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Choosing a Treatment for Psoriasis

There isn't a cure for psoriasis, and there isn't a perfect treatment either. Treatment for psoriasis can be demanding and cause side effects.

 Before treatment, you should make sure that your doctor is comfortable prescribing systemic and biologic medications when they're necessary, advises Bruce E. Strober, MD, PhD, co-director of the Psoriasis and Psoriatic Arthritis Center at New York University. He says that some doctors are reluctant to ever use these powerful drugs because of their side effects. While caution is understandable, certain cases demand systemic and biologic medicines. Strober suggests that you find a physician who really understands all of the possible treatments so you have the widest array of options.

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To describe his battle against psoriasis, Alan Eisenberg likes to quote John Paul Jones, the famed Revolutionary War mariner: “I have not yet begun to fight.” For six years, the Portland, Ore., resident has been trying treatments for his skin condition. Methotrexate helped his nails, but didn’t cure the skin outbreaks. He says the prescription drug Enbrel worked for six months, then lost its effect. Another drug gave him hives. Yet another worked better, but put him at risk of infections. He had...

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Here are some questions you can ask your doctor about psoriasis treatment. They might help you figure out the best way to treat your psoriasis. Although not all of these questions may apply to your situation, it's still a good idea to look them over.

  1. If my psoriasis doesn't bother me much, do I really need treatment?
  2. Will I need different kinds of treatments for different parts of my body, such as my elbows, face, or fingernails?
  3. Is my psoriasis so severe that I need to use phototherapy or systemic therapy instead of topical treatments? What are the side effects of these treatments?
  4. Does your office have all treatments for psoriasis available -- such as light boxes for phototherapy -- and do you routinely prescribe systemic or biologic medications to treat the condition?
  5. If I'm too busy to make regular phototherapy appointments, can I use a light box at home?
  6. Should I be evaluated for psoriatic arthritis? If you think I have psoriatic arthritis, should I see a rheumatologist as well? What treatment will help both my psoriasis and arthritis symptoms?
  7. How much will psoriasis treatment cost? Does my insurance limit the number of therapeutic choices that are open to me?
  8. Will my therapy be long-term, or will it be sporadic?
  9. How often will I need to come in for check-ups in order to treat my psoriasis effectively?
  10. 0. If nothing seems to help my psoriasis, what should I do?
  11. 1. Are there any medical conditions that may prevent me from getting systemic treatments?  What do you need to know about my past medical history?


WebMD Medical Reference

Reviewed by Norman Levine, MD on May 21, 2012

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