People who live with the diagnosis of psoriasis", do not know first hand about how so much depends on the correct choice of medicine. It is a disease that does not forgive mistakes in the treatment and negligence to health. An important role in the fight against the symptoms of psoriasis play with competence in selected outdoor therapy and in a timely manner began the treatment. A key principle in the choice of the treatment scheme, especially in the early stages of development of psoriasis, is the principle of "do no harm" — the treatment should not cause a negative impact on the health of the skin, causing the occurrence of undesirable effects such as atrophy of the skin or of a withdrawal syndrome. After all, the main goal of therapy — to extend the periods of peace and the health of the skin without sudden and painful recurrence and exacerbation.
Hormonal ointment of psoriasis: cure or kill?
Common of a group of outdoor funds for the treatment of psoriasis are ointment special based on hormones. These substances have the property of inhibiting the activity of the immune system, decreasing inflammation. Therefore, for severe cases of psoriasis, acute exacerbation of steroids is prescribed in a systematic way — in the form of tablets or injections. However, this approach is fraught with serious side effects: therapy changes hormone of the body, and the cancellation of medicines can cause failures in the functioning of the endocrine and cardiovascular systems.
Topical steroids (external hormonal tool) and, in part, devoid of the hazardous properties of the system based medications hormones: the effect manifests exclusively at the site of application. The advantage is speed of action: already after a few minutes after application patients have pointed to the reduction of the itch, and in the next few days is significantly reduced redness in the area psoriatic plaques, stops their growth and scaling.
However, unfortunately, the side effects are characteristic and for topics of steroids, and not less serious: because of the reduced immunity at the site of application, the skin thins and discolored, occurs the risk of accession of secondary infection. It is, without doubt, complicates the treatment. The most serious consequence of the application of topical steroids is the development of dependence. The result is that other tools (even the topical steroids) they cease to help, provoking criticism at times more strong relapse after withdrawal of the drug. That is why the sale of topical steroids in Europe and in the united states without a prescription is prohibited. Independent and uncontrolled use of these tools, belonging to the category of powerful, it is inadmissible.
It is important to know! Addison disease — the condition, that develops due to a long period of receiving corticosteroid medications. In response to the hormone therapy adrenal glands let alone to produce cortisol and other steroids, which is manifested by symptoms such as muscle weakness, loss of weight and appetite, lowering blood pressure, dehydration, tachycardia, and a constant feeling of alarm. In Addison's disease the doctors are not always able to restore the function of the adrenal gland, as a result, patients for life prescribe hormone therapy.
Most of the tools based on the topics of steroids is cheap and is sold without prescription, so the cases of abuse this type of treatment of psoriasis are common. Meanwhile the dermatologists do not recommend the use of local steroids with extensive (more than 20% of the surface of the skin) squares of injuries, as well as to apply such resources in the sensitive areas of the body — the face, neck, skin folds and place of diapers. Preference, and not to abandon the idea of applying the ointments and creams without the prescription of a physician: is able to reduce the main effect of treatment, harm to health and cause a heavy attack worsening of psoriasis.
More often than hormonal creams and ointments are manufactured in accordance with the following substances:
- betamethasone;
- hydrocortisone;
- mometasone;
- methylprednisolone;
- triamcinolone;
The traditional method of non-hormonal ointment for the treatment of psoriasis: worse than not and the best?
Considering the serious side effects of hormone creams and ointments, many patients prefer to treat psoriasis, using less "aggressive" medication. Some of them are common to traditional medicine and traditional recipes of skin treatment, popular in the past.
The advantages of the conventional treatment without hormones of psoriasis should be assigned to its comparison with hormonal security tools, low cost and absence of serious side effects. The disadvantages — different (often low) degree of efficiency and, in some cases, allergic reactions that develop with patients, the components of one or another tool.
- Naftalan, Ichthyol, dermatology, the ointment to the base of the tar sands — have an anti-inflammatory and anti-septic action. However, some of them may not be applied when a phase of psoriasis, and of large areas for the defeat, and others (for example, tar ointment) have a particular effect and, therefore, it is not advisable to combine with phototherapy. In addition, the prolonged use of these funds increases the likelihood of developing skin cancer. The traditional ointment is also a strong smell and can stain your clothes, that they are not very easy to use.
- Special substances have an anti-inflammatory and antimicrobial action, cause reinforced exfoliate dead skin cells, which accelerates the process of healing psoriatic plaques. Among the possible side effects — the risk of inflammatory reactions, burning sensation and pigmentation in healthy skin (healthy coloration of the skin and the hair in brown color).
- Herbal (ointments and creams the base of aloe vera, elecampane, celandine, sage, and other herbs) have an anti-inflammatory and healing actions, which prevent the development of skin infections. Are auxiliary in the treatment of psoriasis, complementing the main effect of the treatment.
- Moisturizers (creams and oils, cosmetics) are also auxiliary in the treatment of psoriasis and help to combat the dryness and feeling of tightness of the skin. Use them in combination with medications to increase the effect of performed therapy.
Method non-hormonal ointments, and creams, with a pronounced effect healing: clinically proven to
Separately, you should select a group of medicines non-hormonal, whose efficacy in the local treatment of psoriasis has been demonstrated in clinical trials. Unlike ointments and creams of the previous group, the mechanism of action of these drugs is thoroughly studied. They have an indisputable advantage before hormonal means of communication with a higher security profile. However, and in the treatment of these funds should be clearly adhere to the instructions for use, and learn about possible contra-indications.
