The management of Psoriasis has made huge leaps forward over the last two decades. This has transformed our ability to treat this condition. The greatest advances have been in the realm of systemic biologic medications. These work by altering the immune system. They, therefore, are generally considered immune suppressants, weakening the immune system. Taking this into consideration, the best dermatologists worry about what this means for patients on biologic medicines for psoriasis during the time of the COVID 19 (Coronavirus) viral pandemic. Considering that, some patients are deciding to hold their biologic medication until the viral pandemic has ended.
Psoriasis Treatments During Viral Pandemic
So, can be done in the meantime for Psoriasis treatments during this viral pandemic? In answering that question, one of the greatest challenges is knowing when the COVID 19 crisis will end. Additionally, we worry that a second wave of the infection could occur down the road before a vaccine is approved and available. Right now, we are working under the assumption that issues with COVID 19 will be better sometime in the summer of 2020. This could be 2-3 months away or more. The good news is that several alternative things can be done in the meantime to help with your psoriasis.
Phase 1- The Basics of Psoriasis Treatments During Viral Pandemic
The importance of good care for dry and sensitive skin cannot be overstated when it comes to psoriasis. Dry skin begets more psoriasis. It is for this very reason that most patients with this skin problem are worse in the winter (dryer months). A few different measures can help with this issue.
- using a good thick moisturizing cream like CeraVe cream or Vanicream twice a day can be very helpful
- avoiding scrubbing or scratching areas of psoriasis also helps; friction tends to worsen the disease, so minimize that as much as you can.
- long hot showers and baths may also dry out the skin. Try to take a daily short shower or bath with warm (not hot) water. Use your moisturizer right after that.
Phase 2-Over-the-Counter Psoriasis Treatments
You can use a few different OTC treatments as a crutch to help control your symptoms during this time. Topical cortisone/steroid medications have been a mainstay of treatment for psoriasis for decades. Hydrocortisone 1% in the ointment version is the strongest of these medicines that you can purchase OTC without a prescription. A secret approach is to apply this, then wrap the affected area with saran wrap (or another similar plastic wrap)—this wrapping dramatically boosts the potency of the medicine. Of course, exercise caution with this approach in children due to the risk of suffocation if used near the head and neck region. For the same reason, never leave the wrap on when you sleep. Doing this 2-3 times daily for an hour or two for a few weeks at a time can be very helpful for psoriasis.
Hydrocortisone 1% in the cream version (instead of the ointment) can be used by a different approach—one we call wet dressings to also help control the rash or symptoms of psoriasis. With wet dressings, the hydrocortisone is first applied then soft towels soaked in lukewarm water are used to wrap the areas of application. These are left in place for 1-3 hours (based on how much time you have available). Done for 1-2 weeks at a time, wet dressings can greatly reduce symptoms of itching.
Remember to take a rest period after using your steroid cream. For example, you may use it for two weeks then rest for two weeks. Another approach is to limit use to 10 days a month.
Phase 3-Prescription Topical Treatments
We have numerous prescription treatments that can be used by our patients to better control their psoriasis. Generally, these include topical steroids and non-steroidal, and all are superior to anything OTC. These may be a temporary alternative you could switch to during the time of the viral pandemic, as they do not weaken the immune system.
Phase 4-Alternative Systemic Prescription Treatments
Many of the best systemic treatments for psoriasis can weaken the immune system. We still aren’t certain exactly how these may change your risk of getting Coronavirus or alter the outcome of those infected with it. Yet, we worry that they may increase the chances of someone coming down with the infection or having a worse result with it. Please refer to our earlier post on this for more details on these specific medications. https://www.midlandsderm.com/coronavirus-statement-2020/
However, a few systemic treatment options may be used that do not weaken immunity. Apremilast (Otezla) and Acitretin (Soriatane) are both medicines taken by mouth that are FDA-approved for psoriasis and do not weaken the immune system. These may be good alternatives for some patients with more severe psoriasis. Otezla may also help with psoriasis affecting the joints (psoriatic arthritis).
Advanced Dermatology of the Midlands | Best Dermatologist Omaha & Council Bluffs, IA | Board Certified Dermatologists
Remember, at Advanced Dermatology of the Midlands we are here to help. Barring unforeseen circumstances, we plan to keep our dermatology clinics open to serve patients’ dermatology needs during the viral pandemic crisis. Our dermatology providers deliver amazing care to thousands of patients with psoriasis every year.
Can’t make it in for an appointment or wanting to maximize social distancing by staying home? We now have telemedicine appointments (https://www.midlandsderm.com/teledermatology/) where you can have your visit with us right from the comfort of your own home. If we may be of any further assistance, please contact us to schedule a consultation. in any of our clinics in Omaha, Council Bluffs or the surrounding communities.