Ronald E. Reece, MD

Board Certified - American Board of Dermatology
1441 Liberty Street Suite 206
Redding, California 96001
530-246-0236

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           Psoriasis is a skin disease that affects between 1-3% of the population.  It can be seen in all ages. The cause of psoriasis is unknown; although research is actively being done to find a cure or adequate treatment.   Presently, it appears that T-lymphocyte activation plays a major role in causing the skin to replicate 3-4 times more rapidly than normal skin thus causing silver red scaling patches and plaques to form.
           Psoriasis classically is on the elbows, knees and trunk in scaling patches and plaques.   It can also being in a seborrheic distribution (scalp, underarms, and groin) or it can be diffusely over the entire body (erythrodermic psoriasis).
           Psoriasis is not contagious.  A diet with foods high in omega-3 polyunsaturated fats (salmon, herring, mackerel) and a diet low in red meats may improve psoriasis.  Stress is not the cause of psoriasis; although, many patients with psoriasis feel stress may trigger an outbreak. The key to treatment is to slow the replication of the cells of the epidermal layer (the top layer of skin)

Treatments: crude coal tar.   Crude coal tar in a variety of preparations have been used to reduce the patches of psoriasis.  One can soak in a tar bath with Balnetar or Cutar or wash with Polytar Soap or one can use a lotion or gel such as Estar Gel or DHS Tar Gel.  Note, topical tars can be irritating so use as directed.

Shampoos: There are many shampoos that are helpful for psoriasis.  Shampoos that cantain crude coal tar as described above such a Neutrogena T/Gel, Creamy Tar Shampoo, DHS Tar are available at DermatologistRx.com.  Salicylic acid, a keratolytic, present in Neutrogena T/Sal, DHS Shampoo are helpful in removing the scales seen.

Topcial Zinc:  Topical zinc has been shown to be helpful in psoriasis. Zinc can be found in DHS Zinc Shampoo and DermaZinc Spray.

Topical Steroids:  Hydrocortisone 1% and Pramoxine 1% (Prax Lotion)  are topical steroids available over the counter and can be used on the patches and scales of psoriasis. The best ways to use a topical steroid is twice a day for 2-3 days and then stop for several days.  Note, everyday usage of a topical steroid may thin the skin and may cause small blood vessels to form on the skin.

See the Dermatologist? Many of the more effective treatments for psoriasis are by prescription only. These include

•  Stronger topical steroids
•  Dovonex, a topical Vitamin D3 preparation
•  Tazorac, a topical retinoid
•  Anthralin, a topical tar derivative
•  UVB (ultraviolet light therapy)
•  PUVA (oral psoralen and UVA, ultraviolet light therapy
•  Methotrexate, an oral anti-metabolite that inhibits cell replication
•  Cyclosporin an oral anti-T lymphocyte inhibitor

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