1.INTERNAL OR SYSTEMIC TREATMENTS
Treatments by oral via (mouth) or by means of injections.

a) Metotrexato: Powerful drug that is administered in severe and extensive ways of psoriasis as well as in the arthropatic. It is usually ingested for via oral. This treatment can last several months and to be presented intermittently after the lesion improvement. It is recommended in serious cases and if other therapies fail. It is necessary to carry out blood analysis to control the liver operation.

b) Retinoids (neotigason): The etretinato and the acitretino are reserved for severe psoriasis ways (palm-planting pustulous, widespread pustulous, erythrodermic) and it is taken by oral via. Due to its risk of causing defects in the foetus, the females of childbearing should use effective birth-control methods during the treatment and for a 2 year-old period after stopping taking the retinoid. This is not applied to men. In both cases, blood should NOT be donated after having received treatment with retinoids since these are accumulated in the blood for a long time.

As for the retinoids it is relevant to outstand the acitretino appearance. This presents advantages regarding the etretinato as for it is removed more quickly from the blood since it is not accumulated in the fat. Also, it presents a smaller risk of inducing foetal bad formations. Recently the tazarotene has been introduced which there exist studies that indicate that provides improvements to 60% of affected people after eight weeks of use.

c) Ciclosporina: It acts reducing the interleukina-2 production which is a citoquina that intervenes in the T lymphocytes production, components of the immune system that intervene in the psoriasis. However, this REAPPEARS if a minimum dose is not kept. The ciclosporina is reserved for serious cases since it has secondary effects as the hypertension and can affect irreversibly to the kidneys. It is also a treatment that is applied to other illnesses like the cancer.
Given the immune background of the psoriasis problem, a very important drug in the illness treatment whose introduction has marked a before and a later, is the ciclosporina, an immune suppressor whose action consists on impeding the cellular expansion from the lymphocyte population when interfering the interleukina 2 action. Many patients with psoriasis improve by its use, although its action mechanism is too unspecific for the treatment and the secondary effects are important. The good news is that the ciclosporina has opened a new panorama in that the appearance of more specific and more intelligent immune regulatory therapies is glimpsed which might be thrown as selective bombs on the populations of “guilty” lymphocytes located in the lesions, leaving intact to the innocent lymphocytes. However, it is not to reject the traditional therapies that have been used up to now, since many of them will go evolving and they will be benefited from the new knowledge together to the responsible mechanisms for the psoriasis.

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d) Oral corticoids (synthetic): The steroids applied directly to an isolated lesion (inter-lesion injection) can be effective to remove the psoriatic lesions and they rarely produce secondary effects. Sometimes, small doses of an oral steroid are given during a short interval of time to control an outbreak. Usually, the intra-muscular injections and the pills are avoided in the routine treatments to their potential serious secondary effects: non controlled increase of weight (irreversible) and infarct risk that is almost sure, etc.

e) Anapsos: Obtained from the plant : Polipodium leucotomus, it acts as an immune regulator reducing the effects of certain lymphocytes with which an improvement of the psoriasis is gotten. The doses vary among 3-5 capsules of 120 mg every day. Adverse effects have not been described.

f) PUVA (photo-chemical therapy): A pill, psoraleno and the ultraviolet radiation (UVA) are combined. See phototherapy. PUVA means psoraleno + UVA. First the psoraleno is taken and after a while the UVA beams are applied in a special hospital booth.
The psoralenos come from a well-known plant in the old Egypt and it is a photo active compound (that is to say that reacts with the light) that is administered in pills and that increases the effect of the ultraviolet beams. It is used in serious patients that have not reacted to other therapies, with several sessions per week; if positive results are gotten a following-up treatment is provided. The psoraleno dose will depend on the patient's weight and in some people can cause nuisances like nauseas, headache and seasickness. There are other application ways: in baths way or applying it (“painting”) on the lesions directly, removing so the internal secondary effects of the pills, but there is bigger risk of burns and it is required a better UVA beams dosage that in this photo-therapy are different than those of the advices used in gyms and similar.

Cautions: The PUVA photo-chemical therapy is not applied when there exist a few plaques neither in pregnant women, children or patient with advanced varicose veins, liver and kidneys illnesses, etc. As it is known, the ultraviolet A radiation produces an effect of skin aging causing cancerous cells due to its continuous use.

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2. TOPICAL TREATMENTS

These are directly applied on the skin, as the tars, corticoids, calcipotriol, antralina, Burasil, emollient, baths, etc. The hands are generally used but in some cases they can be applied with paper gloves or plastic to protect the skin. Treat the affected area only.They are the most used since you can suspend them in any moment if you notice adverse results or to continue them if they are positive.