- Pimecrolimus has inflammatory activity high. However, you should know that, in the case of the bacterial or fungal skin lesions, the application of tools based on pimecrolimus cream is only recommended after healing of the infection. When uncontrolled use pimecrolimus cream can cause local immunosuppression in the skin (reduction of the immunity local), which increases the risk of accession of secondary infection in the affected areas of the skin. Therefore, in the united states, for example, pimecrolimus is only recommended as a drug of "second-line" treatment, that is, only when there are no effects from other funds of therapy. Pimecrolimus denied the application of children of up to two years.
- Calcipotriol is a kind of synthetic vitamin D3. Its action is based on the increase in the level of calcium in the cells of the skin, which normalizes the rate of their division and promotes the reabsorption of psoriatic plaques. Because of calcipotriol is hormonal tool that after a series of biochemical reactions turns into an active hormonal metabolite calcium exchange), there are a number of restrictions on its use. In particular, calcipotriol does not apply when the defeat of more than 30% of the surface of the skin due to the risk of hypercalcemia. The latter may cause cardiac arrhythmia and muscle cramps. It is also not recommended to apply calcipotriol on sensitive areas of skin (face, neck, folds). Cleaning on the basis of this ingredient have age restrictions. Calcipotriol also is not suitable as auxiliary means in the case of a method of treatment of phototherapy, because under the action of UV rays causes photosensitization and leads to the development of a burn of the skin.
- Zinc pyrithione. Due to its proven safety and efficacy of the treatment, medicines for the treatment of psoriasis at the base of this ingredient can be attributed to the category of tools of the "medium term". Zinc is a organic and natural remedy for the treatment of skin diseases. Your concentration healthy epithelium of humans is about 20% of the total content in the organism, and the scarcity of this precious metal accompanied by a variety of skin lesions and the deterioration in the healing of wounds. Medicines with active zinc (pyrithione zinc), which have a variety of specific properties (anti-inflammatory, antibacterial, antifungal), to help reduce the itching of the skin, contribute to the preparation of ceramides (lipids) in the skin, which leads to the recovery of their barrier function. The tool zinc pyrithione activate the so-called apoptosis (natural desired default conviction) pathologically altered skin cells and inflammatory cells, thus, the activation of a natural renewal of skin cells, reducing flaking and eliminating psoriatic arthritis plate. Studies prove that the active zinc has comparable with hormonal means efficiency and good safety profile, as well as practically it is not absorbed from the surface of the skin, has no annoying and damaging steps.
Ointment or cream?
Many of the ones listed above are the drugs are released such as in the form of ointment, and in the form of cream. How to choose the most appropriate way?
- The ointment has a more dense and coarse texture, which allows the drug tool too much time to be on the surface of the skin, especially if infligi it under the bandage.
- The cream has a soft texture, easy to apply, and more quickly absorbed, making it can be applied, leaving the skin open, not using bandages and not afraid to stain clothing or hands. As a rule, the cream has a pleasant smell, which is also important when daily applied.
- Unlike ointment, cream, in the smallest degree, has the irritating to the action, therefore, is more suitable to be applied on the face, flexural surfaces of the joints, the sites with the highest sensitivity. Also, the ointment is not suitable for the application of weeping areas of skin affected with the liquid detachable. Cream in this sense, is more versatile.
- Traditionally, the ointment of psoriasis are presented in more broad, however, this imbalance is slowly stabilizing in the market there are more and more new pharmaceutical forms in the form of creams, gels, as well as aerosol, easy to apply and is especially suitable for application in areas inaccessible (for example, in the fibrous part of the head).
Looking for a balance of price and quality
We will try to summarize this information in table form:
|
The group of the medicine |
The substance |
Action |
Possible limitations and side effects |
|
Hormonal creams and ointments |
Betamethasone |
Have an anti-inflammatory, antiallergic (including antipruritic), and decongestant action. Hydrocortisone-a, methylprednisolone, and other means also have a specific action (overwhelming the local immunity of the skin). |
1. Is not recommended the application of long duration (over 5 days) and frequently. 2. May cause the development of complications locations:
|
|
Mometasone |
|||
|
Hydrocortisone |
|||
|
Glucocorticoids tool |
|||
|
Methylprednisolone |
|||
|
Triamcinolone |
|||
|
The traditional means of a method of non-hormonal |
|
Have an anti-inflammatory and anti-septic action. |
|
|
A substance that causes the active exfoliate dead cells from the surface of the skin:
|
Cause reinforced exfoliate dead skin cells to have an anti-inflammatory action and antimicrobial. |
Can cause an inflammatory reaction, the feeling of burning and pigmentation in healthy skin (healthy coloration of the skin and the hair in brown color). |
|
|
Method of non-hormonal medicines |
Pimecrolimus |
Has activity anti-inflammatory. |
|
|
Calcipotriol |
It is an analogous synthetic vitamin D3, promotes the resorption psoriatic plaques. |
|
|
|
Zinc pyrithione |
It has integrated action:
|
|
Psoriasis is a chronic disease, so each patient is important to find the best medicine that combines high efficiency and minimal side effects (and, preferably, by means of appropriate price). And remember: before you start using any tool, check the manual of instructions, all the possible contraindications and side effects, and also do not forget to consult your doctor. This will help to achieve the best possible result, without compromising the health.
In a timely manner began the treatment for psoriasis is a key success factor. Remember that the sooner you begin to treat psoriasis, the less likely that you'll never have to resort to "heavy artillery" — hormonal tools.