The Newest Psoriasis Treatments Will Have You Wearing Short Sleeves Again
While there is still no cure for psoriasis, newer treatments allow people who live with this inflammatory skin condition to sport short sleeves once again.
"The newest biologics can take someone from having psoriasis to no psoriasis. They are completely clear," says Mark Kauffman, MD, an associate clinical professor of dermatology at Icahn School of Medicine at Mount Sinai in New York City. Given by shot or intravenous (IV) infusion, biologics are reserved for people with moderate to severe psoriasis. In the past, biologic drugs tended to aim their bow and arrow at tumor necrosis factor-alpha, which plays a role in the inflammatory cascade known to cause psoriasis. The latest biologics, approved by the Food and Drug Administration in the last five years or so, are more specific in their aim, making them that more effective and safer. They are even effective if someone has tried and failed or stopped responding to older biologics.
Bruce Strober, MD, of Central Connecticut Dermatology, agrees. "The most exciting new treatments for psoriasis lately are Tremfya, Cosentyx, Siliq, and Taltz, as they clear most patients who receive them and have very few side effects, and no need for blood test monitoring (except for a pre-treatment test for tuberculosis)," he says. Biologics do confer their share of risks, namely infections, because they work by suppressing your immune system. These drug are thought to be more "skin-specific" which means there is less broad immunosuppression and thus a lower risk for infections.
Find out the best skin care routine for psoriasis from top dermatologists.
Combo dream creams (or foams)
There is no cure for psoriasis. That said, there are some combinations of topical steroids and vitamin D that pack a one-two punch against its inflammation and scaling. These are helping people with moderate psoriasis get and stay clear. Taclonex ointment is a once-daily medication that is used for up to eight weeks to treat scalp and body plaque psoriasis. (This is also the only FDA-approved treatment for teens with scalp psoriasis, and the once-a-day regimen means teens are hopefully more likely to use the ointment as directed.) It also comes as a foam and goes by the name of Enstilar. The foam formulation may allow people to use it on larger body areas.
Find out the 10 things dermatologists wish you knew about scalp psoriasis.
Is this a newfangled psoriasis treatment? Not exactly, but a growing body of evidence suggesting that psoriasis is more than skin deep has made weight loss a key part of therapy. Psoriasis can increase the risk of heart disease and diabetes so doing everything to lower these risks is essential, Dr. Strober says. "Losing weight is key as is regular exercise, which can be difficult if people also have psoriatic arthritis," he says. And weight loss works wonders. In a 27-year review of clinical data, published in the journal Cureus, diet and exercise were considered effective treatments for psoriasis. Now learn the foods to avoid when you have psoriasis.
Phototherapy has been a mainstay in psoriasis treatment for years, but today's therapies are more effective and safer, says Dr. Strober. In particular, narrowband ultraviolet B (UVB) devices and excimer lasers can help clear psoriasis, allowing you to wear short sleeves again, he says. Both treatments use UVB light, which reduces inflammation, slows abnormal skin cell growth, and minimizes the plaques. The excimer laser zaps psoriasis plaques with a wand-like device that emits high-intensity beams of UVB light, and it works really well, he says. These treatments can be combined with other therapies to boost results. The downside? Both involve multiple trips to the dermatologist's office for treatments. Check out these must-ask questions for your next dermatologist visit.
There are even more treatments for psoriasis on the horizon: IDP-118 (halobetasol propionate and tazarotene) lotion is an investigational topical treatment for plaque psoriasis. Halobetasol propionate is a steroid that cools inflammation, and tazarotene is a topical retinoid that slows the rate at which skin cells develop. Both ingredients are approved to treat plaque psoriasis, but due to side effects, their use is limited to shorter durations. The new formulation may cut back on those side effects, allowing people to use the cream for longer periods of time. Stay tuned.
There are also new biologics being investigated that may be even more targeted, Dr. Kauffman predicts. Most available biologics are given weekly, biweekly or monthly. "It's plausible in the next five years, we will have biologics that are given once a year and then you will have no psoriasis for the rest of the year. It's the most incredible time in the treatment of psoriasis."
In the meantime, here are some natural treatments for psoriasis.
- Cureus: "Effects of Weight Loss on Psoriasis: A Review of Clinical Trials."
- Mark Kauffman, MD, New York, NY.
- Bruce Strober, MD, Cromwell, CT.
- National Psoriasis Foundation: "Moderate to Severe Psoriasis and Psoriatic Arthritis: Biologic Drugs."
- National Psoriasis Foundation: "Phototherapy."
- National Psoriasis Foundation: "Topical treatments."