Psoriasis treatment has come a long way in the past 10 years. That's welcome news for the 7.5 million Americans with this complex skin disease.
"Every year, we've had either a new medication or a new use for one of these medications," says Michael P. Heffernan, MD. He's a dermatologist with Central Dermatology in St. Louis. That’s led to "a marked improvement in successful treatments."
Could one of the newer medications -- or a drug in the research pipeline -- help you? That may depend on how severe your psoriasis is. Many people can control the disease with medicine they apply to their skin, called topicals, or treatment with ultraviolet light, called phototherapy. Others need more powerful medication.
Doctors tend to use a stepwise approach to treatment. They start by prescribing milder creams and phototherapy. If those don't work, they move on to drugs that affect your whole body.
"You'll often be asked to try older, less expensive medications before getting access to newer ones," Heffernan says. "So you have to be your own best advocate with your physician and the insurance company."
Keep that in mind as you think about taking advantage of psoriasis treatment advances.
Developments in Topical Treatments and Phototherapy
In recent years, scientists have found new ways to deliver topical psoriasis treatments. Sprays, foams, and shampoos, as well as more advanced gels and ointments treat larger or more sensitive areas. They’re easier, safer, and more effective than older drugs.
Phototherapy is now available in a new form called narrow-band ultraviolet B (UVB) therapy. It’s more focused than other light treatments and has a lower risk of skin cancer. Another approach combines ultraviolet A (UVA) light with a drug, called psoralen, which makes the skin more sensitive to light.
State-of-the-Art Biologic Medications
Some of the biggest recent advances in psoriasis treatment have been in biologic drugs. They're made from living cells, and they target certain parts of the immune system that play a role in psoriasis. That’s what makes them different from older psoriasis drugs, which turn down the entire immune system. Because their action is specific, biologics cause fewer side effects.
Heffernan says biologics are helpful for people who have psoriasis on a large area of their skin, or symptoms that greatly affect their day-to-day life.
"Biologics have offered a new long-lasting form of treatment that has been life-changing for many patients," he says.
Biologics are exciting not only because they offer good control, but also because they've filled certain voids in psoriasis care, Heffernan says. For example, they're safer than the old drugs for women who want to get pregnant. And many biologics treat psoriatic arthritis as well as the skin disease, he says.