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a) Tars: The tars (coaltar) are maybe the oldest treatment against the psoriasis and they clarify the lesions. For the scalp, they can be used in form of shampoo, at the same time that there exist preparations to be added to the bath.
One of their inconveniences uses to be the unpleasant scent that varies depending on the composition since there exist a great variety of tars. Also in certain cases they can cause irritation, for what they should be applied before going to bed and cleaning in the morning. The tars are formed by thousands of different substances by what is difficult to discover which of them are the most effective. Cancerous effects have been reported.

Tars with UVB: The tars can be used in UVB combination. See photo-therapy. Also in combination with sunbaths. After their application caution should be kept with the sun exposition or the ultraviolet beams because the skin is sensitive and could be burned.

b) Antralina: It is highly irritating and stains the skin. For this reason, it should be only applied to the psoriasis plaques. It should never be applied to the healthy skin. The strongest compounds have been limited historically to their use in hospitals, although there exist new derived applied in external consultation, as well in the body as in the scalp. It is applied with gloves for not damaging the hands skin, allowing it to rest during some minutes on the affected part and cleaning it later on. c) Antralina and UVB: As the tars, it is also used in combination with UVB. See photo-therapy.

d) Corticoids: Their discovery was a revolution in the dermatology since they have many applications and are the most prescribed ones. They have anti-inflammatory effect, they are a medication of very quick action, they are not irritating, and they don't stain the skin neither the clothes. They cause local secondary effects in the skin (weigh loss, atrophies) and it is necessary to increase the dose gradually to produce the same effect. When they are stopped of using they can cause re-outbreaks of the illness with more force so that they should be applied following strictly the dermatologist’s instructions. They should not be stopped to apply suddenly. In a period of several days the dose will decrease gradually. There are many varieties and different powers.

e) Calcipotriol: This is a recent derived from the D vitamin that is applied in soft and mild psoriasis. It doesn't have colour neither stains the clothes but it is something irritating, especially in the face and in the skin folds. After its application it is important to wash well your hands to avoid its contact accidentally with the face, since it can cause irritation to some people. It regulates the cell differentiation, that is to say, how they are multiplied, and it moderates the keratinocitos proliferation stopping the cells growth in the epidermis. It also acts on the skin inflammation.

The maximum dose is 100 g of ointment per week in adults that it should not be exceeded because it can alter the calcium levels in the blood. As many medications, for lack of rehearsals, its security in the children has not been shown. The patients should be subjected continually to laboratory exams for a better control.
Those derived from the D vitamin appeared accidentally in scene, as many other drugs to be discovered that improved the psoriasis in affected patients that were treated with other pathologies. The Calcipotriol, external use, improves the lesions in many cases, although it does NOT get its total removal. At the present time new derived from the D vitamin are being researched but its benefits are not known against side effects.

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f) The Tacalcitol: It was discovered in 1986 in Japan and in the last three years it is being used in Europe (Great Britain, Germany, Austria and Switzerland). It is similar to the D3 vitamin that acts in similar form to the Calcipotriol, regulating the cell proliferation and differentiation that are part of the epidermis: the keratinocits.
Effective clinical rehearsals have been carried out in psoriatic patients with plaques and in a 58 sick people survey that were treated during an average of 25 weeks with tacalcitol once a day, an improvement obtained was qualified of good or very good in 57% of the cases. In all ways, and for not creating false expectations, it is convenient that the patient knows that the tacalcitol reduces the infiltration (plaques thickness), the erythem (the redness) and the hyper-keratosis (the flakes), but it does NOT remove them completely. In other studies in those the tacalcitol has been compared with the betametasona valerato and the ditranol an equivalent effectiveness was shown. In summary, although the tacalcitol has a similar effectiveness to that the middle-high power topical corticoids, it has the advantage of not producing atrophy (irreversible weigh loss of the skin), vascular scratches (small dilations of the capillary) nor grooves. "Allergies" have been neither described nor sudden lesion recurrence when stopping the treatment (rebound effect). The advantage that contributes on the tars and the antralinas is that it irritates less, it doesn't stain the skin nor the clothes.
The tacalcitol, compared with the calcipotriol, is a medication of similar but less irritating effectiveness, so that can be applied in the face and in the skin folds. It is more comfortable since it is only applied once a day and it reduces the time that the patients with psoriasis must devote to their treatment significantly. It is sure and well tolerated long term, with few secondary effects and 1% of the patients only presents skin irritation in the application area.

g) Burasil (Cream, Lotion): It is a combination of salicylic acid, urea, vegetable and animal primary oils, D3 vitamin, hialuronic acid and anti-inflammatory natural. Potent topical medication that removes the itching and the annoying scaling off, doesn't stain neither the skin nor the clothes. It doesn't have well-known side effects. In the whole patients it achieves 90% improvements up to for a year and more time, making sure that a positive result is available. It is applied 1 or 2 times a day in the affected areas and it should control its application according to the presented improvement. The plaques will disappear after 4 or 6 weeks of application in the body, and in the scalp in 2 weeks.

