Psoriasis Management
Understand · Calm · Maintain
Medical Understanding — Considered Care — Excellence on Harley Street
Psoriasis is a chronic autoimmune condition, not a skin problem with a cosmetic solution. Managing it well means working with its underlying immune mechanism — reducing the triggers that drive flares, calming inflammation safely, and supporting the skin with treatments that do not provoke the condition further.
Psoriasis affects around two per cent of the UK population and can begin at any age. It occurs when an overactive immune system accelerates the skin cell cycle from the normal 28–30 days down to as little as three to four days — causing immature cells to accumulate rapidly on the skin’s surface and form the raised, scaly plaques that characterise the condition. This is not a process that can be corrected by resurfacing or injectable treatments; it requires a medical approach that addresses the immune response directly.
At PHP Aesthetic-Wellness, Dr Philippe Hamida-Pisal and Dr Jihyun Byun are clear about what we can and cannot offer for psoriasis. Because psoriasis is a systemic autoimmune condition, the majority of aesthetic procedures — including microneedling, chemical peels, and injectable treatments — carry a meaningful risk of provoking the Koebner phenomenon: the development of new psoriatic plaques at sites of skin trauma. Our approach is therefore deliberately limited to the two modalities that can be used safely — LED therapy and prescription topical treatment — within a management programme that also addresses lifestyle triggers and coordinates with your wider medical team where appropriate.
Types of Psoriasis
Psoriasis presents in several forms, each with a different distribution, appearance, and management priority. Accurate identification informs every decision we make.
“Psoriasis is a systemic disease that happens to be visible on the skin. The most important thing we can offer a patient is honesty about what we are able to treat safely, and a clear path to the care that goes beyond what we can provide.” PHP Aesthetic-Wellness, 22 Harley Street
Our Treatments for Psoriasis
Given the autoimmune nature of psoriasis and the risk of the Koebner phenomenon, we offer two evidence-based treatments that can be used safely alongside medical management: LED phototherapy and prescription topical therapy. Both are appropriate for use during stable disease and selected flares, under clinical supervision.
LED Therapy
Narrowband red and near-infrared LED wavelengths have a well-established anti-inflammatory and immunomodulatory effect on psoriatic skin. By reducing the pro-inflammatory cytokines — including TNF-α, IL-17, and IL-23 — that drive the accelerated cell cycle in psoriasis, LED therapy slows plaque formation, reduces erythema and scaling, and relieves itch without any physical trauma to the skin.
LED phototherapy carries no risk of Koebner phenomenon, requires no downtime, and is safe for all skin tones and body sites. It is the only in-clinic aesthetic procedure we can offer during active psoriasis and is suitable for maintenance use between flares.
Prescription Topical Therapy
Prescription topicals remain the cornerstone of psoriasis management for mild-to-moderate disease. We prescribe and supervise a range of agents according to the location, severity, and subtype of your psoriasis:
Topical corticosteroids reduce inflammation and slow cell turnover. Potency is matched carefully to body site — higher potency for limbs and trunk, lower potency for the face, flexures, and genitals — and courses are supervised to avoid tachyphylaxis and skin atrophy with prolonged use.
Vitamin D analogues (calcipotriol, calcitriol) regulate keratinocyte proliferation and differentiation, reducing the accelerated cell cycle that produces psoriatic scale. Often combined with a topical corticosteroid for additive effect.
Coal tar preparations have anti-proliferative and anti-inflammatory properties and remain a useful option for scalp and chronic plaque psoriasis, particularly where steroid use needs to be limited.
Emollients are prescribed alongside all active treatments. Keeping psoriatic skin adequately moisturised reduces scale, relieves itch, and supports the barrier — the one area where we can directly assist regardless of disease activity.
Understanding Your Triggers
Psoriasis is a condition with a strong genetic basis, but the frequency and severity of flares is significantly influenced by modifiable triggers. Identifying and managing your personal profile is one of the most effective long-term interventions available.
Stress
Psychological stress is one of the most consistent psoriasis triggers, mediated through cortisol’s effect on immune regulation. Stress management forms a meaningful part of any long-term psoriasis programme.
Lifestyle Factors
Alcohol consumption, smoking, and obesity are each associated with more severe and treatment-resistant psoriasis. We discuss these openly and support patients in addressing them alongside clinical treatment.
Medications & Infection
Certain medications — including beta-blockers, lithium, and NSAIDs — are known psoriasis triggers. Streptococcal infections can precipitate guttate flares. A full medication and infection history is taken at assessment.
Your Psoriasis Journey
Psoriasis cannot be cured, but it can be well controlled. Our role is to provide the safest and most appropriate management within our scope, and to ensure every patient has access to the right level of care beyond it.
Full Assessment
A thorough evaluation of your psoriasis type, distribution, severity, trigger profile, current and previous treatments, and any associated conditions including nail involvement and joint symptoms.
Topical Treatment Plan
A supervised prescription protocol covering the right agents at the right potency for each affected site, with a clear application routine and a step-down plan as the skin responds.
LED Phototherapy Course
A course of LED sessions alongside topical therapy, reviewed at regular intervals. LED can be used during active disease and continued as a maintenance treatment between flares.
Referral & Co-Management
Where systemic treatment, biologic therapy, or specialist dermatology input is needed, we support referral and are available to co-manage patients already under consultant care.
Related Skin Concerns
Psoriasis often presents alongside or gives rise to associated concerns that are relevant to the overall management picture:
Psoriatic Arthritis
Present in up to 30 per cent of psoriasis patients, psoriatic arthritis requires rheumatology input. We flag joint symptoms at assessment and facilitate referral where indicated.
Psychological Impact
Psoriasis carries a significant psychological burden, with elevated rates of depression and anxiety. We take this seriously and can signpost patients to appropriate support alongside clinical management.
Scalp & Nail Care
Scalp psoriasis and nail involvement require specific product and treatment guidance. Both are addressed within the topical prescribing plan and reviewed at every follow-up.
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PHP Aesthetic-Wellness
22 Harley Street, Suite 8, London W1G 9PL
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