certain things that you can do to help manage your psoriasis. Bathing each day, adding oils or Epsom salts or Dead Sea salts to lukewarm water, and using gentle soaps, can reduce inflammation, remove skin cells, and improve your skin. Using a thick moisturising cream or ointment after bathing and frequently during cold dry weather will help your skin retain its moisture. Covering psoriasis after moisturising at night will reduce the redness and promote skin cell removal when bathing.

A healthy lifestyle (i.e. a balanced diet, exercise, maintaining a normal body weight, low alcohol consumption, and not smoking) will maximise treatment effects, reduce your risk of developing other diseases associated with psoriasis, and may improve your condition. Note what happens around the time your psoriasis worsens and try to avoid these triggers. Importantly, get informed about psoriasis and its treatment, and what will/will not help it.

Psoriasis can be difficult to treat and treatments do not always work for everyone. To ensure that you are using the treatment most suitable for your psoriasis, particularly if you have not seen improvement or you are experiencing side effects, contact us to discuss available treatment options.