- With or without hormones?
- Hormonal ointment for psoriasis
- nonhormonal ointment for psoriasis
article summarizes the classification of ointments (more than 100), used for psoriasis, describes the main group of hormonal and non-hormonal ointments, their advantages and disadvantages, the therapeutic properties and side effects.
psoriasis treatment is never easy.With regard to the stage of disease dermatologists elect initially means and methods of therapy, characterized by having lower toxicity and minimal risk of possible side effects.And only when there is no therapeutic effect, doctors turn to other, more active and "aggressive" means.This tactic is called "ladder of therapeutic interventions."
One of the first steps of this 'ladder' is a local treatment, ie,the impact on the affected skin with special ointments and creams.Only if these means do not give the desired effect, the skin of the patient undergoes treatment psoriasis irradiation (phototherapy, photochemotherapy, etc.)and then assigned to a patient taking medication orally or by injection - systemic treatment.
With or without hormones?
Depending on the medicinal substances contained in the ointment and "meet" for its therapeutic effect on psoriasis ointment all divided into two large groups: hormonal creams and ointments that do not contain hormones.
Hormonal ointments , which are so often prescribed for psoriasis doctors have both undoubted advantages and obvious disadvantages.The main advantage of ointments, corticosteroids - this is their capacity for early withdrawal symptoms.After their application is a rapid improvement, but this is only apparent and short-term effect: in the future the use of hormonal ointments can lead to serious violations of which the doctor is obliged to warn in advance and are usually listed in detail in the instructions of use.
The use of hormonal drugs is associated with the occurrence of the effect of the abolition of the drug, that is addictive when to stop applying the ointment becomes problematic, and the expected effect of the medicine is not giving.
Another important drawback of hormonal ointments - is the presence of a huge range of contraindications and side effects:
- part of the endocrine system of the use of hormonal methods leads to a logical reduction of the synthesis of their own hormones and disruption of the body's total hormone regulation.In most cases, after the end of treatment the concentration of own hormones stabilize, but over time this feature can be broken.
- liver also suffers from hormonal drugs: the presence of the synthetic steroid hormones in the body causes accumulation in it of various toxic substances.Gradually, the liver ceases to cope with them - there is a reduction of its functions and the deterioration of its circulation.Because treatment of hormonal ointments requires special care with the dosage and duration of treatment.
- The kidneys respond to the abundance of toxins in the body by reducing the permeability of cell membranes, glomerular filtration calcium retention in the body and the formation of kidney stones.Cardiovascular
- reception system responds to hormones increasing fatty acid content in the blood, as well as cortisone hormone, which a patient affected by psoriasis and so in excess.
Hormonal ointment for psoriasis
Today there is a huge amount of glucocorticosteroid drugs used to treat psoriasis.For convenience, they can be grouped according to their "base" of the active ingredient:
1. Triamcinolone - synthetic glucocorticosteroid, which is part of the following medicinal products: "Berlikort", "Kenakort" "Kenalog", "Nazakort""Polkortolon" "Triakort" "Ftoderm" "ftorokort".
All these drugs have anti-inflammatory, antiallergic, antipruritic effect and similar in effect to prednisolone.
The main side effects include itching, irritation, eczema development.Long-term use of products containing triamcinolone, increases the risk of secondary infection and atrophic lesions.
2. flumethasone, fludkortonol, fluocinolone acetonide as active ingredients are part of ointments for psoriasis as "lokakortena", "Lokasalen", "Lorinden", "Sinalar", "sinaflana", "Sinoderm""Ultralan" "Flukort" "Flunolon" "flutsinar".
This group has antiekssudativnoe hormonal agents, antiallergic, antipruritic, anti-inflammatory effect.
Adverse reactions - itching, burning, atrophy, stretching, hypopigmentation, iediscoloration, weakening natural color - from the skin, and prolonged use - the occurrence of systemic side effects.
