Ointment psoriasis - what is the more effective ointment for psoriasis?

People who live with the diagnosis "psoriasis", I know firsthand how much depends on the correct choice of medication. This disease does not forgive mistakes in treatment and the negligent attitude to their health. An important role in controlling the symptoms of psoriasis play a well-chosen external therapy and just started treatment. A key principle in choosing treatment regimens, especially in the early stages of psoriasis development, is the principle of "do no harm" treatment should not strike at the health of the skin, provoking the emergence of unwanted consequences in the form of skin atrophy or syndrome. After all, the primary goal of therapy is to prolong the periods of peace and health of the skin without sudden and painful relapses and exacerbations.

ointment psoriasis

Hormonal ointments for psoriasis: cure or kill?

A common group of external agents for the treatment of psoriasis are ointments on the basis of special hormones. These substances have the property to suppress the activity of the immune system, reducing inflammation. Therefore, in severe exacerbations of psoriasis steroids administered systemically as tablets or injections. However, this approach is fraught with serious side effects: therapy hormonal changes the body, and withdrawal of drugs may lead to malfunction of the endocrine and cardiovascular systems.

Topical steroids (external hormonal) are partly devoid of dangerous properties of system of drugs based on hormones: the effect is manifested solely at the site of application. Their advantage is speed of action: a few minutes after application, patients notice a decrease in pruritus, and in the next few days significantly reduced the redness of psoriatic plaques, stops their growth, and peeling.

Unfortunately, the side effects typical for topical steroids — and no less serious: because of low immunity at the site of application, the skin becomes thinner and discolored, there is a risk of secondary infection. This, no doubt, complicates treatment. The most serious consequence of the use of topical steroids is the development of addiction. As a result, other products (even the topical steroids) already stopped to help, causing another, sometimes more severe relapse after discontinuation of the drugs. That is why the sale of topical steroids in Europe and the United States without a prescription is prohibited. Independent and uncontrolled use of these funds, which are classified as highly potent, unacceptable.

It is important to know! Addison's disease — a condition that develops due to prolonged medication of corticosteroids. In response to hormonal therapy alone adrenal glands cease to produce cortisol and other steroids, which is manifested by symptoms such as muscle weakness, loss of weight and appetite, lowering blood pressure, dehydration, heart palpitations and constant anxiety. In Addison's disease the doctors are not always able to restore adrenal function, so patients life prescribed hormonal therapy.

Most of the funds on the basis of topical steroids is inexpensive and sold without prescription, so the cases of abuse of this kind of psoriasis are common. Meanwhile, dermatologists do not recommend the use of local steroids is extensive (more than 20% of the surface of the skin) areas of the lesions, and to apply such funds to the sensitive areas of the body — face, neck, skin folds and diaper rash. It is desirable to completely abandon the idea to use hormonal ointments and creams without prescription: it is able to reduce the effect of the primary treatment, harm to health and provoke an attack of severe exacerbation of psoriasis.

The most common hormonal creams and ointments are based on the following substances:

  • betamethasone;
  • hydrocortisone;
  • mometasone;
  • methylprednisolone;
  • triamcinolone;

Traditional non-hormonal ointments for the treatment of psoriasis: will not be worse, but better?

Given the serious side effects of hormone creams and ointments, many patients prefer to treat psoriasis with a less "aggressive" medicines. Some of them are the heritage of folk medicine and traditional recipes of skin treatment, popular in the past.

