Scalp Psoriasis Treatments Ladder

What is the Treatment Ladder?

As can be seen from the diagram above, the more powerful a treatment is, the greater its risk of adverse side-effects. Powerful medications tend to have side-effects that are more severe, dangerous, and of a permanent nature as they tend to affect fundamental mechanisms of the body. The concept of increasing risk and reward as treatments becomes more powerful, resemble climbing a ladder, which is where the name, treatment ladder originates.

In treating chronic diseases, the overall goal of treatment is to effectively control unwanted symptoms using the least powerful medications. The main reason for this is that patients and doctors want to minimize the risk of adverse side-effects. If a weaker treatment is effective in clearing scalp psoriasis, generally, there is no reason to use the stronger treatment with potentially higher risk. Secondly, the body is adept at building resistance to the effects of medication over time. It effectively builds a kind of immunity to the foreign effects of medication, and this effect can last for some time. Starting out with powerful medications at the higher level effectively cuts down on available options for the patient when the body builds a resistance to the stronger treatments.

The treatment ladder should be thought of as a general, but flexible guideline for treating scalp psoriasis. Depending on the situation, a doctor may suggest moving up or down the ladder. For example, during flare-ups, your scalp psoriasis may worsen significantly over a short period of time, thus justifying stronger treatments to control the flare. When the psoriasis clears or is reduced significantly, a weaker medication, or a different type of therapy altogether may be proposed. Mixing up different types of medication is also a sound strategy to prevent the body from building resistance too quickly.

In the subsequent sections, you can read more about the various treatments.