Psoriasis has come a long way in the last decade. The "thick scales for life" reality our parents knew has been replaced by clear-skin outcomes for most patients — driven by phototherapy, modern systemic therapy, and biologics that target specific immune pathways. This page explains the full toolkit we use at Derma Essence.
Match the treatment to severity
- Mild (under 3 percent body surface): topical corticosteroids + calcipotriol (vitamin D analogue), gentle moisturiser, salicylic acid for thick scales
- Moderate (3 to 10 percent): NB-UVB phototherapy 3x weekly for 8 to 12 weeks, plus topicals
- Severe (over 10 percent or special sites): systemic therapy — methotrexate, cyclosporine, or biologics
- Scalp psoriasis: medicated shampoos (coal tar, salicylic acid, ketoconazole), steroid lotions, calcipotriol scalp solution
- Nail psoriasis: intralesional triamcinolone injections, biologics if widespread
- Psoriatic arthritis: co-managed with rheumatology — biologics often first-line
NB-UVB phototherapy — the cornerstone
For most moderate psoriasis patients, NB-UVB is highly effective and drug-free. Patient stands in a UV cabinet for 1 to 5 minutes, three times weekly. The 311nm wavelength suppresses the overactive immune response specifically in skin without affecting the rest of the body. Most patients achieve significant clearance by week 8 to 12. Maintenance every 2 to 4 weeks afterwards.
Biologics — the game-changer
For moderate-to-severe disease unresponsive to topicals and phototherapy, biologics target specific immune pathways:
- Anti-TNF (adalimumab) — older but well-established
- Anti-IL-17 (secukinumab, ixekizumab) — fast onset, effective for psoriatic arthritis
- Anti-IL-23 (risankizumab, tildrakizumab) — newer, longer dosing intervals
Most biologic patients achieve PASI 90 (90 percent clearance) within 12 to 16 weeks. Cost is significant; insurance support varies in India. We discuss options realistically based on your specific situation.
What we screen for on consultation
- Psoriatic arthritis — joint exam, morning stiffness questions
- Cardiovascular risk factors — psoriasis patients have higher rates of cardiac disease
- Metabolic syndrome — diabetes, obesity, fatty liver
- Mental health — depression and anxiety are common with chronic psoriasis
Psoriasis is far more treatable in 2026 than it was a decade ago. Book a consultation for a personalised assessment and treatment plan tailored to your severity.
