Treating Mild, Moderate, and Severe Psoriasis: Options You Should Know
Both the type and severity of your symptoms can impact your psoriasis treatment.
You can categorize psoriasis—a skin condition that causes red and flakey patches—in a few different ways. There are multiple types of psoriasis, and psoriasis can also vary by severity.
“Some of the things that determine severity of psoriasis include the body surface area involved, the degree of redness of the skin, the degree of thickness of lesions, and the degree of thickness of the patient’s scale,” says Suzanne Friedler, MD, dermatologist in New York City.
In addition to the physically visible symptoms, doctors also consider how much the psoriasis affects the individual’s quality of life. For example, a small amount of psoriasis plaque may have a disproportionate effect on an individual if it’s in a prominent location.
Treating Mild Psoriasis
Specifically, mild psoriasis is described as affecting less than three percent of the body’s surface area. Treating mild psoriasis involves a combination of medications (both prescription and over-the-counter), lifestyle changes to avoid psoriasis triggers, and a healthy skin care routine for psoriasis.
People with mild psoriasis can often treat their skin symptoms using over-the-counter products, according to the American Academy of Dermatology (AAD). These include the following:
Soaps, ointments, and hair care products containing coal tar
Hydrocortisone creams and ointments
And fragrance-free moisturizers.
However, some people with mild psoriasis may benefit from a stronger corticosteroid, which requires a prescription. Corticosteroids can help reduce the itch and the visible redness and scaling of psoriasis symptoms.
Treating Moderate and Severe Psoriasis
Moderate and severe psoriasis rely on prescription steroid creams as well, but they also many require additional therapies, such as:
Phototherapy: This treatment uses UVB light from a light box or light source to slow skin cell growth and suppress the overactive immune system. It’s also called light therapy.
Laser therapies: This treatment is a type of phototherapy that uses a laser to target affected areas of the skin with high doses of UV light.
Oral systemic therapies: These are medications that are used for people who have not been responsive to topical steroid creams or light therapy.
And biologics: This medicine is a newer treatment that is less toxic to the body yet extremely effective at reducing inflammatory attacks on the skin. Biologics are also effective for treating pain from psoriatic arthritis. (Learn more about biologics for psoriasis here.)
Regardless of your type and severity of psoriasis, your treatment plan is very individualized and takes many factors into account. “Please go see your dermatologist,” says Dr. Friedler. “Speak with them about what’s going to work the best for you.”
Dr. Friedler is a dermatologist and clinical instructor at The Mount Sinai Hospital and St. John's Episcopal Hospital.
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Psoriasis is a condition of autoimmune
dysregulation which causes your skin cells
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to turn over much more rapidly.
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So the skin ends up getting red and
very flaky.
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There are several different
types of psoriasis.
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There is a plaque type of psoriasis,
there is palmoplantar psoriasis,
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there are erythrodermic psoriasis.
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They do vary in their
severity among each type.
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Some of the things that determine severity
of psoriasis include the body surface area
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involved, the degree of redness of the
skin, the degree of thickness of lesions,
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and the degree of thickness
of the patient scale.
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Also the effect on
the patient's quality of life.
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Mild psoriasis is typically categorized
as less than 3% of the body surface area,
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moderate from 3 to 10%, and severe as
greater than 10% of the body surface area.
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But often times practitioners will also
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take into account patients'
quality of life as well.
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Mild psoriasis might involve
a smaller body surface area,
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but it really depends on how
a patient interprets it.
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If it's in a very visible
part of the body,
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then even mild psoriasis can be very
clinically relevant for a patient.
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No matter what type of psoriasis you have,
topical steroids are a mainstay of
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therapies, regardless if your
patient is mild, moderate or severe.
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However, in moderate and
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severe patients we will typically add on
additional measures, possibly UV light,
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laser therapy, oral systemic therapies,
and even biologics.
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Please go see your dermatologist,
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speak with them about what's
gonna work the best for you
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Psoriasis: tips for managing. Schaumburg, IL: American Academy of Dermatology. (Accessed on May 13, 2019 at https://www.aad.org/public/diseases/scaly-skin/psoriasis/tips-for-managing-psoriasis.)
Psoriasis treatment: biologics. Schaumburg, IL: American Academy of Dermatology. (Accessed on May 13, 2019 at https://www.aad.org/public/diseases/scaly-skin/psoriasis/diagnosis-and-treatment-of-psoriasis/biologics.)
Psoriasis treatment: coal tar. Schaumburg, IL: American Academy of Dermatology. (Accessed on May 13, 2019 at https://www.aad.org/public/diseases/scaly-skin/psoriasis/diagnosis-and-treatment-of-psoriasis/coal-tar.)
Psoriasis treatment: corticosteroids you apply to the skin. Schaumburg, IL: American Academy of Dermatology. (Accessed on May 13, 2019 at https://www.aad.org/public/diseases/scaly-skin/psoriasis/diagnosis-and-treatment-of-psoriasis/corticosteroids-for-the-skin.)
Psoriasis treatment: phototherapy. Schaumburg, IL: American Academy of Dermatology. (Accessed on May 13, 2019 at https://www.aad.org/public/diseases/scaly-skin/psoriasis/diagnosis-and-treatment-of-psoriasis/phototherapy.)
Traditional systemic medications. Portland, OR: National Psoriasis Foundation. (Accessed on May 13, 2019 at https://www.psoriasis.org/about-psoriasis/treatments/systemics.)
What psoriasis treatments are available without a prescription? Schaumburg, IL: American Academy of Dermatology. (Accessed on May 13, 2019 at https://www.aad.org/public/diseases/scaly-skin/psoriasis/diagnosis-and-treatment-of-psoriasis/what-psoriasis-treatments-are-available-without-a-prescription.)