10 Drugs Commonly Prescribed for Psoriasis
Psoriasis is a chronic skin condition that can occur anywhere, but tends to affect the elbows, knees and scalp. If you are one of the 7.5 million Americans who have it, you know how uncomfortable it can be. Symptoms typically include red patches with silvery scales and small scaly spots that can bleed and crust. Skin can itch and become sore. Some people also notice changes in their nails.
Psoriasis is an autoimmune disease, meaning your immune system mistakenly attacks healthy tissue. In the most common form of psoriasis, your immune system causes skin cells to grow faster than your body can shed them. This leads to an accumulation of skin cells into plaques or patches.
In most cases, psoriasis cycles through periods when symptoms worsen and then resolve. These flares can last for weeks to months. Between flares, your disease may go into remission. Medications can help manage symptoms when they occur and decrease the frequency of flares.
There is currently no cure for psoriasis. However, medications can relieve symptoms and maintain your quality of life and self-confidence. The goal of treatment is to slow skin cell growth. To achieve this goal, doctors follow expert practice guidelines to choose psoriasis medicines. Classes of psoriasis drugs include:
Biologic response modifiers (BRMs) target specific parts of the immune system to suppress it. This stops the process of skin cell overproduction and brings about remission of symptoms. Side effects include injection site reactions and flu-like symptoms.
Systemic medications are oral or injectable medicines that work throughout the entire body. The side effects vary depending on the specific drug.
Topical medications are medicines you apply directly to the skin. They do not affect the rest of your body, which minimizes side effects. This class includes both over-the-counter and prescription products.
A complete treatment plan for psoriasis may also include light therapy—or phototherapy—and self-care. Self-care primarily involves regular moisturizing, stress reduction, and quitting smoking.
About 80% of people with psoriasis have mild to moderate disease. They may only require topical treatments and light therapy to control their symptoms. However, the 20% of psoriasis sufferers with moderate to severe disease require a combination of medications. Finding the right treatment for you may involve some trial and error. Here are 10 drugs commonly prescribed for psoriasis:
Adalimumab (Humira) is a biologic medication for injection under the skin—or subcutaneously. You will get the first dose in your doctor’s office. After that, the typical dose is every other week.
Apremilast (Otezla) is a PDE4 inhibitor, which is a systemic medication. It is a tablet you take twice a day. You usually start on a low dose and increase the dose over the first several days of treatment.
Calcitriol (Vectical) is a topical vitamin D analog. This synthetic form of vitamin D slows skin cell growth. Vectical may be less irritating than other topical vitamin D analogs.
Cyclosporine (Gengraf, Neoral, Sandimmune) is an oral systemic medication. It suppresses your immune system, but is not specific like the BRMs. It comes in different dosage forms and brands with different dosing. Be sure you understand how to take your particular form of cyclosporine. Ask your doctor or pharmacist if you have questions.
Etanercept (Enbrel) is a BRM for injection under the skin. Like Humira, you will get the first dose in your doctor’s office. For the first three months, your doctor may prescribe Enbrel for twice weekly use. After that, the usual dose is once a week.
Hydrocortisone (Cortaid and others) is a topical corticosteroid that reduces inflammation and itching. It comes in both an over-the-counter and prescription strength. Corticosteroids are the most common treatment for mild to moderate psoriasis.
Methotrexate (Rheumatrex, Trexall) is systemic medication that reduces skin cell turnover and inflammation. It is available as a tablet and an injection. Doctors usually prescribe a weekly dose to decrease side effects.
Mometasone (Elocon) is a prescription topical corticosteroid. You usually apply it once daily.
Tazarotene (Tazorac) is a topical retinoid—a vitamin A derivative. Skin irritation and increased sensitivity to sunlight are common side effects. It’s important to use a daily sunscreen with topical retinoids.
Triamcinolone acetonide (Aristocort, Kenalog) is another topical corticosteroid. You usually apply it a few times each day.
In general, doctors start with milder treatments and monitor your progress. The goal is to reduce or eliminate your symptoms while causing the least amount of side effects. This usually means starting with topical treatments. However, your doctor may recommend systemic treatments to start, depending on the severity of your psoriasis.
Researcher continue to study psoriasis causes and treatments. If researchers can understand how plaques develop, they can better design treatments aimed at stopping them. They are also testing new targets for developing additional BMRs. Clinical trials can give people access to experimental treatments not currently on the market. If you are interested in participating in a trial, talk with your doctor.