Psoriasis and Skin Care

What is psoriasis?

With psoriasis, your skin produces new skin cells too quickly. There is also an inflammatory reaction in the skin. The cells build up into clearly defined patches with scales. On fair skin, these patches are often red; on darker skin, the color may be different. Psoriasis is not contagious. The patches may calm down and then flare up again later. Sometimes your nails may change, or you may experience painful, stiff, or swollen joints.

Psoriasis can appear in various places, such as on your elbows, knees, scalp, or in skin folds. The location is important when choosing an ointment: the skin on your face and in skin folds requires different treatment than that on your arms and legs.

A basic ointment is part of the treatment

Use a basic ointment or rich cream without medication every day, even when your skin is calm. This keeps the skin supple and reduces dryness. Choose a product you like; your pharmacist can help you with this. A basic ointment nourishes the skin, while a medicated ointment treats inflammation or thickened areas. Often, you’ll use both. If you have a thick layer of scales, your doctor may recommend gently soaking them off for a short time first, for example with a greasy ointment or salicylic acid.

What medical treatment will you receive?

For adults, the doctor usually starts by applying a class 3 corticosteroid ointment to the torso, arms, and legs once a day for four weeks. This reduces inflammation. If that is not effective enough, a vitamin D-like medication, such as calcipotriol, may be added. This slows down the excessive production of skin cells. Sometimes both medications are combined in a single formulation. If the effect remains insufficient, the doctor will assess the next step.

For the face, skin folds, and children, the primary care physician usually prescribes a less potent Class 2 corticosteroid. If the effect is insufficient, the doctor may adjust the treatment, for example, by adding a vitamin D-like medication. On the scalp, a lotion, gel, or solution may be more practical than an ointment. The primary care physician will assess the effectiveness after about four weeks. In cases of severe psoriasis or insufficient response, a referral to a dermatologist may be necessary.

Proper application makes all the difference

Apply the medicated ointment to the prescribed areas and follow the schedule on the label. Do not use more or for longer on your own initiative. Are you also applying a base ointment to the same area? If so, wait at least one hour between applications. The pharmacist can demonstrate how much ointment you need, help you determine which ointment is intended for which area, and work with you to create a manageable daily schedule. Wash your hands after applying the medicated ointment, unless your hands are being treated as well.

What can the pharmacist do for you?

At the pharmacy, you can have your ointments reviewed: which ones are you using for what, in what order, and how much? We’ll help you choose a suitable base ointment, explain the use of corticosteroids and vitamin D-like medications, and discuss irritation or other side effects. If the treatment isn’t helping enough or the regimen is difficult to follow, we’ll work with you to find a solution and consult with your primary care physician if necessary.

When should you contact us?

Are the affected areas not improving, is the ointment causing irritation, or are you experiencing painful, stiff, or swollen joints? Contact your family doctor. If things are going well, the medicated ointment is often used less frequently. Be sure to continue caring for your skin with a basic ointment.

Read more about psoriasis and applying ointments on Thuisarts.nl. On Apotheek.nl, you’ll find explanations about the prescribed medications.

Sources: NHG Standard on Psoriasis, Thuisarts.nl, and Apotheek.nl.