Psoriasis is a chronic inflammatory disease that affects roughly 125 million people worldwide. For mild cases, topical lotions or phototherapy are typically enough to manage symptoms. But for more severe cases, injectable or intravenous biologic treatments are proving to be the most effective form of relief.

If you’re considering starting biologics for psoriasis, bring this list of questions to your next doctor appointment.

1. What are the advantages?

Biologics are quickly becoming one of the most popular forms of treatment for moderate to severe psoriasis — and for good reason. These drugs can produce dramatic results in a relatively short period. They also have a distinct advantage over systemic psoriasis treatments. They target specific immune system cells to reduce inflammation rather than affecting the whole immune system. Biologics also can provide relief to people with psoriatic arthritis, something topical creams and light therapy can’t do. Talk to your doctor about whether these advantages make biologic treatments the best option for you.

2. What are the downsides?

Since biologics target overactive portions of the immune system, using them may increase your risk of infection. This risk is even higher if you have an infection, active or untreated tuberculosis, or have recently gotten a live vaccine for measles, mumps, and rubella (MMR) or shingles. Make sure to ask your doctor if anything in your medical history might have an impact on your reaction to biologic treatment.

The price of biologics can also be burdensome. In some cases, the price of a biologic is double that of phototherapy treatments. Talk to your doctor about whether your healthcare plan covers biologic drugs, and the financial commitment you’ll need to make if you start biologic treatment.

3. What side effects could occur?

It’s a good idea to discuss what potential side effects you may experience if you start using biologics to treat your psoriasis. A few common side effects of biologics include:

  • nausea
  • fatigue
  • flu-like symptoms
  • headaches
  • abdominal pain
  • fungal and respiratory infections

Most of these side effects are easily treatable. But if you experience one or more of them for a prolonged period, consult your doctor as soon as possible.

4. Will my other medications affect my treatment?

One of the benefits of biologics is that almost all of them can be used in combination with other forms of psoriasis treatment, such as topical creams, phototherapy, and oral medications. However, it’s still important that you talk with your doctor about how a biologic could potentially interact with your current medications. Although you can take biologics in conjunction with other treatment methods, you should not use two biologic treatments together. This can cause a weakened immune system that isn’t able to fight off infection.

5. How soon can I expect results?

Everyone’s treatment path is different. Your doctor can likely give you a general idea of when you can expect results after starting a biologic. Some people who treat their psoriasis with a biologic see changes in symptoms almost immediately. Others may need to wait a year or longer. Researchers believe that the effectiveness is strongly related to how healthy you are when you begin treatment. Consult your doctor about how to be in the best shape possible when you start treatment.

6. What will happen if I stop taking a biologic?

If you don’t keep up with your biologic treatment plan, there is a 75 percent chance your psoriasis symptoms will return by your first follow-up appointment. The average time it takes for symptoms to return in patients who discontinue biologics is roughly eight months. So if you start taking a biologic, plan to be in it for the long-term. Talk to your doctor about whether this is a good option for you, or if you should continue to explore other avenues of treatment.