Different psoriasis types and existing treatments

Psoriasis is a disease, the multiple causes of which are still virtually unknown and inadequately controlled, which explains why, to date, no drugs can fight this disease. The only pharmaceutical or medical answers in use today all have the same objective: to bleach psoriasis, to (more or less) remove its traces and leave the sufferer feeling more at ease, especially regarding the looks of others. However its resurgence is inevitable. Those with psoriasis or eczema are looking for an easy and effective treatment without negative side effects or leading to more damage.

Here is what the scientific community knows about psoriasis today: psoriasis is a chronic inflammatory skin disease which affects approximately 2 to 5% of the population, both men and women. The disease presents as red patches covered with whitish flakes which are raised from the skin ‘squama’.

The psoriasis patches are often located on the elbows, scalp and knees, but can also reach other parts of the body such as the face, the hands, the feet, the mucous membranes… Psoriasis is neither contagious nor allergy-based, but it is likely to be hereditary, in the form of a predisposition to developing the disease.

Psoriasis is a genetic disease, caused by a cluster of, not a single, gene, precipitated by environmental factors, both external: changes of season, friction from clothing… and internal: infectious diseases, psychological stress, taking certain types of medication...

Running parallel to the genetic and environmental factors, indicating a particular predisposition to develop the disease, specific immune reactions appear at skin level which maintain the psoriasis inflammation.
The psoriasis plaques are the consequence of an accelerated renewal of skin cells: approximately one week for “psoriatic” skin as opposed to one month for “normal” skin.

Psoriasis can occur at any age, but the first signs usually appear between 10 and 30 years. It is a chronic disease whose evolution is unpredictable: phases of recurrence follow phases of remission.

Psoriasis has a strong impact on an individual's quality of life. Due to its unaesthetic aspect and its resilience, psoriasis often gives rise to feelings of low self-worth, mental anguish and, with the passage of time, to depression.
Psoriatic people often have communication problems, particularly when their affected areas are visible: face, scalp and hands.
Psychological traumas – emotional upsets, bereavement, relationship breakdown or physical shocks - accidents, surgical interventions – are frequently the cause of first appearances and recurrences. Moreover, stress provokes new psoriasis patches, as a result of which the affected person can quickly become trapped in an vicious cycle.

Types of psoriasis

There are two types of psoriasis
• Type I, where the disease appears in the child or the young adult, with family antecedents, accompanied by a rather rapid evolution.
• Type II where psoriasis develops after 40 years, without family antecedents and accompanied by a more benign evolution.

Classifications according to lesion type

With regard to the type of lesion, one distinguishes:

Psoriasis Vulgaris. It is undoubtedly the most widespread form: it applies to 95% of people affected by the disease. The lesions, with well defined contours, are surrounded by a clear ring. This description covers various types of psoriasis lesions which cause itching in 60-70% of cases

Plaque psoriasis, by far the most frequent, circular in shape.

Guttate psoriasis, resembling small drops.

Flexural psoriasis, characterised by round patches a few centimetres in diameter.

Two more severe forms:
- pustular psoriasis
- erythrodermic psoriasis.

To find out more we suggest you go to: www.psoriasis-association.org.uk 

Treatment inventory

We propose here to draw up an overview of the existing treatments against psoriasis. This document is the result of the compilation of thousands of pages on psoriasis; however it does not claim to be exhaustive. Our objective is to present you with various alternatives suggested by doctors and also of the non-pharmaceutical treatments which answer the problem of psoriasis.

Our derma-cosmetics laboratory has developed non pharmaceutical treatments, of which the proven effects on psoriasis are undeniable: the Pso Natura® range. Pso Natura® is an organic, treatment, which is 100% natural. It can be an alternative to medical care or used complementarily with a medical treatment. Its excellent results and its ease of use have made it a treatment that is increasingly chosen by people suffering from psoriasis (guttate, patches).

To find out more about the various treatments for psoriasis, here is our overview:

Local treatments

Cream is applied to affected areas. 60 to 70% of patients use this kind of treatment. Some of the best known treatments are:

Corticosteroids - Containing cortisone. They have a favourable effect on psoriasis, but patches often return when the treatment is stopped. The best known and most popular are: Diprosone (ointment or cream), Diprosalic lotion for the scalp.
Risks: Dependency, which results in increased usage over time, however cortisone cannot be used daily over a long period. 
Risks: Resurgence of the disease.

Corticosteroid derivatives, treatments combining cortisone and calcipotrine (Vitamin D derivative) - Vitamin D is synthesized during exposure of the skin to the ultraviolet light of the sun. Calcipotrine treatments can thus replace, in particular, PUVA-therapy.
The most common are: Daivonex, Daivobet (calcipotriol betamethasone).
Risks: With a  high dosage, Calcipotriol becomes toxic.
Potential to be slightly irritating on skin.

Salicylic acid - best known: Salicylated vaseline 5%-10% (warning, not for children) – soothing action, known to alleviate fever. Used in preservatives. Anexeryl is an example.
Risks: Toxic in large quantities.

