Systemic treatment

This term is used to refer to treatment which deals with other areas of the body as well as a skin condition. One example of this is treatment for moderate to severe forms of psoriasis which has not responded to topical treatment or alternatives, e.g. phototherapy.

Systemic treatment involves the use of medication in the form of tablets or injections which may be more effective. But these need to be monitored on a regular basis as there is a risk of side effects.

The other problem is that the symptoms may return once the treatment is discontinued or completed.

Examples of systemic treatment

These include:

  • Cyclosporine
  • Retinoids
  • Methotrexate

Cyclosporine

This is an immunosuppressant drug which is prescribed for severe forms of psoriasis. An immunosuppressant works by calming an overactive immune system which has turned on itself, causing skin inflammation and soreness. It slows down the growth of new skin cells.

Immunosuppressant drugs are given to people with autoimmune diseases or have undergone an organ or bone marrow transplant to prevent rejection.

There are risks with cyclosporine which high blood pressure and kidney damage. Your GP will explain the risks as well as the benefits of this drug with you. Plus it is only effective whilst you use it but once you stop then the symptoms will return.

Retinoids

These are Vitamin A derivatives which are available as a topical treatment and tablets (oral). They help control the skin life cycle as well as reducing any inflammation.

They are used to treat psoriasis and acne.

Psoriasis is caused by a speeded up skin cell life cycle which results in red, scaly, skin with a silvery covering which itches and flakes. Acne is a common condition in puberty and is caused by too much oil in the skin (from the sebaceous glands) which results in greasy, inflamed skin and spots.

Retinoids are used to treat acne and psoriasis.

There are risks associated with retinoids which include birth defects which is bad news for women who are pregnant or looking to start a family. Your GP will discuss this with you.

Methotrexate

This is an immunosuppressant drug which dampens down an over-stimulated immune system. It is used to treat psoriasis and works by calming an over-active immune system, preventing excessive skin cell growth and shedding.

It is taken in oral form or via an injection.

There are mild side effects with methotrexate which include nausea and tiredness. But there is also a serious risk of liver damage which means this drug is not suitable for people with anaemia or liver disease.

Your GP will discuss the risks of methotrexate with you.