How to Treat Your Psoriasis

Although you can’t cure psoriasis, there are ways to ease its symptoms, and you don't have just one or two options. There are many ways to treat it. You can even combine some of them. So if one thing doesn't work, something else likely will.

You and your doctor will decide on a treatment plan based on:

  • How severe your psoriasis is
  • What treatments you've already used
  • Whether you have other medical conditions
  • How much you’re willing to do
  • What insurance will cover financially

 

Making Your Plan

Your doctor will probably first suggest that you try a preparation you apply to your skin. Topical medications include lotions, creams, ointments, shampoos, foams, and oils/solutions. You’ll probably need a prescription, but some products are available over the counter.

The most common ones use corticosteroids to calm inflammation. Others use salicylic acid to help remove scales.

Other options you might try include:

If your psoriasis covers more than 10% to 20% of your skin, you’ll probably need more than these treatments alone. Your doctor may recommend:

Light therapy (phototherapy). Exposing your skin to the sun or other ultraviolet light can improve your symptoms. You do this at a doctor's office or with a phototherapy unit at home. Newer techniques use an Xtrac laser, which can target a small area of psoriatic skin with a highly focused UVB light.

Pills. For psoriasis that doesn't respond to other treatments, drugs like acitretin (Soriatane), apremilast (Otezla), cyclosporine (Neoral, Sandimmune), and methotrexate (Trexall) may help. They're usually reserved for moderate to severe psoriasis because the side effects can be harsh. Your doctor will need to keep a close watch on you.

“Biologic” drugs. These may improve psoriasis if other drugs don’t help enough. They seem to have fewer side effects than some other medications, too. Most of them work by suppressing your immune system, so serious infections and even cancer are risks, though rare ones. Biologics used to treat psoriasis include adalimumab (Humira), adalimumab-adbm(Cyltezo) or adalimumab-atto (Amjevita), both biosimilar to Humira, brodalumab (Siliq), etanercept ( Enbrel), etanercept-szzs (Erelzi), a biosimilar to Enbrel, guselkumab (Tremfya), infliximab (Remicade), infliximab-abda (Renflexis) or  infliximab-dyyb (Inflectra), both biosimilar to Remicade, ixekizumab (Taltz), secukinumab (Cosentyx), and ustekinumab (Stelara).

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Alternative Medicine for Psoriasis?

Many products on the market claim to treat psoriasis, including vitamins, enemas, acupuncture, shark cartilage, and emu oil. You can even go to a spa where you relax in a hot pool while little fish eat psoriasis plaques off your body.

While a healthy diet and stress management are good for your whole body, no alternative approaches are proven to help with psoriasis, and some may not be safe.

Check with your doctor first so you know what’s OK for you. Even some herbal supplements and drugstore treatments can be risky -- more so if you use them with other treatments. So ask before you try.

WebMD Medical Reference Reviewed by Stephanie S. Gardner, MD on October 05, 2017

Sources

SOURCES: 

Abel, E. ACP Medicine, April 2005.

American Academy of Dermatology.

Bruce E. Strober, MD, PhD, associate director of dermatopharmacology, department of dermatology, New York University School of Medicine; co-director, Psoriasis and Psoriatic Arthritis Center.

FDA. "FDA approves new psoriasis drug Taltz." “FDA approves Amjevita, a biosimilar to Humira.”

Jeffrey M. Weinberg, MD, director, Clinical Research Center, St. Luke's-Roosevelt Hospital Center, New York City; assistant clinical professor of dermatology, Columbia University College of Physicians and Surgeons.

National Institute of Arthritis and Musculoskeletal and Skin Diseases.

National Psoriasis Foundation. 

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