Tar – Very dirty and strong smelling, but effective. Notably, in particular, shampoos containing Cade oil, tar or carbodome. Emollient baths (Caditar soap, Aveenoderm, Polytar).  Another example is Coaltar.
Disadvantages: Soiling, requiring bandages for night time, and therefore very inconvenient.

PUVA-therapy (A or B ultraviolet rays) /Phototherapy – A recognized degree of effectiveness. Variable tolerance level according to patient. Can obviously be combined with other treatments.
Lengthy treatment: 8-10 weeks, with, generally, thrice-weekly dermatologist meetings.
Risks: Exposure to heliodermy (pigmentation) and risk of melanomas.

General treatments (or systemic)

They treat the body as a whole, distributing the medication via the bloodstream. Generally used in stage 2, after having tried local treatments. Systemic treatments are often heavy and can present mid to long term risks. 30 to 40% of patients are concerned. Treatment inventory (not exhaustive but generally complete):

Methotrexate: Well-known with 70% good results.

Retinoids – Properties closely resembling Vitamin A, for serious types of psoriasis which do not respond to other therapies. Frequent resurgence after stopping of treatment. In particular Soriatane.
Risks: Can cause birth defects if patient is pregnant.

Soriatane: Can cause hair loss, dry lips and dryness of the mucous membranes.

Cyclosporine: Most powerful of the general treatments. Immune-depressant, can produce positive effects, but also serious side effects mainly due to the weakening of the auto immune system.
Other risks: Renal toxicity, maximum 1 year duration.

NEW on the market!
ANTI-TNF ALPHAS: Some already on market but not earmarked for psoriasis. Also new, Alefacept. Intravenous treatment. Long length remission.
Disadvantage: Time constraining and treatment is repeated.

Alternatives to medical treatments

These alternatives are natural.

Pso Natura® … Naturally; Pso Natura® is a 100% organic, foaming, regenerating Complex. An organic, derma-cosmetic treatment, proven to deliver very convincing results to the problems of psoriasis squama with the use of our exclusive wild Carapa Procera. Follozing customer demand, we have developed other complementary treatments to treat the outside and inside of your body, our Rich Restructuring Cream, Dermatological Shampoo and our Detox and Zen capsules. The results speak for themselves as our customers leave their feedback.

Its advantages: Natural, organic, does not induce dependency, ease of application.

Sylvie Méliet, the founder of "Laboratoires des Mascareignes", and a psoriatic for more than 20 years testifies: “The most effective answer I know.” Results in approximately 1 month.

Essential oils (Phytotherapy): Namely burdock, wild pansy and salsaparilla. Can be useful. Warning, often greasy and very pungent. Ill advised to self medicate as some oils can be very toxic for the body. Very progressive improvement (but slow).

Aloe Vera - Results are often visible, but very seldom entirely removes the traces. Most effective: Freshly collected Aloe Vera, therefore not easy to find.

Cures: Double objective for these cures: local applications of “active substances” combined with patient relaxation (important since psoriasis is triggered by stress). Relatively effective, but often of short duration when one returns to normal life. The best known are:

- Dead Sea Cure: Minimum 2 weeks (avoid December & January, too little sun - and August, too much sun). Expensive, non-refundable (partially refunded by certain mutual insurance companies). Repeat visits necessary.

- Icelandic Blue Lagoon Cure: 37 deg hot water lagoon deep in the Icelandic countryside. Care necessary when exiting the bath… Very expensive due to all the extras (taxis to the countryside, hotels etc), but generally effective. Repeat visits necessary.

- Some 15 different cures in France (Avène, La Roche Posay etc…). 3 weeks. Total program similar to the above, sometimes with group discussions. Reduction of patches, rather than disappearance.

Homeopathy – More suitable for light psoriasis, less than 5 years. 3-4 months to see results and only in certain cases.

Chinese medicine - Based on the observation of the laws of energy circulation.  Take care to find a genuine professional. Can be helpful.

Others include certain known methods of treatment which can sometimes lead to results: Acupuncture, Sophrology, Hypnosis.

Nutritherapy: 3 best known alternatives
Nutritional methods by a Dr. Seignalet, who recommends returning to ancient food groups. Eating organic, removal of foodstuffs introduced by man. Very prone to controversy by experts.

There are also marine phospholipids, such as natural marine lecithin. Extracts of wild pelagic fish (rich in omega-3). Acts on liver, heart, brain.  Could have virtues against psoriasis. Studies still in progress to confirm this. An example being “Psoriacalm“. 9 gel capsules per day, minimum 2 months treatment.
Warning: Could cause thinning of the blood. A particular warning for people following an anticoagulant treatment.

Probiotics: Lactic ferments and bifidus, believed to have an influence on our internal wellbeing and thus on psoriasis. Presented as gel capsules. Consult a naturopath.

Psychotherapy: To reconcile oneself to the problem of psoriasis, for clarity and to decrease stress. Why not? Even if results are obviously hard to measure…