Best Psoriasis Treatment in Lahore, Karachi & Islamabad, Pakistan

Latest psoriasis treatments in Pakistan at COSMETIQUE can be easily compared with the top centers in the world. From topical treatments with different medicines in the form of creams, to Narrow Band Ultraviolet-B therapy, oral treatments including Methotrexate and Retinoids are freely available in Lahore. Now the most advanced treatments with biologic agents like Enbrel (etanercept), Humira (adalimumab) and Remicade (infliximab) are available at the Institute Cosmetique. Since these were the intravenous or subcutaneous agents with needles and discomfort involved, the latest oral treatment with with Apremilast (Apremist) is available as well. These PDE-4 (phosphodiesterase-4) inhibitors are the latest in the armamentarium in the fight against psoriasis. Fortunately all the cutting edge treatment options available at the most advanced centers in the United States or European countries, are available in Pakistan at the Institute Cosmetique, Alhamdulillah (Praise Be to Lord). Psoriasis is a skin disease in which red patches covered with silver or white colored dry skin scales appear on different parts of the body. There are two age groups that are mostly affected 20-30 years age and then another peak comes at 50-60 years of age for most patients. Psoriasis typically affects the skin of head (scalp), elbows, knees and lower back areas but may spread to other parts of the body as well. The skin lesions (red and scaly patches) are usually painless and do not itch, but they may be itchy in some patients. For most patients they are cosmetically unacceptable and a source of embarrassment and depression. Fortunately, in most patients the disease is limited to small portions of the skin like scalp only, whereas in other patients the skin may be involved extensively involving most of the body surface area.

Narrow Band Ultraviolet B has emerged as the gold standard for extensive psoriasis and is very convenient and extremely safe. In this form of treatment, we expose the patient's skin to violet-colored light called 'Narrow-Band Ultraviolet B' or 'Narrow-Band UVB'. We use our state-of-the-art special equipment made by Daavlin USA and National Biological Corporation, USA, which are the same phototherapy machines used at the best centers in the United States. You can read more about phototherapy here. For those who suffer from psoriatic arthritis, we collaborate closely with some of the most qualified rheumatologists in Pakistan. .
We provide the most comprehensive, advanced, and cutting-edge psoriasis treatment in Lahore. We encourage our patients to join the National Psoriasis Foundation online for free and extremely useful information.

A: In Pakistan, Psoriasis is commonly known as Chambal or Dadri. It is a disease in which the skin starts to accumulate and make thick scales which peel off like white sheets mostly on knees, elbows and scalp. Usually silvery scales are the hallmark of psoriasis. It can affect the skin of the scalp, face, body, armpits, groin and especially knees, elbows and lower back or sacral areas. It can affect virtually any part of the body. It may even affect children and the two most common age groups affected are between the ages of 20-30 years and then around 50-60 years.

A: Following are some of the treatments available for Psoriasis:
1. Topical Treatment using ointments, creams and lotions:
Different creams and lotions that contain certain specific medicines can be prescribed to be applied on the affected area. In most instances, such medicated creams and lotions are very effective especially if the area of psoriasis is small and it is practical to apply creams, lotions or oils containing the medications. Wonderful medications are available today to treat psoriasis very very effectively in most of the cases if the area is limited as it is difficult to apply the topical medications if too many small spots are present or the area is too large. This makes it difficult for the patient to cover all these spots and may take too much time and energy to apply the medication on all these areas. In such cases, we prefer to change the treatment to either the light therapy (phototherapy) or systemic therapy meaning the pills, capsules or injections.
2. Light Therapy / Phototherapy - Latest Narrow Band Ultra Violet B (NBUVB) or PUVA (psoralen orally or topically plus Ultra Violet-A (thus the name PUVA):
If the area of the skin involved is too big or the small spots of psoriasis are too many in number (in 100's), making it impossible for the patient to apply the medication on all these spots, then we consider the light therapy as the safest choice as it is only done from outside and does go into the body, like oral pills/capsules or intravenous injections. In old days PUVA was used and caused skin cancers if used for a prolonged period of time in white skin but the latest treatment with Narrow Band UVB phototherapy, no case of cancer has ever been reported anywhere in the world. So, alhamdulillah it is an extremely safe option. A special kind of light with a specific wavelength (311 nm in case of narrow band UVB) is used to treat the affected area. The patient is given timed and controlled exposure to light in a special computerized chamber, or with a handheld home use device if the area is too small. We use highly advanced machines by some of the finest brands in the United States for Narrow Band UVB therapy. Treatment with this special light is especially indicated if the area involved is too large to be handled with topical medicines or if the later has failed to treat psoriasis completely. Narrow Band UVB (NBUVB) therapy is the latest and highly recommended treatment available in the world today which has been available at Institute Cosmetique since it's inception in 2005, Alhamdulillah.
3.Treatment with oral and injectable medications
a. Oral Medications There are many inflammatory molecules involved in the causation of psoriasis and numerous oral medications including Acitretin, Mycophenolate Mofetil, Methotrexate and Cyclosporine are the options easily available in Pakistan. Although old, these are true and tried therapies with decades of safety records. So they can be tried in those cases where neither topical therapy nor phototherapy worked, or these were not the options to begin with. Such cases usually include the worst cases of psoriasis or psoriasis with psoriatic arthritis - arthritis caused by psoriasis. We work in close collaboration with some of finest Board Certified Rheumatologists in Lahore, Pakistan, to treat our patients of psoriasis who also have psoriatic arthritis. In such cases, we treat the psoriasis, while the rheumatologist treats the arthritis caused by psoriasis.
b. Latest Intravenous Biologics: There are many inflammatory molecules involved in the causation of psoriasis including a notorious molecule called as TNF-alpha. Most commonly used medications in this category are Enbrel (etanercept), Humira (adalimumab) and Remicade (infliximab) and Cosyntax are available at the Institute Cosmetique, in Lahore.
c. Latest PDE-4 (Phosphodiesterase-4) inhibitors (Apremilast)- Phosphodiastersae-4 has been implicated in the causation of psoriasis and it's inhibitors are becoming the leading treatment option in the treatment of psoriasis as well as psoriatic arthritis. The advantage is the availability of oral form, thus avoiding injections.