Biologic Therapy

Biological therapies are prescribed predominantly for those people with moderate to severe psoriasis who have failed to respond to other treatments, or are unable to take other medications for their skin. They target a part of the immune response that is problematic, and are either monoclonal antibodies or fusion proteins. These drugs are very specific and are expensive to produce, and their use is therefore governed by NICE (the National Institute for Clinical Excellence) ensuring that they are available to those patients who need them the most. Patients being considered for a biological therapy will be assessed by the Consultant.

All biologic medication is given by injection, either in the home (etanercept / Enbrel, adalimumab / Humira and ustekinumab / Stelara) or as an intravenous infusion at St Mary's Hospital (infliximab / Remacaide). The choice of drug will depend upon the severity of the condition, any contra-indications and personal preferences. Prescriptions for home injections are managed either by Healthcare at Home or Bupa Homecare, who deliver the drugs to the patient's home and send a nurse out to teach self-injection. Patients may stay on a biological therapy for many years, sometimes with short breaks in treatment depending on the drug and individual circumstances. As time goes on the treatment may become less effective, and it may be necessary to add in other treatment or switch biological drug. 

Phototherapy

This is the technical name for ‘light therapy’ in which ultraviolet (UV) rays are used to treat a range of skin conditions such as psoriasis, vitiligo, eczema, mycosis fungoides and dermatitis. But it can be combined with other treatments for a more effective response. It is carried out in the Beacon dermatology department. Treatment is limited to a maximum of once per year and has a life time limit of 300 UVB and 150 UVA per patient.

Its main purpose is to reduce skin inflammation and other associated symptoms. But this is a temporary relief: the symptoms often return when the treatment is discontinued.

This involves an average of 18-24 individual sessions to a maximum of 30 (with the exception of vitiligo which takes longer to treat). Sessions last from less than a minute to several minutes but the duration of each session gradually increases throughout the course of treatment. The patient needs to be committed to this treatment. It will only work if they undergo a series of sessions in order to get maximum benefits.

Iontophoresis Treatment

Tap water Iontophoresis involves applying a low intensity electrical current to the hands and/or feet or axillae by means of an Iontophoresis machine and water baths containing ordinary tap water. Exactly how tap water Iontophoresis works remains unclear; however the treatment has been shown to be effective in up to 98.5% of people making it a safe first line treatment option.