After a psoriasis diagnosis, you probably have many questions, including questions about psoriasis treatment. These answers will help you understand what to expect and how to better manage your condition.
A. Topical medications are products you apply directly to your skin to improve its condition. They come in ointment, cream, and lotion formulas and can be in prescription or over-the-counter (OTC) strengths.
A. There are many types of topical medications. The most common ones are corticosteroid drugs, synthetic types of vitamin A and vitamin D3, anthralin, salicylic acid, and coal tar.
A. Creams and ointments containing corticosteroids reduce inflammation. Medications containing synthetic vitamin A or D3 slow skin cell turnover. Coal tar and anthralin slow skin cell turnover and reduce inflammation. Products with salicylic acid reduce scaling.
A. If you have mild psoriasis, your doctor will probably prescribe topical medications. If you have moderate or severe psoriasis, your doctor may prescribe topical medications in combination with other forms of therapy.
A. Systemic medications are prescription drugs that work throughout the entire body. You take them internally, in pill or liquid form, or by injection. Systemic medications include acitretin (Soriatane), cyclosporine (Gengraf, Neoral, Sandimmune, SangCya), methotrexate (Rheumatrex, Trexall), 6-thioguanine, and hydroxyurea (Droxia).
A. Your doctor may prescribe systemic medications if you have moderate to severe psoriasis or if for some reason you are unable to use topical medications.
A. When a medication that has been approved by the U.S. Food and Drug Administration to treat one illness is prescribed for a different condition without separate approval, that usage is called off-label. A number of systemic medications not specifically approved for the treatment of psoriasis may be beneficial for psoriasis patients. Prescribing medications off-label is a common medical practice and is based on the prescriber's clinical judgment and experience. Your insurance may not fully pay for off-label treatments.
A. Biologic drugs are a relatively new treatment for moderate to severe psoriasis. Your doctor may prescribe biologics if your psoriasis has not adequately responded to the more conventional systemic treatments, or if you had a bad reaction to them.
A. Unlike systemic medications that target the whole body, biologics target specific pathways within the immune system. They work by blocking certain cells and proteins that directly contribute to the development of psoriasis.
A. Biologics are available in tablet form, however, most are given by injection or through an IV.
A. Because biologics dampen the immune system, they are not for everyone. If you have a significantly compromised immune system or an active infection, you should not take biologics. They are also usually not prescribed for pregnant women, women who may become pregnant, or women who are nursing. If you are prescribed biologics, your doctor will monitor you carefully.
A. Not unless a psoriasis flare-up is caused by bacteria.
A. Absolutely. Medications are often used in combination. What might work for you won’t necessarily work for someone else with psoriasis; so doctors often use a trial-and-error approach, trying different combinations of drugs to give you the best results.