The more potent the steroid, the greater potential for skin damage. That’s why steroids should be used with caution, especially if you have psoriasis.
To guide you in this matter, here are more tips on steroid use:
When stopping steroid therapy, taper off gradually. Stopping suddenly can cause a flare.
Steroids can cause skin damage not always apparent to the patient. A physician should check the skin periodically.
Steroids generally clear psoriasis lesions for variable periods of time depending on the individual.
Use steroid medications sparingly. In this instance, more is not better.
“Steroid creams and ointments do not smell or stain and are pleasant to use. Unfortunately they are not that effective in clearing plaques of psoriasis and the psoriasis tends to rebound after withdrawal, often in a more unstable form. Local steroids are therefore not recommended for chronic plaque psoriasis. Nevertheless, steroids are indicated for certain types of psoriasis. The skin on the face tolerates tar and anthranol (which were previously discussed in this series) poorly, and one percent hydrocortisone ointment is the treatment of choice; more potent steroid preparations should not be used,” explained Dr. S.M. Going, clinical assistant, department of dermatology at the Royal Infirmary in Edinburgh, in The British Medical Journal.
“Flexural psoriasis (which is characterized by well-defined red areas and minimal scaling) is another form where tar and anthranol are likely to irritate the skin and steroids are indicated. It is often useful to choose a preparation which combines a mild or moderately potent steroid with antifungal and antibiotic agent as secondary infection in these warm moist areas is often a problem. Systemic steroids should not be prescribed in psoriasis,” Going concluded.
Psoriasis can also be controlled using ultraviolet radiation. This can be done in two ways: through ultraviolet B or ultraviolet A therapy.
In the former, which is called phototherapy or UVB, the skin is exposed to shortwave ultraviolet light in a cabinet filled with 16 or more UVB lamps. This is effective against moderate to severe psoriasis, particularly those with small plaques or guttate psoriasis which is characterized by small pink macules or discolored spots on the skin. UVB therapy doesn’t work well in patients with very thick or big lesions.
Phototherapy can be done at home or at a physician’s office although the latter is preferable for advanced cases. The idea is to expose the skin to gradually increasing doses of UVB light until it turns pink.
When the skin becomes accustomed to a certain dose and no longer takes on a pink color, the UVB exposure time is further increased until the lesions disappear.
“The first exposure to the light is usually short, lasting as little as 15 to 30 seconds, depending on the person’s skin type and the number of UVB lamps in the unit. People with a lighter skin type are more sensitive to the UVB so they may start out with a lower exposure time than a person with dark skin,” according to the National Psoriasis Foundation (NPF) in Portland, Oregon. (Next: Enhancing the effects of phototherapy for psoriasis.)
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