Creams and ointments for the treatment of psoriasis
The treatment of psoriasis is a therapy aimed at achieving and prolonging the remission of the disease. Unfortunately, at this stage in the development of medicine, a complete cure is impossible.
Many people who first encountered this problem are wondering how to treat psoriasis and is there a cure for psoriasis?
The main drugs used to eliminate psoriatic plaques are topical agents: hormonal or non-hormonal psoriasis ointments , lotions, sprays, gels, creams, ointments. A cream or ointment for psoriasis is applied in a thin layer to the affected area of the skin several times a day. The duration of treatment depends on the composition of the drug, the severity of the disease, the age and concomitant diseases of the patient and other factors.
What is the difference between cream and ointment for the treatment of psoriasis?
When buying a product, pay attention to the release form. Both creams and ointments for the treatment of psoriasis are available in tubes or jars and may have a similar consistency. However, hormonal or non-hormonal ointments for psoriasis have a denser fatty base – bear or badger fat, lanolin, vegetable oils, grease, naftalan . Accordingly, the ointment provides a slow flow of the active substance into the skin cells. This makes therapy with an occlusive dressing possible: under the influence of a compress and due to the warming ability of ointments, the damaged (or keratinized) epidermis softens, and the skin becomes more susceptible to the action of the medicinal substance.
Creams are made on a lighter basis (water, vaseline oil or petroleum jelly, stearic alcohol, methyl parahydroxybenzoate , polyethylene glycol , propylene glycol), so they are quickly absorbed without leaving any residue and have a cooling effect. That is why creams are suitable for removing edema. Due to the structure, the active substance is quickly absorbed into the skin, including the subcutaneous fat.
Hormonal ointments and creams for psoriasis
Hormonal ointments for psoriasis are a remedy that is resorted to during an exacerbation of the disease. These drugs contain hormones of the glucocorticosteroid group . Hormonal drugs have a strong and fast action: in a matter of minutes, they relieve itching, reduce inflammation, and inhibit the growth of skin cells at the site of inflammation.
Glucocorticosteroid ointments and creams differ in their effect. Weak hormonal drugs are prescribed for adults or children with minor skin lesions. In the modern pharmaceutical market, weak -acting agents are represented by hydrocortisone ointment of various concentrations (0.1%, 0.25%, 1%, 5%). Moderately strong drugs contain hormones such as prednisolone, fluocortolone , prednicarbate . They are used in the chronic course of the disease, skin lichenification . Strong ointments and creams are used for extensive skin lesions. These include budesonide , betamethasone , halomethasone , mometasone , dexamethasone, triamcinolone, flumethasone .
Glucocorticoid drugs differ not only in the power of impact, but also in generations . The earlier generation means are less effective and have fewer side effects, the later ones, on the contrary, are highly effective, but they also have more side effects. In psoriasis, it is most preferable to use the drugs of the last at the moment, the fourth generation of glucocorticoids: mometasone furoate , methylprednisolone aceponate , hydrocortisone butyrate. They do not contain fluorine atoms, which means they reduce the severity and number of side effects.
Side effects from hormonal drugs for the treatment of psoriasis occur due to their uncontrolled, too long use, use in excess, or due to individual characteristics of the organism. The main danger is addiction to the drug, because of which it is necessary to increase the dose, which leads to an overdose and, subsequently, to a withdrawal syndrome. After discontinuation of the drug over time, the synthesis of its own hormones, as a rule, is restored without problems.
On the part of the skin , side effects such as skin atrophy, hypertrichosis, pyoderma, rosacea , folliculitis, hypopigmentation , striae , pustular or papular rash, increased burning sensation, itching, irritation, dryness, etc.
Side effects from the liver may also occur . A high concentration of synthetic hormones reduces the efficiency of this organ, which leads to a deterioration in both digestion and the state of the body as a whole. This is also why hormone therapy recommends a sparing diet and additional intake of sorbents and hepatoprotectors.
With improper use of glucocorticoids, the kidneys also suffer : calcium metabolism is disrupted, which provokes the formation of kidney stones, blood filtration worsens, and the permeability of cell membranes decreases. Cardiovascular activity is disturbed, arterial hypertension may develop.
Hormonal cream or ointment for psoriasis is usually applied 1-3 times a day, the duration of treatment is 5-7 days, followed by a decrease in dosage. Another treatment regimen may also be prescribed: at the beginning of treatment, strong drugs are prescribed for 2-4 days, and then weaker ones.
Glucocorticoid agents are used during an exacerbation and in small quantities. Due to the many side effects, these drugs are used only under the supervision of a physician.
Non-hormonal ointments and creams for psoriasis
Non-hormonal cream or ointment for psoriasis can be prescribed both together with a hormonal agent, and separately. Non-hormonal ointments can be used for a long time, as they are not addictive, but their effect usually does not come immediately, but after a few days or even weeks after the start of use. Unlike hormonal drugs, non-hormonal psoriasis ointment rarely causes adverse reactions.
The complex use of non-hormonal drugs can significantly improve the patient’s condition in chronic skin diseases.
Creams for the treatment of psoriasis have a similar therapeutic effect, but at the same time they have a light structure, are quickly absorbed and do not leave a greasy film on the skin. The active ingredients of the creams quickly penetrate the epidermis, providing a complex effect on all the symptoms of the disease.
For example, when applying Losterin cream , the effect is achieved due to its multicomponent composition. The composition of ” Losterin ” includes deresined naftalan , urea, salicylic acid, D- panthenol , Japanese Sophora extract and almond oil. This composition provides a simultaneous anti-inflammatory, antipruritic , exfoliating, antiseptic, softening and regenerating effect.
