### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi, Ive scalp psoriasis since last 7-8 months and Ive tried all varieties of shampoo, cream all possible things but nothing worked. Now Im getting treated under homeopathy and some ayurvedic medicine and Im yet to see any result. Do you have cure for the same Im scared it should not affect other area of my body. Its causing lot of stress. Please advise if its curable and how many months will it take to cure psoriasis in complete.

### output:

Hello. Thanks for writing to us at Chat Doctor Psoriasis is a chronic disease. Till recently there have been no treatment which cures it permanently; it can recur after seemingly complete cure. However, there is a lot of research going on, and it may be possible that in the near future, we have a permanent cure for psoriasis. Nonetheless, treatments are plenty and well established to manage all grades of psoriasis. I am not sure if you should be trying homeopathic or ayurvedic treatment for psoriasis. I would rather suggest that you visit a dermatologist for a proper assessment, appropriate treatment and follow up at regular intervals. It is important to know about the triggering factors/exacerbation factors and avoid them as far as possible. Various triggering factors are :stress, alcoholism, sore throat, topical irritants like coal tar, pregnancy, certain Chat Doctor. Treatment of psoriasis is guided by the extent of involvement. It may remain limited to a few patches Or may extend to involve vast areas of the body. Limited disease is best managed with just topical applications (creams, ointments, gels, lotions, shampoos); whereas extensive disease (involving >20% body surface area) is usually managed with systemic treatments in addition to topical applications. Psoriasis is steroid responsive; the disease gets better with topical steroids, however, it may recur; sometimes as soon as you stop steroids. One has to be very careful in using steroids because though steroids are effective in psoriasis, one cannot use them forever because steroids can lead to side effects like skin atrophy if used over long term; moreover, steroids if stopped suddenly can lead to a rebound flare, which may be of increased intensity as compared to previous episodes.Therefore, while steroids are good for providing initial rapid improvement, they should be substituted with alternatives like vitamin D analogues like calcitriol, calcitriol once the initial rapid response is attained. Vitamin D analogues are devoid of the side effects of steroids and can also be used safely over long term; moreover rebound flare is not an issue with vitamin D analogues. Scalp involvement requires a coal tar+salicylic acid based shampoo, which can be used thrice weekly. Extensive disease on other hand requires systemic treatment in addition to topical. Methotrexate, Cyclosporin, phototherapy, Biologic response modifiers etc. are the treatment options for systemic use. You may ask more about these treatment options from your treating dermatologist. Psoriasis, as I said before is a recurrent condition, therefore I would suggest that you follow up regularly with your treating dermatologist. Your dermatologist can modify your treatment depending on the response. Regards