When Your Psoriasis Treatment Isn't Working

What to consider if you're not getting the results you wanted.

From the WebMD Archives


When deciding which treatment to try first, a doctor will consider how much of your body is affected by outbreaks, says Lawrence Green, MD, a dermatologist in the Washington, D.C. area and a trustee of the National Psoriasis Foundation.

If just a small amount of skin is involved, you may be able to use a topical treatment, such as applying medicine to your skin. If more than 5% of your body is covered with outbreaks, you may need systemic therapy (treatments that go throughout your body, such as pills or injections). (The palm of your hand is the size of about 1% of your body’s surface area, Blauvelt says).

Other signs that suggest you may need a systemic approach include:

  • Having psoriatic arthritis
  • Having outbreaks on more sensitive areas, such as your palms, soles of your feet, face, or genitalia
  • Lack of success with all the topical treatments

You play a role in the success of your treatment. So while you’re seeking a drug that will bring your psoriasis under control, the experts who spoke to WebMD suggested these strategies:

Be Patient

Depending on the treatment, you may need one to three months before the drug starts working, Van Voorhees says. Be sure to ask your doctor how soon you might notice improvement, and how you’ll be able to know if the treatment is helping, she says.

Remember That Control Is a Long-Term Process

“There’s not a treatment that allows you to take a pill once and make psoriasis go away, like treating an infection with an antibiotic,” Van Voorhees says. If your treatment is to rub steroid medicine onto your skin, you may do it several times a day until your lesions have dwindled away, then hold off on further treatment until they start to return, Blauvelt says. You’ll then continue this cycle indefinitely.

Be sure to stick with your treatment, even when your skin starts looking better, Van Voorhees says. “When their skin is looking good, sometimes patients get more casual, and they need to remain conscientious about continuing their treatments.”