Psoriasis

Treatment

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.

Goeckerman treatment

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 very cost-effective compared to 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, spending nights in a hotel room. 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. Leftover tar will be 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 side effect of the treatment was an infection of hair follicles (folliculitis) in about 40 percent of children and 20 to 30 percent of adults; this was treatable with a topical solution.