From healthline.com
Topical corticosteroids are the first-line treatment for mild psoriasis, and other options, like vitamin D analogs, are often considered as well.
Detecting and treating psoriasis early, especially in its mild stage, can prevent the condition from worsening and minimize the risk of complications.
Mild psoriasis is often manageable with topical treatments, such as corticosteroids and vitamin D analogs, which help reduce inflammation and slow skin cell turnover.
Here’s a look at the different treatments and their effects.
Mild psoriasis is a less severe form of psoriasis, characterized by a few dry, discoloured patches or plaques covered in silver scales. It usually affects less than
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How to recognize the early stages of psoriasis
Recognizing early psoriasis involves noting the following specific signs:
- Small red patches: Initial spots are often small, discoloured, and may be slightly raised.
- Dry or scaly skin: Patches can become dry and develop silvery-white scales, especially on elbows, knees, or the scalp.
- Itching or discomfort: Some areas may itch or feel uncomfortable, though this isn’t always the case.
- Nail changes: Psoriasis may cause nails to become pitted, ridged, or discoloured.
- Gradual spread: Spots may grow larger, merge, and develop more pronounced scales over time.
Early treatment for psoriasis focuses on managing discomfort, improving appearance, and maintaining skin health.
Prompt treatment helps control the condition and reduces the risk of the condition getting worse. While these treatments alleviate symptoms and inflammation, they do not cure psoriasis or address the underlying immune system dysfunction.
Dermatologists
Topical corticosteroids
Topical corticosteroids are often the
Common types include:
- hydrocortisone: over the counter; often used for very mild cases of psoriasis
- betamethasone valerate: prescription; a medium potency corticosteroid effective for managing flare-ups
- clobetasol propionate: prescription; a high potency corticosteroid used for more persistent symptoms, generally for short-term use
- fluocinonide: prescription; a high potency corticosteroid used for moderate to severe inflammation, typically for short durations
- desonide: prescription; a low potency corticosteroid suitable for sensitive areas and managing mild symptoms
However, care should be taken when using topical corticosteroids, as there is the potential for side effects, such as skin thinning. For this reason, healthcare professionals typically recommend low strength topical steroids for use in sensitive areas. It’s also important that topical steroids are not used for long periods of time or without close supervision.
Topical vitamin D analogs
Topical vitamin D analogs work by acting like vitamin D to help control the growth and turnover of skin cells. They slow down the rapid growth of skin cells and reduce inflammation, which helps to lessen the thickness and scaling of psoriasis plaques.
Here are the common types, all of which require a prescription:
- Calcipotriene: Calcipotriene is commonly used in treating plaque psoriasis and is often combined with other treatments.
- Calcitriol: This drug is primarily used for treating mild to moderate psoriasis and may be better tolerated by some patients.
- Tacalcitol: This drug may be effective for patients who do not respond well to other vitamin D analogs.
Topical calcineurin inhibitors
Topical calcineurin inhibitors are prescription creams or ointments, typically used for sensitive areas like the face or skin folds. They work by suppressing the immune response that causes inflammation and skin cell overgrowth.
These inhibitors are often chosen when topical steroids aren’t suitable or effective. Unlike steroids, they don’t thin the skin, making them a better option for long-term use in delicate areas.
Common types include:
- Tacrolimus (Protopic): Tacrolimus (Protopic) is often prescribed for its effectiveness in reducing inflammation and discoloration.
- Pimecrolimus (Elidel): Pimecrolimus (Elidel) is used for similar purposes, particularly in sensitive skin areas.
Combination topical treatments
Combination topical treatments pair two active ingredients, typically a corticosteroid with a vitamin D analog, to enhance effectiveness by reducing inflammation and normalizing skin cell turnover.
These treatments are often formulated into a single product like Taclonex (calcipotriene/betamethasone dipropionate).
Though this approach is sometimes used for mild cases, it’s more common in moderate psoriasis.
Keratolytics
Keratolytics are treatments that help soften and remove thick, scaly skin by breaking down the protein keratin. This process sheds dead skin cells and reduces scaling in psoriasis.
Keratolytics can be found both over the counter and by prescription, depending on the concentration and formulation.
Common types include:
- Salicylic acid: Salicylic acid is often used in shampoos, ointments, and creams. It helps remove scales and reduce inflammation.
- Urea: Urea is available in creams and ointments. It softens and hydrates the skin, making it easier to remove scales.
- Coal tar: Coal tar is used in shampoos, ointments, and lotions. It helps slow down the production of skin cells and reduce inflammation and scaling.
- Prescription topicals: Prescription topicals are drugs such as Zoryve and Vtama that come in the form of a cream and sometimes foam. Both are applied directly to your psoriasis plaques.
Targeted phototherapy
Targeted phototherapy involves exposing specific areas of the skin to ultraviolet (UV) light. This helps reduce inflammation and slow down the rapid growth of skin cells typical of psoriasis.
This treatment is usually administered in a dermatologist’s office or a specialized clinic.
Here are some common types:
- Narrowband UVB (NB-UVB): a type of UVB light that is more specific and effective for treating psoriasis; reduces inflammation and slows down skin cell production
- Excimer lasers: deliver high intensity UVB light directly to the psoriasis plaques, allowing for targeted treatment with minimal exposure to surrounding healthy skin
If your symptoms are not improving with current treatments, your doctor might switch to stronger options or combine therapies for better results.
For example, if over-the-counter moisturizers and hydrocortisone cream are not effective, your doctor might prescribe a stronger topical corticosteroid like betamethasone dipropionate or a combination treatment with corticosteroids and vitamin D analogs like calcipotriene.
When to contact your doctor
Signs that your mild psoriasis may be worsening include:
- patches or plaques spreading or growing larger
- plaques becoming thicker or more scaled
- more frequent or severe flare-ups
- affected areas becoming more uncomfortable or painful
- new patches appearing on previously unaffected areas of your body
- plaques becoming redder, swollen, or starting to ooze, which might indicate an infection
If you notice any of these signs or if your current treatment is not effectively managing your symptoms, it’s important that you contact your doctor.
Treating mild psoriasis is important to prevent symptoms from worsening and to keep symptoms manageable.
If you think you have mild psoriasis, it’s important to see a healthcare professional for proper diagnosis and treatment. Early treatment can help manage the condition and maintain better skin health.
https://www.healthline.com/health/psoriasis/psoriasis-stages-of-treatment-1
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