Psoriasis Treatment Options

Topical therapies are often the first line of treatment for mild to moderate psoriasis. These medications are applied directly to the affected areas to reduce inflammation, slow the growth of skin cells, and ease discomfort.

• Topical corticosteroids are the most commonly prescribed option. These help reduce redness and itching and vary in strength depending on the area of the body being treated. Vitamin D analogs, such as calcipotriene and calcitriol, help slow cell growth and can be used alone or in combination with steroids. Clobex® is a brand of super-potent topical corticosteroid formulated as a spray, shampoo, or lotion. It is reserved for short-term control of moderate-to-severe plaque psoriasis when rapid reduction in redness, thickness, and scaling is needed. Dr. Zeena Al-Dujaili typically employs Clobex in “rescue” or “induction” phases: patients apply a thin film once or twice daily over resistant plaques (or massage the shampoo
• Non-steroidal creams like tapinarof (Vtama®) and roflumilast (Zoryve®), two newer options, offer additional choices for patients who want to avoid prolonged steroid use. For sensitive areas like the face and skin folds, calcineurin inhibitors such as tacrolimus may be recommended.

For moderate to severe psoriasis, or when topical and light therapies are insufficient, oral medications may be prescribed. Traditional whole body medications such as methotrexate, cyclosporine, and acitretin work by suppressing the immune system and are typically used under close supervision due to potential side effects. A newer oral option is apremilast (Otezla®), a PDE4 inhibitor that works by reducing inflammation without broadly suppressing the immune system. Apremilast is often well tolerated and does not require routine lab monitoring, making it an appealing option for many patients.

Phototherapy uses ultraviolet light to reduce inflammation and slow the overproduction of skin cells. Narrow-band UVB therapy is the most common form and is effective for moderate to severe psoriasis. It is typically administered in a medical office several times per week. Patients whose symptoms are widespread or not responding well to topical treatments may benefit from phototherapy. While New Orleans Aesthetics does not currently offer in-house phototherapy, the practice can refer patients to local facilities that provide safe and controlled light therapy in a clinical setting.

Biologics are a highly targeted treatment option for moderate to severe psoriasis. These medications are derived from living cells and are designed to block specific pathways in the immune system that drive psoriasis inflammation. They are typically administered by injection or infusion and are used when other treatments have failed or when the disease significantly impacts a patient’s daily life. These therapies have shown excellent long-term results, with many patients experiencing significant improvement or complete skin clearance. At New Orleans Aesthetics, Dr. Al-Dujaili works with patients to determine the most appropriate biologic therapy based on disease severity, medical history, insurance coverage, and lifestyle.

Managing psoriasis is a long-term effort, and treatment plans may involve a combination of approaches. Patients may also rotate therapies over time to reduce the risk of side effects or resistance. At New Orleans Aesthetics, follow-up visits important to monitor progress and adjust therapy as needed. The goal is to maintain clear or nearly clear skin while minimizing side effects and disruptions to daily life.

In addition to medical treatments, lifestyle factors can play a role in psoriasis management. Dr. Al-Dujaili and her team educate patients on strategies to reduce flares, including avoiding known triggers such as stress, infections, skin injuries, and certain medications. Moisturizing regularly helps reduce dryness and scaling, and using gentle skincare products can prevent further irritation. Patients are also encouraged to adopt a healthy lifestyle, which includes a balanced diet, regular exercise, and avoiding smoking and excessive alcohol intake, all of which can influence immune function and skin health.