The advantages of the traditional non-hormone treatments of psoriasis should be attributed its comparative with hormonal products safety, low cost and absence of serious side effects. The disadvantages of the different (often low) degree of efficiency and, in some cases, allergic reactions that develop in patients on the components of a means.

signs of psoriasis
  • Naftalan, Ichthyol, dermatological, based ointment of tar — anti-inflammatory and antiseptic. However, some of them cannot be used in the progressive stage of psoriasis, and large areas of lesions, while others (for example, coal tar ointment) have a certain effect, so they are not recommended to be combined with phototherapy. In addition, prolonged use of these drugs increases the likelihood of developing skin cancer. Traditional ointments have a strong smell and can stain clothes, therefore they are not very comfortable to use.
  • Special substances have anti-inflammatory and antimicrobial action, and cause increased exfoliation of dead skin cells that accelerates the healing process of psoriatic plaques. Among the possible side effects — the risk of inflammatory reactions, burning sensation and pigmentation of the surrounding healthy skin (staining of healthy skin and hair in brown color).
  • Herbal (ointments and creams based on aloe, elecampane, celandine, sage and other herbs) have anti-inflammatory and healing effects, prevent the development of skin infections. Aided in the treatment of psoriasis, complementing the effect of the primary treatment.
  • Moisturizers (creams and baby oil, cosmetics) are also auxiliary in the treatment of psoriasis and helps fight skin dryness and feeling of tightness of the skin. They are used in combination with drugs to enhance the effect of the therapy.

Non-hormonal creams and ointments, with a pronounced therapeutic effect: the clinically proven

Separately it is necessary to select a group of non-hormonal medicines which efficiency in the local treatment of psoriasis has been confirmed in clinical trials. Unlike ointments and creams of the previous group, the mechanism of action of these drugs is studied in detail. They have an undeniable advantage over hormonal products in connection with a higher safety profile. However, in the treatment of these assets should closely follow the application instructions and be aware of possible contraindications.

  • Pimecrolimus has high anti-inflammatory activity. However, be aware that in the case of bacterial or fungal skin application of funds on the basis of pimecrolimus is recommended only after treatment of the infection. Uncontrolled use of pimecrolimus may cause local immunosuppression in the skin (local suppression of the immune system), increasing the risk of joining a secondary infection to the affected areas of the skin. Therefore, in the US, for example, pimecrolimus is recommended only as a drug "second-line" treatment, that is, only in the absence of effect from other means of therapy. Pimecrolimus is prohibited for use by children up to two years.
  • The calcipotriol is a synthetic analogue of vitamin D3. Its action is based on increasing the level of calcium in the skin cells, normalizes the rate of their division and promotes the resorption of psoriatic plaques. Because of calcipotriol is hormonal remedy (which, after a series of biochemical reactions is converted to the active hormonal metabolite of calcium metabolism), there are a number of restrictions on its use. In particular, the calcipotriol does not apply if you lose more than 30% of the surface of the skin because of the risk of hypercalcemia. The latter can cause irregular heartbeat and muscle cramps. It is not recommended to apply a calcipotriol on sensitive skin areas (face, neck, folds). Means on the basis of this active substance have age restrictions. Of calcipotriol also not suitable as auxiliary means in case of treatment of phototherapy, because under the action of UV light causes photosensitivity and leads to the development of skin burns.
  • The pyrithione zinc. Due to the proven efficacy and safety of treatment, drugs for treatment of psoriasis based on this active substance can be attributed to the categories "Golden mean". Zinc is a organic and natural cure for the treatment of skin diseases. Its concentration in healthy human epithelium is about 20% of the total content in the body, and deficiency of this precious metal is accompanied by various skin lesions and impaired wound healing. Drugs with the active zinc (zinc pyrithione) have a whole set of specific properties (anti-inflammatory, antibacterial, antifungal), to help reduce itching, promote the development of ceramides (lipids) to the skin, which leads to restoration of its barrier function. Tools zinc pyrithione activate the so-called apoptosis (natural programmed death) pathologically altered skin cells and cells of inflammation, thereby activating the natural renewal of skin cells, reducing flaking and eliminating psoriatic plaques. Studies have shown that the active zinc has a comparable hormonal products efficacy and good safety profile as is practically not absorbed from the skin, has no annoying and damaging effect.

Ointment or cream?

Many of these medicines are produced in the form of an ointment and a cream. How to choose the most appropriate form?

