Emollients psoriasis

Non-medicated moisturizers. Maintaining adequate skin moisture helps to control the scaling associated with psoriasis. Emollients restore skin pliability, reduce skin shedding, reduce pruritus, and help prevent painful cracking and bleeding.2 Non-medicated moisturizers may be liberally applied several times daily to help prevent skin dryness. Fragrance-free products should be selected when available. 

UVB light (290 to 320 nm) therapy is an important phototherapeutic intervention for psoriasis. The most effective wavelength is 310 to 315 nm, which led to development of a UVB narrowband light source, in which 83% of the UVB emission is at 310 to 313 nm. Topical and systemic psoriatic therapies are used adj unctively to hasten and improve the response to UVB phototherapy. Emollients enhance efficacy of UVB and can be applied just before treatments. Combining short-contact anthralin, calcipotriene, or topical retinoids to UVB may also improve results. However, topical application should be done after or at least 2 hours before UVB therapy because phototherapy can inactivate the topical product. UVB phototherapy may also be more effective when added to systemic treatments such as methotrexate and oral retinoids. 

Eczema is managed by emollients and topical corticosteroids. Fatty cream base is an emollient and is therefore indicated in eczema. Podophyllum is used in warts, lidocaine is an anaesthetic, calcipotriol is used in psoriasis and... 

Watsky, K.L., L. Freije, M.C. Leneveu, H.A. Wenck, and D.J. Leffell, Water-in-oil emollients as steroid-sparing adjunctive therapy in the treatment of psoriasis. Cutis, 1992, 50 383-6. 

Tanghetti, E.A., An observation study evaluating the treatment of plaque psoriasis with tazarotene gels, alone and with an emollient and/or corticosteroid. Cutis, 2000, 66 (Suppl. 6) 4—11. 

The first line of treatment is usually the application of topical products, ranging from over-the-counter products to topical steroids. Emollients may be used to reduce dryness and scaling, as well as reducing the hyperproliferation associated with plaque psoriasis. The use of vitamin D analogues, tazarotene, dithranol or coal tar preparations aims to lessen or remove the patient s scaly plaques. However, excess use can irritate the skin and their use is not recommended for the more irritant forms of psoriasis. Tar baths and tar shampoos (containing coal tar) may help with managing the condition. Treatment, if nonirritating, should be continued for 4-6 weeks and thereafter assessed. Emollients... 

Topical corticosteroids are usually given in combination with other topical treatments for the treatment of chronic plaque psoriasis. Sensitive areas, such as the face, should be treated with a mild corticosteroid and other areas, such as the scalp, with moderate to potent corticosteroids. In general, use should be maintained as early improvements in the condition are not maintained if use is halted. Such a pattern of use may worsen the condition, possibly causing a deterioration of the condition to unstable forms, such as erythrodermic or pustular psoriasis. Co-administration of topical medicaments usually involves alternating administration of each product. Scalp psoriasis is normally treated with softening emollients in combination with salicylic acid with coal tar or sulphur. 

An emollient such as aqueous cream will reduce the inflammation. The proliferated cells may be eliminated by a dithranol (antimitotic) preparation applied accurately to the lesions (but not on the face) for 1 hour and removed begin with 0.1% and increase to 1%. Dithranol is available in cream bases or in Lassar s paste (the preparations are not interchangeable). It is used daily until the lesions have disappeared it is irritant to normal skin and stains skin and fabrics. Tar preparations are less effective alternatives, and are commonly used for psoriasis of the scalp. 

Tazarotene. Tazarotene (Tazorac) is indicated for the treatment of stable plaque psoriasis. It is applied topicall) as a 0.05% or 0.1% emollient cream. It has been used on up to 20% of the skin. As with other topical retinoids, care must be taken to protect eye. mouth, and mucous membranes. and occlusive dressings should be avoided. 

Topical corticosteroids have been the standard approach for treating the inflammation and pruritus of AD. Typically used in shortterm reactive treatment of acute flare-ups, topical corticosteroids must be supplemented with emollients. Clinicians unfamiliar with topical corticosteroids find them a challenge to use, due to the numerous types, strengths, generic versus brand name formulations, and the wide variety of ways to use the products. The corticosteroids are ranked according to potency depending on vasoconstrictor assays (see Table 96-4 in Chap. 96, on psoriasis). Most commonly, the highest-... 

Kanzler MH, Gorsulowsky DC. 1993. Efficacy of topical 5% liquor carbonis detergens vs. its emollient base in the treatment of psoriasis. Br J Dermatol 129(3) 310-314. 

As with eczema, emollients can have beneficial effects on dry, cracked skin and may also reduce hyperproliferation in mild psoriasis. 

The applications of these dosage forms can be used for their physical effects, in that they act as protectants, lubricants, emollients, drying agents, and such. They may also be used for the specific effect of the medicinal agent present. Preparations that are sold over-the-counter (OTC) often must contain a mixture of medicinal substances for the treatment of minor skin infections, itching, burns, diaper rash, insect stings and bites, athlete s foot, corns, calluses, warts, dandruff, acne, psoriasis, eczema, pain, arthritis, and to supply warmth to aching joints. 

Uses Lubricant, emollient, solvent, cosolvent, conditioner in cosmetics, pharmaceuticals vehicle, solvent for pharmaceutical ointments, liniments castile soaps textile soaps sulfonated oils salad dressing and other foods softener for ear wax, crusts of eczema and psoriasis nutrient in food-pkg. adhesives defoamer in food-contact paper coatings, paper/paperboard... 

Important Treatment Modalities. Common ways of dealing with dermatological problems are topical treatments (such as ointments and creams) and oral treatments (drugs taken by mouth). Any bodily injury, irritation, or trauma that eliminates water, lipids, or protein from the epidermis compromises its function. Restoration of the normal epidermal barrier can often be accomplished using mild soaps and emollient creams or lotions. The often-cited dermatologic adage is If it is dry, wet it if it is wet, dry it. Consequently, wet compresses are a frequendy used remedy. A multitude of other topical treatments are available, from antibiotic, antiviral, or steroid ointments applied to treat infectious diseases or eczema to vitamin D derivative creams for psoriasis and retinoid creams for acne. Drugs can also be taken orally to treat a variety of conditions such as acne and autoimmune disorders. 

Traditional Medicine. Chippewa Indians used a strained decoction of the leaves used to wash sore eyes used by Iroquois in a compound poultice to treat rheumatism (moerman) also antirheumatic, galactogogue, gastroenteric diseases, toothache, swellings, antipuritic, demulcent, emollient, and vulnerary activity reported externally applied in poultices for boils, eczema, inflammation, psoriasis, sores, ulcers ointment also used to allay itching, weiss reports negative results as antirheumatic. 

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