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It comes in two presentations: CORPORAL LOTION CREAM for the body and CAPILLARY LOTION for the scalp that should be supplemented with the TREATMENT CAPILLARY collagen with placenta and/or the REVITALIZING for better results. BURASIL therapy administration can be used permanently in combination with the holistic medicine and the natural therapy that are a new lifestyle. (See combined treatments). “Illness” means lack of harmony, and so the mind influences in the organism, the anguish, the contained emotions, the rejection feelings, the solitude, the anxiety generated by the STRESS and many other negative behaviour factors have a devastating effect on the health state general. Everything originates an imbalance that has as consequence the lack of harmony. The psoriasis is very variable as well as the quantity and the size in different moments, increasing or diminishing the lesions like reflect of the sick person’ emotional, psychic and physical state. The negative reaction to the permanent stress has consequences in the digestion and elimination system causing an increment of the toxins. The organism always tends to keep healthy and the skin that is an elimination organ, is saturated by toxins and it becomes an alternative system of waste accumulation.

A very good strategy in the psoriasis control is the use of a traditional medicine in coordination with other therapies according to the intensity of the illness. Keep in mind these combinations:

SOFT PSORIASIS : Burasil + natural therapy + sport
SOFT PSORIASIS : Burasil + natural therapy + puva + sport
MILD PSORIASIS : Burasil + natural therapy + yoga + sport
MILD PSORIASIS : Burasil + psychotherapy + natural therapy + sport.
SEVERE PSORIASIS: Burasil + psychotherapy + natural therapy + yoga + sport.
SEVERE PSORIASIS : Burasil + internal + puva + psychotherapy + natural therapy + yoga + sport.

h) Emollients or lubricants: Although some of them are not considered as medications they are the preventive basic and of maintenance treatment, since they keep the humidity, reduce the itching, increase the skin elasticity and avoid cracks. Although they are not as effective as other treatments they can help and they are enough in some cases. They should be applied daily.
They moisturize the skin, contain mineral oils (vaseline, paraffin, glycerine), vegetables oils (coconut, olive, sweet almonds, soy, sesame) or animal oils (lanolin, emu). The regular use of moisturizers can help to diminish the inflammation and the scaling off.

SEE: BURASIL CAPILLARY TREATMENT. Collagen with placenta, A, D and E vitamins, helping in the scalp treatment.

SEE: BURASIL CAPILLARY REVITALIZANTING, with placenta, A, D and E vitamins, helping in the scalp treatment.

3.PHOTO-THERAPY (ULTRAVIOLET LIGHT)

The ultraviolet light is used between 290 and 320 manometers, of high energy and of a bigger frequency that the visible one. The sunlight contains, in its luminous spectrum, the ultraviolet of three classes: UVA, UVB and UVC. This last one is that of most frequency and the most harmful but it hardly arrives to the Earth thanks to the ozone layer that protects us. The UVA and the UVB do arrive and they are used in many treatments.
The ultraviolet beams affect to the DNA molecule responsible for the cells genetic information, their metabolism and their reproduction, and they inhibit the cell hyper proliferation (exaggerated growth of skin cells in the psoriasis). The secondary, long term effect, is a bigger probability of skin cancer, so that it is necessary to protect with solar filters the most sensitive areas, especially the face, the nape, the hands and the genital. See Climate therapy. The ultraviolet beams are applied in special private use booths at the hospitals.
See: OTHER INTEREST SITES AND TOPICS.

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It can be combined ultraviolet beams with tars treatment (so-called Goeckerman’s régime), with BURASIL, with emollient or with topical corticoids. It is also mixed with retinoids or fish oil. The administration, according to the individual, can last several months and in the remissions it is also variable. It is applied in the whole body or in concrete areas (feet, hands, head, etc.).
In this way, enormous efforts are being done to restrict the issuing spectrum of UVB screen with the purpose of reducing the risk of suffering skin burnings and cancerous tumours. Regarding the PUVA therapy, this can be improved with the introduction of alternative psoralens, metoxipsoraleno, with less secondary effects. Finally, the introduction of the photodynamic therapy that combines the use of the laser with photo sensitive drugs opens new alternatives in the lesion treatment.

