Psoriasis

A few days back, one of my friends requested me to write on PSORIASIS. So here it is, my blog on Psoriasis.

Psoriasis is a chronic, non-contagious autoimmune disease that causes skin cells to grow too quickly, leading to thick, itchy, and scaly patches known as plaques. It commonly appears on the elbows, knees and scalp. With symptoms often cycling between flare-ups and periods of remission. Treatments include topical, phototherapy, and systemic medications.

Key Aspects

• Immune System Connection: An overactive immune system causes rapid cell turnover, accelerating the cycle from weeks to just days.
• Symptoms: Patches are typically silvery scales on lighter skin, and dark brown or purple with grey scales on darker skin. Symptoms include intense itching, burning, and dry, cracked skin.
• Types: The most common form is Plaque Psoriasis, but other types exist, including Guttate (small dots), inverse skin (skin folds) and Pustular.
• Triggers: Flare-ups are often triggered by stress, infections (like strep throat), skin injuries, and certain medications.
• Associated Conditions: About 10-30% of people with psoriasis also develop psoriatic arthritis, causing joint pain and swelling.

Treatment

Treatments aim to stop skin cells from growing so quickly and to remove scales. Options include creams and ointments (topical therapy), light therapy (phototherapy) and oral or injected medications.

Topical Therapy

• Corticosteroids– These drugs are the most frequently prescribed medications for treating mild to moderate psoriasis. They are available as oils, ointments, creams, lotions, gels, foams, sprays, and shampoos.
• Vitamin D Analogues– Synthetic forms of vitamin D- such as calcipotriene (Dovonex, Sorilux) and calcitrol (Vectical)-slow skin cell growth.
• Retinoids– Tazarotene (Tazorac, Avage, others) is available as a gel or cream. It’s applied once or twice daily. It is not recommended for pregnant or breastfeeding women or if you want to become pregnant.
• Other topical drugs are Calceneurin inhibitors for rash calming and reducing scaly buildup. Salicylic acid shampoos for the scalp, for reducing scalp psoriasis. Coal Tar is used for reducing scaling, itching and inflammation

Light Therapy

It is a first-line treatment for moderate to severe psoriasis, either alone or with combination of medicines.

• Sunlight– Brief, daily exposures to sunlight(heliotherapy) might improve psoriasis.
• UVB broadband– Control dosage of UVB broadband light from an artificial light source can treat single psoriasis patches, widespread psoriasis and psoriasis that does not improve with topical treatments.
• UVB narrowband-This light therapy might be more effective than UVB broadband treatment. It is usually administered two or three times a week until the skin improves, and then less frequently.
• Psoralen plus ultraviolet A (PUVA)– This treatment involves taking a light-sensitizing medication (psoralen) before exposing to UVA light. UVA light penetrates deeper into the skin than UVB light, and psoralen makes the skin more responsive to UVA exposure.
• Excimer laser– With this form of light therapy, a strong UVB light targets only the affected skin. Excimer laser therapy requires fewer sessions than does the traditional phototherapy because more-powerful UVB is used.

Oral or Injected Medications

Most of these drugs are used only for brief periods and might be alternated with other treatments because they have potential for severe side effects.

• Steroids– if you have a few small persistent psoriasis patches, your healthcare provider might suggest an injection of triamcinolone right into them.
• Retinoids– These pills are used to reduce the production of skin cells. Side effects might include dry skin and muscle soreness.
• Biologics– These drugs, usually administered by shot, alter the immune system in a way that disrupts the disease cycle and improves symptoms and signs of disease within weeks. These drugs must be used with caution because they carry the risk of suppressing the immune system in ways that increase the risk of serious infections.
• Targeted oral medications– They help to calm the immune system. These medicines are approved for moderate to severe psoriasis, especially when other treatments have not worked.
• Methotrexate– It is administered weekly as a single oral dose, it decreases the production of skin cells and suppresses the inflammation.
• Cyclosporine– It also suppresses the immune system

While there is no cure, treatments effectively manage symptoms, and reduce the frequency of flare-ups.

Alternative Treatments

Allopathy offers the fastest, most evidence-based relief for acute psoriasis, while Ayurveda focuses on long-term holistic detoxification (Panchkarma) to address root causes. Homoeopathy offers personalized, side-effect-free remedies. The best treatment depends on whether the goal is rapid symptom control (Allopathy) or long=term management (Ayurveda/Homoeopathy).

• Ayurveda– Highly effective for long-term remission by addressing the root cause (Dosha imbalance) through detoxification (Panchakarma) and herbs. It is safe, natural, and addresses the whole person, though it works more slowly than allopathy
• Homoeopathy– Focuses on treating the individual rather than just the disease, using diluted natural extracts, which are generally safe. It is reported to be effective, especially for treating root causes, though evidence is limited compared to allopathy.

The patient of psoriasis must choose the line of treatment which suits him/her better.

Anil Malik

Mumbai, India

22^nd April 2026

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