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Light Therapy (Phototherapy) continued...

Side effects can include skin irritation, redness, a burning or itching sensation, blisters, dry skin, sunburn, and a higher risk for skin cancer.

2. PUVA Therapy (Photochemotherapy)

What it is: You use a medicine called psoralen, which makes your skin more sensitive to light. Then you are exposed to ultraviolet A (UVA) light.

How it works: Psoralen is either applied to your skin or you take it by mouth. Thirty minutes to two hours later, your skin is exposed to ultraviolet A light. The light slows skin cell growth.

Side effects can include nausea (from oral psoralens), itching, redness, burns, blisters, freckles or aged skin, cataracts if you don’t wear sunglasses, and a higher risk for skin cancer, including melanoma.

3. Laser Treatment

What it is: A form of light therapy that uses lasers.

How it works: A thin beam of light targets psoriasis without affecting nearby skin.

Laser types:

  • Excimer laser -- releases a high-intensity beam of ultraviolet light
  • Pulsed dye laser -- destroys the tiny blood vessels that support the formation of psoriasis plaques

Side effects can include redness, blistering, bruising, or scarring.

Medications for Moderate to Severe Psoriasis

Medications that you take by pill or injection affect the whole body. Your doctor may recommend one of these four types of drugs if you haven't responded to topical creams or light therapy.

1. Cyclosporine

What it is: Cyclosporine (Neoral) is a drug that has been used to prevent organ rejection in transplant patients. It is also approved for treating psoriasis.

How it works: It suppresses the immune system and slows the growth of skin cells. Cyclosporine is given by capsule or liquid.

Side effects can include flu-like symptoms, headache, high blood pressure, higher cholesterol, sensitive skin, tingling in the arms or legs, upset stomach, fatigue, kidney damage, excess hair growth, kidney damage, and an increased risk for cancer.

2. Methotrexate

What it is: A drug that was first used to treat cancer.

How it works: Methotrexate slows the rate of skin cell growth. Methotrexate can be given by pill, liquid, or injection.

Side effects can include nausea, vomiting, fatigue, headache, lightheadedness, easy bruising and bleeding, fever, trouble sleeping, sensitivity to sunlight, hair loss, and liver damage.

Pregnant women are at risk of having a baby with birth defects while taking this drug.

3. Biologic Treatments

What it is: Biologic drugs target the immune response that causes inflammation.

 How it works: Biologics block immune cells that are involved in psoriasis. These drugs are given by a shot or by an IV infusion.

 Biologic drugs include:

  1. Ustekinumab (Stelara). This drug blocks cytokines in the body called interleukin-12 and interleukin-23, which are thought to promote the increased growth rate of skin cells and inflammation from psoriasis.
  2. Tumor necrosis factor-alpha blockers, including adalimumab (Humira), etanercept (Enbrel), golimumab (Simponi), and infliximab (Remicade). These drugs block a chemical messenger of the immune system called TNF-alpha. People with psoriasis have too much of this substance, which causes inflammation.

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