3. mometasone - a potent synthetic glucocorticosteroid, which is part of the following drugs: "Avekort", "Gistan H", "Momat", "Momederm", "Mon", "Nasonex", "Silkaren", "Skinlayt""Uniderm", "Elokim", whose therapeutic properties and side effects similar to those of drugs and side effects of the previous group.
4. Hydrocortisone - synthetic glucocorticosteroids, which is the active ingredient of these ointments for psoriasis, "hydrocortisone ointment", "gioksizon", "Daktakort", "Korteid", "Kortef", "Latikort", "Lokoid", "Oksikort "" Sibikort "" Sopolkort "" Sulfodekortem "(with sulfur)," Fucidinum ".
Hydrocortisone is the most active hormone drug is able to inhibit the development of connective tissue at the site of inflammation.Because application of hydrocortisone may also be associated with the development of serious side effects of systemic action.
5. Clobetasol - glucocorticoid agent, which is part of ointments for psoriasis as "Dermoveyt", "Kloveyt", "Pauerkort ',' Skin-Cap '.
Clobetasol has antiproliferative, anti-inflammatory, anti-allergic, antiekssudativnoe, antipruritic effect.
When used for more than 5 days clobetasol leads to skin atrophy, dilation, iediffuse persistent expansion lumen of blood vessels, as well as the possible occurrence of systemic side effects.
6. Betamethasone - another synthetic glucocorticoid drug is contained as an effective drug in the following medicines: "Akriderm", "Belogent", "Beloderm", "Betazon", "Betakortal", "Betasalik", "Betasalin"" Betnoveyt "" Vipsogal "" Diprogent "" Diprospan "" Kuterid "" Flosteron "" Futsikort "" Celestoderm "" Tseleston "in conjunction with salicylic alcohol -" Belosalik "" Diprosalik "in combination with clotrimazole - "Triderm" in conjunction with calcipotriol - "Dayvobet" "Ksamiol-gel".
These drugs have the fastest anti-proliferative and anti-inflammatory effect, because they contain fluoride, which effectively hydrocortisone 30 times.Betamethasone also have vasoconstrictor activity and reduce local vascular permeability increased.
The main side effects of betamethasone are burning and dryness, atrophy of the skin, secondary infection, heat rash, allergic dermatitis.Possible systemic side effects.
7. budesonide - glucocorticoid agent, formed the basis of "Apulein" drugs and "Pulmicort" (issued in the form of suspensions for inhalation).
Budesonide has anti-inflammatory, anti-allergic and anti-pruritic properties.When using the drug for a period of more than one month may appear itching, burning, rash, dermatitis and systemic side effects occur.
number of side effects associated with the use of hormonal ointments, as they say, on the face.Because of their use as a drug is unacceptable without consulting a dermatologist.to the content ↑
nonhormonal ointment for psoriasis
As noted above, non-hormonal ointment for psoriasis have advantages in comparison with hormonal drugs.Firstly, they do not possess such a wide array of side effects and do not affect the level and balance of hormones in the body of a patient with psoriasis.Secondly, most of them more accessible to the ordinary purchaser, including costs.
nonhormonal ointment for psoriasis can also be present in the form of classification - depending on the material constituting the basis of medicinal product:
1. Apathetic ointments and pastes: «salicylic acid", "boric acid", "Zinc oxide", "Ointment zinc "," zinc Ointment sulfuric "," Pasta zinc-Naftalan "," Liniment boric-zinc ", which are made on the basis of lanolin or lard.
These funds are shown in the advanced stage of the disease.Salicylic acid is contraindicated in peptic ulcer disease, anemia, kidney disorders, pregnancy and other poisoning it can cause dizziness, impaired hearing, in more severe cases -. Convulsions, impaired renal function and liver.
2. Preparations containing tar (birch, coal, juniper, pine), have disinfecting, insecticidal and local irritating action.As a remedy for psoriasis, they are used because of their anti-inflammatory action and the ability to have an inhibitory effect on DNA synthesis.For drugs in this group include "Alfozil-Lotion", "Antraminovaya ointment", "Antrasulfonovaya ointment", "Antipsorin", "Liquid forests", "Kolloidin".
data treatment drugs need to start with small concentration and in limited areas of the skin.If portability is a good drug, the concentration is increased.Since tar has photosensitizing (and even phototoxic) properties during the period of treatment is necessary to avoid all kinds of exposures (sunny, UFO).
