And do I need to treat it to keep it from getting worse?
There are many different treatments for psoriasis. Some may work better than others for a particular person, and their effectiveness may change over time.
For these reasons, it can be helpful to be aware of all available options. Broadly, treatments can be based by formula (how they’re given) or type (how they work). By formula:
Topical medications
Ointment: Medication in an oil-based vehicle (e.g.Vaseline and Aquaphor)
Cream: Usually medication in a base made of water mixed with oil
Solution: Medication in water or water mixed with alcohol, sometimes called a lotion
Foam: Medication in an alcohol-based or water-based foam (consistency similar to hair mousse)
Tape: Medication in an adhesive tape that sticks to the skin
Gel: Medication in an alcohol or water-based for-mulation with a thick consistency (similar to hair gel)
Spray: Medication in water and/or alcohol that is aerosolized into tiny droplets applied to the skin as a mist
Oral medications
Injectable medications
Subcutaneous: Under the skin
Intramuscular: Into a muscle
Intravenous: Into a vein
Ultraviolet light sources
Full-body light box
Hands- or feet-only light box
Natural sunlight
Hand-held light units
Lasers
By type:
Steroid-based medications: Topical steroids, steroid injections into local areas, steroid tape
Vitamin D analogs: Calcipotriene or calcipotriol (two names for the same medication) and calcitriol.
There is also a combination ointment that contains calcipotriene and the steroid betamethasone.
Vitamin A analogs: Tazarotene, acitretin
UV radiation and light-based therapies: UVB, PUVA, narrow-band UVB, tanning beds, lasers (excimer laser), natural sunlight
Nonsteroid immunosuppressants: Cyclosporine, tacro-limus (oral and topical), pimecrolimus (topical only), and sulfasalazine
Drugs that affect cell metabolism: Methotrexate, mycophenolate mofetil, and hydroxyurea
Biologic therapies: Infliximab, etanercept, alefacept, adalimumab, ustekinumab, and golimumab
The choice of treatments might be based on a variety of factors, including:
Effectiveness
Safety
Convenience
Facilities available in your area; light therapy and “day care” may require travel
Medicine preferences, such as topical medications vs. oral
Other diseases you may have
Other medications you are taking
Whether you have arthritis with your psoriasis
Insurance coverage of different therapies
The initial choice of treatment can be made with these issues in mind, and most people continue to change or adjust their psoriasis medication over time. It is important to know the various options available and to con-sider a different approach if a regimen loses its effectiveness.
Finally, it is not absolutely necessary to treat psoriasis, especially if very mild. Some people become concerned that psoriasis, if not treated aggressively, will continue to worsen.
This isn’t necessarily true. How psoriasis responds when treatment is stopped depends on the person’s underlying disease and which treatments they have been using.