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Managing Your Psoriasis

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What to Expect From Your Psoriasis Medication

Medically Reviewed By William C. Lloyd III, MD, FACS

Medications can’t cure psoriasis, so it can be tricky to set realistic expectations of how effective they will be.

woman sitting down and itching arm
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Psoriasis is a chronic inflammatory skin disease, with symptoms that can wax and wane. Some people with psoriasis know what their triggers are, but for others, it may be next to impossible to figure out what causes their skin to break out with psoriasis plaques. This can make psoriasis frustratingly difficult to treat. 

Regardless of the cause, there are several types of medications that your dermatologist may choose from when treating your psoriasis. The choice depends on the severity of your condition and what, if anything, has been tried before.

Topical treatments: Creams and ointments

One of the signs of psoriasis are red, cracking, itchy and sore patches of skin. Usually, the initial treatment—what doctors try first—involves applying creams and ointments directly on the plaques. An advantage to topical treatments is that they may offer instant, even if temporary, relief from the pain or itching.

Creams and ointments can have active medications in them, such as corticosteroids that reduce swelling, and coal tar, which help slow down the skin cell production and the psoriasis flare up. Other products, called emollients, aren’t medicinal and don’t treat the active psoriasis, but they are used to moisturize and protect the skin from further injury.

Another advantage to topical treatments is that you apply them directly to the affected areas, limiting the risk of side effects you could experience. However, they can also be messy to apply, especially the ones that contain coal tar.

Systemic treatments: Oral and intravenous medications

If topical treatments don’t help reduce the number and/or size of the psoriasis plaques, and the discomfort they’re causing you, your doctor may suggest you try a systemic treatment, either through pills (by mouth) or intravenously (IV). These treatments can have serious side effects, so they aren’t used for long periods. Instead, they are used to try to get your psoriasis under control, and then you may be able to switch to different type of treatment that can be used over the long term. The most common medications include:

  • Acitretin (Soriatane)
  • Cyclosporine
  • Methotrexate

If you do take systemic treatments, you should speak with your doctor about the potential side effects and any precautions you must take. For example, methotrexate and cyclosporine can make you more susceptible to catching infections, and women who may become pregnant should avoid taking them as well. Systemic treatments may cause your psoriasis to go into remission, leaving you symptom-free for up to a few months, depending on the the treatment and the severity of your condition.

Biologics

Biologics are a newer type of treatment given by IV or injection. This treatment targets a specific part of your immune system, blocking what is causing your skin to produce the extra cells that form the plaques. Examples include:

  • Adalimumab (Humira)
  • Etanercept (Enbrel)
  • Guselkumab (Tremfya)
  • Infliximab (Remicade)
  • Ixekizumab (Taltz)
  • Secukinumab (Cosentyx)
  • Ustekinumab (Stelara)

It’s possible that your doctor may prescribe biologics along with other treatments, such as methotrexate, in order to increase your chances of going into remission. However, these too have serious side effects, such as an increased risk of developing an infection. Psoriasis treatment is personal. A treatment that helps one person may not help another.

Unfortunately, their effectiveness may even change with the same person. A treatment that helped relieve your psoriasis symptoms for a while, but may stop working as your skin becomes resistant to the medication. It’s important that you work with your doctor to find the best possible therapy – or combination of therapies – to help you live your life without the discomfort caused by your psoriasis.

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  1. Psoriasis Treatments. National Psoriasis Foundation. https://www.psoriasis.org/about-psoriasis/treatments
  2. Biologic Drug Facts. National Psoriasis Foundation.  https://www.psoriasis.org/about-psoriasis/treatments/biologics/resources
  3. Traditional Systemic Medications. National Psoriasis Foundation. https://www.psoriasis.org/about-psoriasis/treatments/systemics
  4. Treatment of Psoriasis. UpToDate.com. http://www.uptodate.com/contents/treatment-of-psoriasis
  5. Psoriasis: Treatments and Drugs. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/psoriasis/basics/treatment/con-20030838    
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2022 Aug 22
View All Managing Your Psoriasis Articles
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