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Treatment
Psoriasis

Today, there are many different treatments to help control psoriasis. Some can be found over the counter at a
drugstore, while others require a prescription from your doctor.
No single treatment works for everyone. The goal is to find a treatment that works the best with the fewest side
effects. Your doctor will look at what kind of psoriasis you have and recommend the treatment regimen that is
best for you.

Psoriasis treatment
Systemics

Systemic medications are prescription medications that affect the entire body, and are usually reserved for
patients with moderate to severe psoriasis who are not responsive to or eligible for conventional topical
medications or ultraviolet (UV) light treatments.  
Biologics
Biologic medications are developed from living sources, such as cells, rather than combinations of chemicals like
traditional drugs. The U.S. Food and Drug Administration (FDA) has approved Amevive and Raptiva for the
treatment of psoriasis. Enbrel is approved for the treatment of both psoriasis and psoriatic arthritis, while Humira
and Remicade are both approved for the treatment psoriatic arthritis.

Cyclosporine
Cyclosporine is a prescription systemic medication used to treat psoriasis. In 1995, Neoral (one brand name for
cyclosporine) was FDA-approved to help prevent organ rejection in transplant patients. In 1997, the FDA
approved Neoral as a treatment for psoriasis.

Methotrexate
Methotrexate is a systemic medication usually sold as a generic. Initially used to treat cancer, methotrexate was
discovered to be effective in clearing psoriasis in the 1950s and was eventually approved for this use by the FDA
in the 1970s.

Soriatane
Soriatane is a prescription medication called an oral retinoid, which is a synthetic form of vitamin A. Synthetic
retinoids were introduced as experimental drugs in the mid-1970s and were approved in the United States in the
1980s. Soriatane is currently the only oral retinoid approved by the FDA specifically for treating psoriasis.

You and your doctor
Making treatment decisions

If you and your doctor have trouble deciding which treatment is most appropriate, ask the following questions:
How long has this treatment been used for psoriasis?

What are the potential benefits of the treatment?

What are the potential risks?

What percent of people are on this treatment?

What percent of people improve on this treatment?

How quickly will the treatment work?

How long have you (the doctor) been prescribing this treatment?

What are the most common side effects of the treatment?

Will I be tested regularly for unwanted side effects? If so, what kinds of tests and how often?

Which side effects will go away if I stop taking the medication? Which side effects might be permanent?

Will I take or apply this drug continuously?

Will it make me more sensitive to sunlight?

Can I use/take this medicine for a short time, just to clear my psoriasis, then switch to a milder medication with
fewer risks? Could I control my psoriasis this way?

Can this treatment be combined with another to make it more effective or decrease unwanted side effects?

Can this treatment be stopped suddenly, or do I need to stop it gradually?

Ordinarily, how long will the drug stay effective?

If it works but I have to stop using it, is it likely to work again if it is resumed?

What will the treatment cost?

If I decide against this treatment, what are my other options?
Special considerations for women:

Can I take it if I am trying to get pregnant?

Do I need to stop treatment if I am pregnant or nursing?
More information about psoriasis treatments and conception and pregnancy.



One of the first principles of psoriasis treatment is to not create anything worse than the disease, according to
Steve Feldman, M.D., Ph.D., professor of dermatology, pathology and public health sciences at Wake Forest
University in Winston-Salem, N.C. "I tell my patients that if I recommend to them anything that they find worse than
having the disease itself, they should ignore my advice," he says.

Staying with the treatment
Once you and your doctor settle on a plan, follow through with it. It is good to give a new treatment eight to 12
weeks to see if it will work. Half of all patients do not adhere to the treatment plan prescribed by their doctors.
Taking methotrexate, for example, means no alcohol consumption. Phototherapy treatments can be very
inconvenient. Some topical medications are messy, smelly and expensive. Still, using them properly–for example,
twice a day as prescribed, instead of once–can make a significant difference in results in some cases. Sticking
with a treatment takes time and commitment.
If you are on several medications, it can be difficult to keep all of the doctor's orders straight. Try to write down all
of the directions in one place. Keep a journal of the various medications that you are on, when you need to take
or apply them, and how you are reacting to the treatment. This journal will be helpful when you follow up with your
doctor at your next appointment.
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