4.COMBINED TREATMENTS

In general they are all those previous therapies that combine at the same time several of the mentioned treatments, whether by applying them in the same day or alternatively. What is attempted is to reduce the necessary quantity of each medication with the purpose of minimizing its secondary effects, or to supplement the positive points of each one by accelerating the treatment process.
In the previous combinations (See Topical Treatments, Burasil) as well as the traditional medicine is so important, the psychotherapy, the natural therapy and the sport are too. Consider the following combinations:

SOFT PSORIASIS: Burasil + natural therapy + sport
SOFT PSORIASIS: Burasil + natural therapy + puva + sport
MILD PSORIASIS: Burasil + natural therapy + yoga + sport
MILD PSORIASIS: Burasil + psychotherapy + natural therapy + sport
SEVERE PSORIASIS: Burasil + psychotherapy + natural therapy + yoga + sport.
SEVERE PSORIASIS: Burasil + internal + puva + psychotherapy + natural therapy + yoga + sports.

The psychotherapy: Because it is very important to identify what aspects, person or situation of the patient's life can be generating him anxiety, anguish, insecurity, depression and stress in general.

The natural therapy: It has been proven (and the same patient can show it) that the consumption of natural products benefits the psoriasis healing highly. At the same time, products that contain toxins and preservatives harm it.

The sports (recreational) and the outdoors or play activities, music, theatre, etc., are the best way of removing the anxiety, the anguish, the insecurity, the depression and, the stress in general. The sport and the outdoors activities regulate the body, relax the muscles, improve the blood circulation, the digestion and the whole organism.
These previous considerations help to understand the reason of the growing popularity of the alternative medicine and in other therapies and helps like optional way of treating the psoriasis in many developed countries.

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5. PSYCHOTHERAPY:

The psychotherapy treats the mind without using drugs. It is a complementary therapy broadly accepted as well as the conventional medicine and the alternative one. Many doctors have received training on it and they use it in the treatment of multiple illnesses. This way of psychological and advice treatment is useful to treat the shock, the emotional stress, the affliction, the divorce, the anger, the frustration, the anxiety, the depression, the addictions, the phobias and the dietary alterations. It liberates the traumas, helps to relax and alleviates the stress, something very necessary to be treated. It is an important part in serious cases of psoriasis when applying the method of combined therapies, and many sick people with psoriasis practice it with remarkable success.

The following combinations can be used:

Burasil + psychotherapy + natural therapy + sport
Burasil + psychotherapy + natural therapy + yoga + sport
Burasil + internal + puva + psychotherapy + natural therapy + yoga + sport

The specialist is able to provide a wide range of useful «tools», related with the autosuggestion and the qualified advice that provide the patient the trust to make the necessary changes in his life to improve his illness. This therapy is able to diminish the sick person tension, to relieve him and to encourage him, to help him to face to the social commitments, to stabilize his psychic state and to teach him to treat all the derived emotional reactions of the skin affection.
By means of the psychotherapy some physical symptoms can be diminished such as the itching and the appearance of flakes. It provides the opportunity to learn a new and more rational method of facing the daily problems presented by the psoriasis. And, even more important, it teaches to the patients to keep their energy. People with psoriasis take a great quantity of tension on the back, and this should be gotten free so that some improvement can take place.

6. BALNEOTERAPIA (baths, mud therapy)

Submerging the body in water or mud helps the skin to feel more comfortable and to reduce the itching that can accompany the psoriasis. Oils can be added, prepared of tars, salts or oats. The bathroom should last at least 15 minutes and it can be useful to remove the flakes that increase the plaques. When concluding it is advisable to apply moisturizers or oils. The thermal baths of mineral waters help to relax the body and to remove the flakes but they irritate and generate skin redness. Only you can evaluate their benefits.

7. CLIMATE THERAPY

It consists basically on taking sunbaths and sea baths. Some places are specially attractive, as the Dead Sea or the Canary Islands. In the Dead Sea they are favourable conditions, as sunlight with less UVB beams. This water contains a great concentration of salts and medical centres where you can find company of other psoriatic people. From biblical times it is an area recognized by its healing properties because the concentrations of bromide in the atmosphere are high there, which penetrates to the skin, what seems to have a beneficent effect in the psoriasis patients.

Further information about other medicines, therapies and help in the psoriasis treatment go to:
THE INDEX OF THE ELECTRONIC BOOK : “PSORIASIS?”

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