Traditional treatments for psoriasis varies greatly in accordance with the severity of the disease. Doctors usually treat mild cases with a combination of topical therapies, including corticosteroids, vitamin D analogs, tazarotene (Tazorac), and calcineurin inhibitors. Local adverse effects are common with topical corticosteroids and include skin atrophy, irritation, and impaired wound healing. Systemic effects, such as insomnia, high blood sugar, and facial flushing, occur with an extended course of high doses.5
For moderate-to-severe cases of psoriasis, doctors utilize both phototherapy (light therapy) and systemic therapy (medications that target the immune system as a whole, as opposed to only the regions with a psoriasis flare up).
The most common phototherapy used in psoriasis treatment is narrow-band UVB, which involves exposure to ultraviolet radiation on either the entire body or just the afflicted region. Its side effects consist of burning, skin aging, and skin cancer.6
The second most common phototherapy treatment for psoriasis is a photochemotherapy treatment known as PUVA (psoralen plus UVA), in which patients are given a drug called psoralen that helps the body absorb the ultraviolet radiation. PUVA’s side effects include all of the ones associated with narrow-band UVB treatment, with the inclusion of a few extras: itching, nausea, tanning, and eye damage.7
While the side effects of phototherapy sound scary, the adverse impacts of systemic therapy aren’t much better. The most common systemic drugs prescribed for the treatment of psoriasis are methotrexate, ciclosporin, and acitretin. Their side effects include dangerous drug-drug interactions for people on other medications, cumulative organ toxicities after long-term usage, as well as, once again, a higher risk for skin cancer—not to mention depression, aggressive thoughts, and liver problems.
