From verywellhealth.com
Psoriasis treatment is not one size fits all and is specific to the individual, the type of psoriasis present, and the severity of their symptoms. It is important to work with your healthcare provider on identifying the right treatment (or combination of treatments) to reduce or eliminate your psoriasis symptoms.
This article discusses medication treatment options, why a healthcare provider might change your medications, and other therapies that help treat psoriasis.
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Why Might a Healthcare Provider Change Your Meds?
There are several types of psoriasis, each of which might require different treatments or treatment combinations depending on their severity.
Because treatment plans are individualized, your healthcare provider might need to change your medication by adding or removing one from your medication regime.
Types of Psoriasis
- Plaque psoriasis: The most common form—tends to affect people on the scalp, trunk, and limbs and appears as raised red patches of skin with silvery-white scales.
- Guttate psoriasis: Small red dots, usually on the torso or limbs. An upper respiratory infection or strep throat infection often triggers an outbreak.
- Pustular psoriasis: Usually affects the hands and feet and is often triggered by medications, infections, stress, or chemicals; appears as pus-filled pockets surrounded by red skin.
- Inverse psoriasis: Smooth red patches, often in skin folds, such as beneath the breasts, groin, or armpit, due to rubbing and sweating.
- Erythrodermic psoriasis: The rarest form of psoriasis, often triggered by a bad sunburn or certain medications; appears as red, rough, and scaly skin over most of the body.
Questions to Ask Your Healthcare Provider
To ensure optimal personal safety, there are questions you should be prepared to ask your healthcare provider in the event of a medication change.
What Are the Side Effects?
Understanding how your medication works and what symptoms it could cause can prevent problems later. It will prepare you for what to expect and when to notify your healthcare provider.
Can I Take This Medication With Other Meds?
It is important to inform your healthcare provider of any other medications, including any over-the-counter (OTC) medications, vitamins, or herbal supplements you are taking to help prevent any adverse interactions or side effects.
How Long Does It Take to Work?
Some medications start working immediately, while others might take several days or weeks. Understanding when to expect symptoms to subside can help you track progress and alert your healthcare team if necessary.
How Long Will I Need To Be On This Medication?
Different medication routes, such as taking a pill versus applying a topical (on the skin) cream, are absorbed by the body at different paces, so treatment length varies.
What Are My Other Treatment Options?
Psoriasis can be treated with oral, topical, injectable, phototherapy (light therapy), and various naturopathic remedies. Psoriasis treatments are often used in combination to maximize results.
Whom Does Psoriasis Affect?
Around 3%, or about 7.5 million Americans, have psoriasis. It affects adults more than children, and men and women have an equal risk of getting it.
How Is Psoriasis Treated?
There are several ways to treat psoriasis; treatment plans are individualized and often involve a combination of therapies.
Topical Treatments
Topical treatments such as creams can effectively manage psoriasis outbreaks. There are many types of topical psoriatic creams, most of which include the following ingredients:
- Corticosteroids
- Retinoids
- Phosphodiesterase-4 inhibitors (PDE4 inhibitors), such as Zoryve (roflumilast)
- Aryl hydrocarbon receptor agonists, such as Vtama (tapinarof)
- Coal tar
- Salicylic acid
- Anthralin
- Squaric acid dibutyl ester (SADBE)
Phototherapy
Light therapy, also known as phototherapy, exposes affected skin to ultraviolet (UV) rays. It is anti-inflammatory and can slow the growth of skin cells, preventing psoriatic outbreaks.
Phototherapy treatment should always take place under healthcare provider supervision.
Systemic Treatments
Systemic treatments affect the entire body, such as the immune system, instead of targeting specific psoriatic areas. Different systemic psoriatic treatments include:
- Biologics: Biologics block the overactive immune system impulses to prevent the overgrowth of skin cells. They are primarily for moderate-to-severe psoriasis. Because biologics impact immune system function, routine medical tests, such as blood testing, are required.
- Cyclosporine: Cyclosporine suppresses the immune system to stop the hyperactive (overactive) immune response that causes the rapid growth of skin cells. It is a powerful immune system suppressant often only used for a short time (12–16 weeks) for extensive or disabling psoriasis outbreaks. Your healthcare provider will likely switch you to a medication that does not impact the immune system significantly after it runs its course.
- Methotrexate:
- Methotrexate is an anti-inflammatory and immunosuppressant that works by preventing the growth of rapidly dividing cells, such as those that cause psoriasis. It requires routine medical tests to monitor and prevent complications and side effects.
Oral medications that treat psoriasis are also systemic treatments.
Oral Medications
Depending on the type of psoriasis, your healthcare provider may prescribe oral medications, such as Otezla (apremilast) (for plaque psoriasis) or Soriatane (acitretin) (for severe psoriasis and particularly effective for pustular psoriasis).
Acitretin is often taken in combination with phototherapy to optimize psoriasis management.
Other oral medications include:
- Sotyktu (ducravacitinib)
- Otrexup, Rasuvo, and RediTrex (methotrexate)
- Cequa (cyclosporin)
Natural Treatments
Several naturopathic treatments (home remedies) for psoriasis include:
- Oregon grape (a topical cream with anti-inflammatory properties)
- Humidity (using a humidifier to moisten the air can help alleviate itchiness and irritation)
- Capsaicin (a topical cream containing a chemical found in chili peppers effective in decreasing itching, redness, pain, and scaling)
- Omega-3 fatty acids (found in fish, nuts, seeds, and other foods, this may help alleviate psoriasis outbreaks)
- Aloe vera (has antioxidant and anti-inflammatory properties that can help affected areas when applied topically)
- Oat baths (oatmeal can soothe and moisturize the skin)
Summary
Psoriasis treatment varies depending on the type (or types) of psoriasis you have and the severity of your symptoms. Your healthcare provider might change your treatment regimen by trying different therapies or a combination of therapies if one alone isn't producing desired effects.
Learning about your options can help you understand why and when your healthcare provider might try something new. Speak to your healthcare provider about your symptoms as you try new medications or treatments to ensure you are on the proper treatment plan.
A Word From Verywell
Managing psoriasis can be challenging, especially if it makes you feel self-conscious. If your current treatment isn't working, speak to your healthcare provider about other treatment options. It may take some trial and error, but your healthcare provider should help you find a treatment(s) that works best for you.
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