  • Ointments are more dense and oily texture, which allows the drug for a long time is on the surface of the skin, especially if applied under a bandage.
  • The cream has a softer texture, easier to apply and absorbed faster, so that it can be applied, leaving the skin open, not using the bandages and not being afraid to stain clothing or hands. Usually, the cream has a pleasant smell that is also important for daily use.
  • Unlike ointment, cream, to a lesser extent an irritant, so it is best suited for application to the face, flexion of the joints, the areas with high sensitivity. Also ointment is not suitable for application on moist areas of the affected skin with liquid discharge. The cream is in this sense more universal.
  • Traditionally, the ointment of psoriasis presents wider, however, this imbalance gradually disappears — the market appears more and more new dosage forms in the form of creams, gels, and aerosols are convenient to use and especially suitable for application to inaccessible areas (e.g. the scalp).
the treatment of psoriasis

Looking for a balance of price and quality

Let's try to summarize the information in a table:

Group drug

The active ingredient

Action

Possible limitations and side effects

Hormonal creams and ointments

Betamethasone

Possess anti-inflammatory, anti-allergic (including anti-itching) and anti-edematous action. Hydrocortisone, methylprednisolone, and other tools also have a certain action (overwhelming local immunity of the skin).

1. Not recommended for use long-term (longer than 5 days) and often. 2. Can trigger the development of local complications:

  • discoloration and metabolic disorders in the skin;
  • syndrome;
  • the immunosuppressive effect can lead to the accession of secondary infection on the skin.
  • Contraindicated:
  • for use in areas with sensitive skin (face, neck, folds);
  • when large areas of the lesion (more than 30% of the skin).

Mometasone

Hydrocortisone

Glucocorticoid remedy

Methylprednisolone

Triamcinolone

Non-hormonal traditional means

  • Oil
  • Sulfur
  • Ichthyol
  • Grease
  • Tar

Possess anti-inflammatory and antiseptic.

  • Have a fairly low efficiency and no effect on bacterial and fungal agents (when joining a secondary infection of the skin).
  • Uncomfortable to apply (applied several times a day, often under the bandage, require very prolonged treatment, stain clothes and have an unpleasant odor).
  • Can cause irritation and dry skin, and allergic reactions.

A substance that causes the active exfoliation of dead cells from the skin surface:

  • dithranol
  • sulfur and salicylic acid

Cause increased exfoliation of dead skin cells, have anti-inflammatory and antimicrobial action.

Can cause inflammatory reaction, burning sensation and pigmentation of the surrounding healthy skin (staining of healthy skin and hair in brown color).

Non-hormonal drugs

Pimecrolimus

Possesses anti-inflammatory activity.

  • Not recommended in case of bacterial or fungal skin infections.
  • Can cause local immunosuppression in the skin (reduction of local immunity).
  • Contraindicated in children up to two years.

Of calcipotriol

Is a synthetic analogue of vitamin D3, promotes the resorption of psoriatic plaques.

  • Not recommended:
  • to apply if you lose more than 30% of the surface of the skin because of the risk of hypercalcemia;
  • apply to sensitive skin areas (face, neck, folds, scalp);
  • combined with the method of phototherapy in connection with the risk of receiving skin burns.
  • Contraindicated for patients under the age of six.

Zinc pyrithione

Has a complex action:

  • anti-inflammatory;
  • antipruritic;
  • protection against infection;
  • activating the natural renewal of cells of the epithelium for the elimination of the psoriatic plaques;
  • the restoration of the barrier function of the skin.
  • It has a high safety profile.
  • Has no restrictions on length of use and area of application.
  • Has no side effects (except individual intolerance).
  • Approved for use children with one year.

Psoriasis is a chronic disease so each patient it is important to find the optimum medicine that combines high efficiency and minimum side effects (and preferably at a reasonable price). And remember: before you start using any tool, read the instructions, all the possible contraindications and side effects, and also be sure to consult with your doctor. This will help to achieve the best results without injury.

ointment against psoriasis

Just started treatment for psoriasis is a key success factor. Remember that the sooner you begin to treat psoriasis, the less likely that you ever will have to resort to "heavy artillery" — hormonal means.

03.10.2018