Tar and preparations based on it are contraindicated in patients with kidney disease, pyoderma - purulent lesions of the skin, as well as in the case of the exudative form of psoriasis.Among the side effects of drugs on the basis of tar - headache, vomiting, skin irritation, folliculitis, and dermatosis.
3. oil preparations: «Naftalan Ointment", "Ointment ihtiola-Naftalan", "Ointment" duty plaques "," Neftesan "," Losterin "have disinfectant, anti-inflammatory, resolving, anti-itching, peeling and someanalgesic properties.
oil-based preparations are contraindicated in the stage of progression of psoriasis, in the case of individual hypersensitivity and so on. Special care is needed in the appointment of patients with kidney disease with poor function, hemorrhagic syndrome, anemia.
as side effects during treatment may temporarily worsen redness and itching, lesions grow and have new elements.You may also experience neurotic reactions occur folliculitis, boils, dry skin, but gradually these side effects in most cases are.
4. Preparations containing mustard (dihlordietilsulfid or trihlortrietilamin): "psoriasin" and "Antipsoriatikum".They belong to the category of substance blister agents.In view of strong mustard toxicity drugs are prescribed in very low concentrations.
Application "psoriasin" and "Antipsoriatikuma" is contraindicated in cases of liver and kidney lesions, the presence of soak, ie,separating serous fluid through tiny defects in the epidermis foci of psoriasis, and allergic diseases and dermatosis advanced stage.In case of contact with the drug on the mucous severe damage may occur.
By side effects of drugs containing mustard gas, is their sensitizing effect on the skin, ie,the ability to increase the sensitivity of the skin and cause allergic reactions, the appearance on the skin pigmentation, as well as the ability to transform the old form of psoriasis in winter, or vice versa.Due to these properties the use of these drugs is limited in recent years.
5. Antiviral agents: «oxoline", "interferon", "Tebrofen".The effectiveness of antiviral agents in the treatment of psoriasis has not been proved, nor disproved.It should be noted as an undoubted advantage of these funds is the fact that they usually do not cause side effects and is quite well tolerated by patients.
6. Cytotoxic agents:
- anthracene derivatives represented 4 generations of drugs:
«Chrysarobin" (1878);"Anthralin" "Dithranol" "Tsignolin" (1916);"Triatsetooksiantratsen" "Eksolan" (1967);"Bunantron" (1989).For the latest developments in this area are "Anthralin" drugs "Dithranol", "Donelvin", "Triatsetooksiantratsen", "Tsignolin";
- antimetabolites: «5-Fluorouracil", "Methotrexate", "Polimerol", "Psorkutan".Antimetabolites have as side effects such as pain, redness and swelling, erosion, and dermatitis.
7. Herbal preparations: «Kolhaminovaya ointment" ointment in a series of clary sage, ointment tincture of Siberian Ginseng (or devil) on the basis of solidolovoy "Plantozan-B", "Psoriaten" mustard essential oil and other homeopathicdrugs.
These drugs are designed to stimulate the body's natural defense system and promote the natural healing process.Positive qualities homeopathic remedies is that they are nontoxic, do not provoke allergic reactions and adverse side effects.
On the other hand, the use of homeopathic remedies rarely gives the expected or even any apparent therapeutic effect.This also applies to homeopathic preparations of general action ( "Loma psoriasis" and others.).
Thus, there is a huge amount of ointments used in the treatment of psoriasis. Their therapeutic effects and possible side effects - especially individual phenomenon, because, unfortunately, it is impossible to foresee how the particular tool will be useful or dangerous to the individual patient .That's why you should not be excessive autonomy in the selection of an external agent for psoriasis: it is best to seek help from a qualified doctor.