Positive dynamics in the form of a decrease in peeling, hyperemia and infiltration in psoriasis was noted 10 days after the start of daily use of Losterin cream .
The maximum effect was achieved after 20-28 days
Non-hormonal ointments and creams are designed to activate the body’s natural defense processes and balance the metabolic processes in the skin, in other words, create conditions for achieving long-term remission.
Let’s figure out how else you can treat psoriasis. So, very often salicylic ointment is prescribed for the treatment of psoriasis. Salicylic acid softens the epidermis, exfoliates dead cells and thereby promotes rapid cell regeneration. Paired with hormonal preparations, salicylic acid serves as a conductor for glucocorticoids in the deeper layers of the skin. The ointment with boronic acid (2%) has the same properties . The average course of treatment is 2-3 weeks, after which the effectiveness of the ointment is significantly reduced. It should be applied once a day with a thin layer on the surface of the plaques. Contraindications: kidney disease, allergic reactions, infancy.
Zinc is part of ointments and pastes and has a drying, adsorbing, anti-inflammatory and antiseptic effect. Zinc ointment inhibits the growth of psoriatic plaques and has a resolving effect on thickened skin areas with altered pigmentation. Zinc preparations are addictive, so it is recommended to use them in monthly courses with monthly breaks.
Salicylic-zinc paste combines the positive qualities of both products. At the same time, it relieves inflammation, and has keratolytic properties, and dries the wounds.
Solidol ointment also has keratolytic , softening and disinfecting properties . It consists of “industrial” oil, rosin, hydrated lime, boric acid, petroleum jelly, distilled water and herbal supplements. The components of the ointment are involved in the normalization of metabolism in the skin, however, the therapeutic effect is not observed immediately, but after at least one course of treatment, which lasts 2-4 weeks. The ointment is applied to the affected area and rubbed with soft massaging movements. The use of solid oil external preparations imposes certain restrictions: for example, the patient is not recommended to take a bath or shower more than once every 2 days. Side effects – an allergic reaction or the development of folliculitis. Solidol ointment should not be used by pregnant and lactating women, people with chronic allergies, kidney disease and children.
On the basis of solidol, cartalin ointment is made . It also contains lavender and eucalyptus oils, honey, vitamins A and D, lysozyme, salicylic acid, string and chamomile extracts. The ointment relieves inflammation, removes dead skin flakes and promotes cell renewal. The optimal duration of treatment is 1 month, the drug is applied to the affected areas 2 times a day. There is only one contraindication for use – an allergic reaction.
Tar creams and ointments are widely used to treat psoriasis. Tar can be coal tar, juniper, pine, birch, it contains organic acids and resins, phenol, xylene, toluene, benzene and more than 10,000 other substances. This product of natural origin is known for its powerful anti-inflammatory, desensitizing , locally irritating effect. Ointments have different concentrations – from 0.5% to 20%, their use depends on the severity of the skin lesion. Usually, treatment is started with drugs of low concentration and, if the skin reaction is positive, the concentration is increased. However, tar preparations have many side effects. So, the contact of the therapeutic agent with the sun’s rays should not be allowed, since a burn and the risk of developing a cancerous tumor are possible. Among other negative effects of using these ointments and creams are acne, an allergic reaction, exacerbation of psoriasis, folliculitis, headache, and vomiting. Tar preparations are contraindicated in patients with acne, exudative psoriasis and kidney disease.
Vitamin D is known to have a positive effect on skin health. However, it is contained in food in a very small amount, and its main share is produced directly by the body under the influence of sunlight. Therefore, creams with a synthetic analogue of vitamin D, calcipotriol, have been developed for the treatment of psoriasis . Under its influence, skin metabolic processes are normalized, pathologically rapid cell division and the inflammatory process are slowed down. Creams and ointments with calcipotriol are prescribed for a long time (from 1 month to 1 year). Among the most common side effects are exacerbation of psoriasis, hypercalcemia, and dermatitis.
Oil preparations are highly effective against skin diseases, including psoriasis. Naftalan oil, which is extracted in Azerbaijan, is especially valued in the Naftalan resort for more than a century. Naftalan oil is a mixture of hydrocarbons, cyclopentanoic acids and resins. Preparations with this component have a pronounced antipruritic , anti-inflammatory, antiseptic and analgesic activity, their use in most patients leads to a long remission (N. G. Tereshina, 1965). Naftalan -containing ointments should not be used for exacerbation of psoriasis, hemorrhagic syndrome, diseases of the urinary system, anemia, on large areas of the body. The main side effect is an increase in the affected areas, increased itching and the appearance of new plaques.
Ichthyol ointment is a disinfectant, antiseptic, epidermostatic , anti-inflammatory and analgesic agent, the active substance of which is the ammonium salt of shale oil sulfonic acids. Ichthyol ointment is especially useful for the treatment or prevention of skin infections that have developed against the background of psoriasis due to the vital activity of streptococci, staphylococci and yeast-like fungi. Mixed with Naftalan oil, ichthyol ointment, among other things, helps to normalize the metabolism in the skin, increases its elasticity and enhances regeneration. The main ways to use ichthyol ointment are simple application or glycerin lotion. The ointment has practically no side effects.
Sulfur ointment is available in two types: with a concentration of 10 and 33%. Ointment 10% stimulates the formation of young skin cells, softens the epidermis, eliminates itching and disinfects the skin. A more concentrated agent enhances blood flow and improves metabolic processes.