When Psoriasis Meds Don’t Work

Months before her wedding, Kim Brown began using adalimumab (Humira), a drug to treat her psoriasis. She’s had the disease, which causes painful, scaly skin rashes all over her body, since age 10.

But her dreams of walking down the aisle with clear skin didn’t come true.

“I thought I was breaking out in wedding stress hives. But it was because of the drug,” says Brown, who lives in Lynchburg, VA. “I had a rash, hives on my chest, and a very bad yeast infection, which is not something you want, especially on your honeymoon.”

Brown’s doctor told her to stop using the drug. She’s tried many psoriasis treatments over the years. They work great for a while but then stop. Others cause side effects like blisters or an upset stomach, making it hard to keep using them.

Why Some Meds Don’t Work

Psoriasis causes inflammation because your body’s immune system isn’t working properly. It’s called an autoimmune disease.

Its many causes make it hard to treat, says Jesse Keller, MD, assistant professor of dermatology at Oregon Health and Science University.

“It’s partly genetic, partly environmental, and partly triggered by lifestyle factors such as body weight and alcohol use. We have no idea why psoriasis affects some more than others in a more aggressive or widespread fashion,” Keller says.

Creams that you rub into your skin (your doctor may call them topical) work well for many people. But if you have psoriasis all over your body, they’re hard to apply, Keller says. And they may not get through the thick skin of your palms or soles to treat rashes there. Neither creams nor light therapy work for outbreaks on your nails.

In those cases, you may need drugs to try to make your immune system work like it should. They all act differently, so you and your doctor will use trial and error to see if one will help you, Keller says.

Doctors can’t predict who will respond to what because everyone’s immune system is different, he says. The wrong drug may cause a severe flare, “leaving you worse off than what you came in with.”

If you can’t afford the cost of your drugs, speak up. Don’t just let your prescription run out, Keller says. He’s seen many people who, rather than reach out to the doctor, will just let the disease get worse.