"Every year, we've had either a new medication or a new use for one of these medications," says Michael P. Heffernan, MD, 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 something more powerful.
Doctors tend to use a step-by-step approach to treatment. They start by prescribing milder creams and phototherapy. If those don't work, they move on to meds 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 if you want to try a new option sooner, let your doctor know. "You have to be your own best advocate with your physician and the insurance company," he says.
What's New in First-Line Treatments?
Topical psoriasis treatments like sprays, foams, and shampoos, as well as more advanced gels and ointments, now treat larger or more sensitive areas. They're safer and work better than older meds.
Phototherapy is 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, called PUVA photochemotherapy, combines ultraviolet A (UVA) light with a drug called psoralen, which makes your skin more sensitive to light.
State-of-the-Art Biologic Medications
Some of the biggest advances have been in this type of drug. Biologics are made from living cells, and they target certain parts of the immune system that play a role in psoriasis.
Heffernan says they're helpful if you have psoriasis on a large area of your skin, or symptoms that greatly affect your day-to-day life.
"Biologics have offered a new long-lasting form of treatment that has been life-changing for many patients," he says.
They've also filled certain blank spots in psoriasis care, Heffernan says. For example, they're safer for women who want to get pregnant than the older drugs. And many biologics treat psoriatic arthritis as well as the skin disease, he says.