As with many autoimmune diseases, finding the right treatment for psoriasis can take time and trial and error. Even therapies that helped you once may stop working. That can happen for different reasons. But if it does, you likely can find other ways to get relief.
You Need More Than One Medication
Even if your psoriasis is mild, one drug may not be enough to ease your symptoms. The steroid skin creams most often prescribed for mild to moderate cases tend to work better when paired with a lab-made vitamin D cream like calcipotriene (Dovonex) or calcitriol (Vectical), or paired with a compound similar to vitamin A like tazarotene (Duobrii).
Or if you’re on phototherapy or light therapy, which exposes your skin to regular UV light, you may see more improvement when you also take a vitamin D drug or a prescription retinoid cream.
You Need to Switch Treatments
Skin creams may help only so much if you have moderate to severe psoriasis. Instead, a newer type of treatment called biologics may be more effective. These drugs are made with living cells and target specific parts of your immune system that trigger psoriasis. Biologics clear up skin more than half the time, and some people see results within several weeks.
The drugs also help with psoriatic arthritis, a type of arthritis that happens 1 in 5 people with psoriasis. But many dermatologists still don’t prescribe biologics. They may be unfamiliar with the drugs, worried about side effects, or may be required by insurers to try other treatments first. But studies found that people who take biologics are happier with the results, even though the drugs must be given as shots or IV infusions and can cause side effects like diarrhea, headaches, and skin reactions.
You Should Stick to Your Schedule
As many as 3 in 10 people with psoriasis don’t take their meds regularly. That can make the drugs not work as well. If you happen to miss a dose, take it as soon as you remember. If you still have trouble, try a smartphone app that prompts you with reminders. If you skip doses because of side effects, talk to your doctor. You may be able to find another treatment that works just as well but bothers you less.
Your Body Gets Resistant
You may feel good with a new treatment, only to have your symptoms come back weeks, months, or even years later. This happens when your body makes antibodies against the medicine, chemicals that mistakenly attack the drug as a harmful invader. This can be especially common with biologics. Your doctor may switch you to another biologic, or combine your old one with methotrexate, a medicine often used to treat rheumatoid arthritis. Some studies suggest this may suppress antibodies that can derail your treatment.
You Need Healthier Habits
Sometimes lifestyle changes like losing weight, getting active, eating well, and lowering stress can help control your psoriasis. One study found that people who were overweight who dropped pounds and exercised three times a week saw big improvements in their symptoms.
Aim to eat more fresh veggies, fruits, whole grains, fish and lean proteins, and legumes like lentils and chickpeas. If you’re often stressed, try yoga, meditation, or deep breathing. Stress can trigger flares because it pushes your immune system into overdrive, causing inflammation that worsens psoriasis.
When to See Your Doctor
Some psoriasis drugs, like steroid creams and ointments, can help almost right away. Other treatments, such as biologics, can take weeks to months to kick in.
Ask your doctor how long you can expect to wait to feel better. Usually, it shouldn’t take more than 3 months to for your skin to look noticeably better. If it doesn’t, ask your doctor about other treatment options.