Treatment of Psoriasis – Which Therapy Is Truly Effective?
Millions of people suffer from psoriasis. Complete recovery is impossible, but in recent years highly effective treatment methods have become available.
Ointments, injections, or tablets — which psoriasis treatment is the best?
The Chief Physician of the Department of Dermatology at the University Hospital Essen, Professor Dirk Schadendorf, explains which approach works best.
Psoriasis is a chronic inflammatory condition of the skin. A characteristic symptom of the disease is the appearance of keratinized, scaling psoriatic plaques: pink, thickened patches covered with silvery scales. When removed from the skin, they may cause itching. Psoriasis can also affect the joints and nails, causing them to lose strength and become brittle.
One of the most common skin disorders
About 3% of the world’s population suffers from psoriasis. Around 2 million cases are registered in Germany alone. In many patients, the condition appears around age 50, while in others the first symptoms develop in childhood. Complete cure is not yet possible, but long-term remission and significant improvement in quality of life can be achieved.
The disease is based on a genetic predisposition. However, its development is influenced by many factors: environment, infections, stress, alcohol consumption, or mechanical skin injury. Any weakening of the immune system can trigger the condition.
The severity of psoriasis is measured using the PASI (Psoriasis Area and Severity Index), which indicates the extent and severity of the disease. A PASI score below 10 corresponds to a mild form, affecting less than 10% of the skin. A PASI score above 10 indicates moderate or severe disease.
Methods of treating psoriasis
For topical therapy, various medications and emollient ointments containing salicylic acid are used. They must be applied regularly for a long time, which is not always compatible with daily life. For this reason, scientists focused on improving systemic treatment.
To develop systemic therapy, physicians used the understanding of the central role of the immune system. Today, severe psoriasis is treated with immunosuppressive therapy using medications such as Methotrexate or Cyclosporine.
In recent years, a true breakthrough has occurred in therapeutic approaches to treating psoriasis.
A revolutionary advance has been achieved thanks to biological therapies, so-called biologics — innovative agents that suppress inflammatory processes by blocking receptors involved in inflammation. Ten biologic agents are approved for use as injections or tablets. They are usually administered every 3 weeks, and the newest generation — once every 3 months.
Biologics significantly improve the treatment effectiveness of severe psoriasis, especially when therapy is started early. Studies have shown that biologics can reduce the PASI score by up to 90%. For many patients, this results in long-term remission and stable disease control.
A disease affecting the whole body
In addition to skin involvement, psoriasis often causes comorbid conditions.
Today physicians know that psoriasis affects not only the skin but the entire body. Comorbid diseases frequently occur, reducing life expectancy by 5–7 years compared with individuals without psoriasis.
About one in five patients develops psoriatic arthritis, which affects the joints. The main symptoms are pain and restricted movement of the spine, finger and toe joints, and knee joints. In most cases, this leads to irreversible joint damage.
Another common comorbidity is metabolic syndrome, characterized by obesity, dyslipidemia, diabetes, and high blood pressure. Combined with chronic dermatitis, these factors increase the risk of cardiovascular diseases, heart attacks, and strokes.
Since biologics suppress inflammation throughout the body, they can also influence comorbid conditions. Clinical studies confirm the positive impact of biologics on psoriatic arthritis: joint inflammation decreases, and patients require fewer painkillers, reducing side effects. The effect of biologics on metabolic syndrome is still under investigation.
The impact of psoriasis on mental health
Due to visible skin lesions, patients often face negative attitudes from others. They may avoid public places such as beaches, swimming pools, or even public transport, which leads to social limitations and problems in personal relationships. Many patients require psychological support.
Close cooperation of specialists from different medical fields is essential.
To develop a comprehensive therapy plan, dermatologists collaborate closely with specialists from various medical fields. They examine not only the patient’s skin but also other organs and assess the patient’s psychological state. Together with patients, physicians determine realistic treatment goals and select appropriate therapeutic measures.
In addition to topical and systemic treatment, lifestyle and habits play a major role. Excess body weight, smoking, and alcohol consumption negatively affect the course of the disease.
Regular physical activity not only reduces the risk of cardiovascular diseases but also has a beneficial effect on psoriasis.
Psoriasis treatment in Germany
Psoriasis treatment in Germany is performed in specialized clinics. Information about the best dermatology clinics in Germany can be found in the dermatology section.
If you are interested in psoriasis treatment by Professor Dirk Schadendorf, fill out the online form or contact our consultants using the phone numbers listed on the website.
