Is Your Psoriasis Treatment Working?

No matter what medicine you use, you want your skin to clear as much and as soon as possible.

Psoriasis treatments aren't a quick fix. Some treatments start to show results faster than others, but they all take time. Each has its own way of relieving psoriasis. And no medicines will make it vanish forever.

Whether a treatment is "working" can mean something different to each person. With your doctor's help and some patience, you should be able to find a treatment that you're comfortable with.

Set Reasonable Goals

Whether you're happy with a treatment depends a lot on your expectations. Some people may want a psoriasis treatment to totally clear up their skin. Others are thrilled if the redness fades or their skin is less itchy.

The first treatment you try may not be the solution. "It's trial and error," says Jenny Murase, MD, assistant clinical professor at the University of California, San Francisco. "We're just testing it to see how [the psoriasis] responds."

Your doctor may have to mix different treatments to improve your skin.

"For a treatment to be working, it has to work to the satisfaction of the patient," says Mark Lebwohl, MD. He's the chairman of the National Psoriasis Foundation Medical Board.

How Long Does It Take?

There's no hard and fast rule about when your skin will get better. On average, psoriasis drugs take about 3 months to start showing results. Other treatments may be a little faster.

  • Acitretin: 2 to 4 months, but it may take up to 6 months to reach its peak effect
  • Biologics: 2 to 3 months or longer
  • Cyclosporine: 3 to 4 months
  • Goeckerman treatment (coal tar plus light therapy): 3 to 4 weeks
  • Methotrexate: 3 to 6 weeks, although you may not see real clearing for up to 6 months
  • Phototherapy: 2 1/2 to 3 months

Give your treatment enough time to work.

If you've been waiting for a few months and still don't see a change, talk with your doctor. You may need to try something else.

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Side Effects

Some treatment side effects are mild, like skin redness or peeling. Others can be serious, including the chance of infections. Stronger medicines and larger doses may help control your psoriasis better, but they can cause more side effects.

"There's always a balance between the safety of treatments and the effectiveness of treatments," Lebwohl says.

Sometimes side effects can make you want to stop taking a drug. You and your doctor have to decide whether the result of any treatment is worth the risks.

Long-Term Psoriasis Treatment

Like diabetes and asthma, psoriasis is a lifelong disease. "We have treatments for psoriasis, but not cures," Murase says.

You'll need to keep taking your medicine, possibly for many years. "We could potentially stop the treatments, but then the disease would gradually come back," Lebwohl says.

Stopping and restarting your treatment can make it less effective. For example, when you stop taking a biologic drug, your body's immune system could develop a defense against it. If you start taking the same drug again, it might not work as well.

Even while you're taking medication, your psoriasis could flare up. "I think there's a natural tendency over time for people's psoriasis to wax and wane," Murase says.

Play Your Part

No psoriasis treatment will work without you. Follow your doctor's instructions. "If you don't take your medicine, expect it not to work," Lebwohl says.

Keep in close touch with your doctor. Visit regularly for checkups, especially if you're taking a drug (such as a biologic) that shuts down your immune system. You'll need tests for tuberculosis and other infections.

Let your doctor know if you have any side effects from your medicine, especially when they're serious or don't go away.

And speak up when your treatment isn't working as well as you and your doctor had hoped.

WebMD Feature Reviewed by Stephanie S. Gardner, MD on September 24, 2014

Sources

SOURCES:

Jenny Murase, MD; assistant clinical professor, University of California, San Francisco; practicing dermatologist, Palo Alto Medical Foundation.

Mark Lebwohl, MD; chairman, dermatology department, Mount Sinai School of Medicine; chairman, National Psoriasis Foundation Medical Board.

National Psoriasis Foundation: "Systemic Medications," "Light Therapy."

American Academy of Dermatology: "Psoriasis Treatment: Medicine Applied to the Skin."

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