Mayo Clinic offers all psoriasis treatments: topical creams and ointments, light therapy, medications, and the Goeckerman treatment (offered at Mayo's Minnesota location). Treatments may be combined to increase effectiveness or decrease side effects.
The Goeckerman treatment is named after a Mayo Clinic dermatologist who developed this treatment in 1925. The Goeckerman treatment is appropriate for most individuals with moderate to severe psoriasis. While it is time-consuming, taking approximately three weeks, it has a long track record of effectiveness with few side effects. It also is cost-effective compared with the cost of other treatments.
Treatment involves daily ultraviolet light exposure and application of coal tar. In the past, people were treated in the hospital. Today, they are treated in an outpatient setting. The procedure is as follows:
- Tar. Three times a day, a nurse will apply crude coal tar, a black substance in a petrolatum base, to your entire body except your neck and head. This therapy makes the skin more sensitive to ultraviolet light. Although the tar feels cool and soothing, it's also messy and staining, so you will be given special clothing to wear during the day.
- Oiling. Any excess tar is removed using a gauze cloth and vegetable oil. This allows the ultraviolet light to penetrate better.
- Ultraviolet (UV) light. You will receive light treatment once a day for an increasing length of time. The UV light helps slow the rapid growth of skin cells. You will lie on a bed while the ultraviolet light is administered.
- Tub bath. You will soak in a tub for 20 to 30 minutes every day. Tar is reapplied after bathing.
- Shampoo and scalp. Your hair and scalp also will be treated and shampooed daily.
Two Mayo studies reviewed long-term results of the Goeckerman treatment at Mayo Clinic (over a 21-year period in children and over six decades for adults). Researchers found that 85 percent of people had a clearing (remission) of 80 percent or more of their psoriasis with the Goeckerman treatment. The average length of the remission was 2.6 years in children and about 1.7 years in adults, with some remissions lasting longer than 10 years. The only significant side effect of the treatment seems to be infection of hair follicles, which is treatable with a topical solution.
Apr. 11, 2014
- Bolognia JL, et al. Dermatology. 3rd ed. Philadelphia, Penn.: Saunders Elsevier: 2012. https://www.clinicalkey.com. Accessed Dec. 6, 2013.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Dec. 6, 2013.
- Papadakis MA, et al. Current Medical Diagnosis & Treatment 2013. 52nd ed. New York, N.Y.: The McGraw-Hill Companies; 2013. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=1. Accessed Dec. 6, 2013.
- Psoriasis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Psoriasis/.Accessed Dec. 8, 2013.
- Weigle N, et al. Psoriasis. American Family Physician. 2013;87:626.
- Feldman SR, et al. Epidemiology, clinical manifestations, and diagnosis of psoriasis. http://www.uptodate.com/home. Accessed Dec. 6, 2013.
- Armstrong AW, et al. The association between psoriasis and obesity: A systematic review and meta-analysis of observational studies. Nutrition and Diabetes. 2012;2:1.
- Korman N. Comorbid disease in psoriasis. http://www.uptodate.com/home. Accessed Nov. 16, 2013.
- Azfar RS, et al. Increased risk of diabetes mellitus and likelihood of receiving diabetes mellitus treatment in patients with psoriasis. Archives of Dermatology. 2012;148:995.
- Armstrong AW, et al. Coronary artery disease in patients with psoriasis referred for coronary angiography. American Journal of Cardiology. 2012;109:976.
- Ahlehoff, et al. Psoriasis and risk of atrial fibrillation and ischaemic stroke: a Danish nationwide cohort study. European Heart Journal. 2012;33:2054.
- Yeung H, et al. Psoriasis severity and the prevalence of major medical comorbidity: A population-based study. JAMA Dermatology. 2013;149:1173.
- Wan J, et al. Risk of moderate to advanced kidney disease in patients with psoriasis: population based cohort study. BMJ. 2013;347:1.
- Papoutsaki M, et al. Treatment of psoriasis and psoriatic arthritis. Biodrugs. 2013;27:3.
- Feldman SR, et al. Treatment of psoriasis. http://www.uptodate.com/home. Accessed Dec. 6, 2013.
- Almutawa F, et al. Systematic review of UV-based therapy for psoriasis. American Journal of Clinical Dermatology. 2013;14:87.
- De Migeul R, et al. Efficacy, safety, and cost of Goeckerman therapy compared with biologics in the treatment of moderate to severe psoriasis. International Journal of Dermatology. 2009;48:653.
- Garcia-Perez ME, et al. New therapies under development for psoriasis treatment. Current Opinion in Pediatrics. 2013;25:480.
- Korteum KR, et al. Results of Goeckerman treatment for psoriasis in children: A 21-year retrospective review. Pediatric Dermatology. 2010;27:518.
- Aloe. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Dec. 9, 2013.
- Fish oil. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Dec. 9, 2013.
- Oregon grape. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Dec. 9, 2013.
You Are ... The Campaign for Mayo Clinic
Mayo Clinic is a not-for-profit organization. Make a difference today.