Psoriasis is a chronic inflammatory disease that affects the immune system. It can cause patches of red, scaly skin to form all over the body. Roughly 7.5 million Americans are living with psoriasis, and it can happen at any age.

There are many treatments available to help manage psoriasis symptoms. Finding the right treatment for you might take some trial and error. If your current treatment isn’t helping, or you’ve only tried over-the-counter medication, talk to your doctor about the following options to see which may work best for you.

Topical creams and ointments are considered the first line of defense against psoriasis symptoms. They’re the most commonly used treatment for mild-to-moderate cases. These medications work to reduce inflammation and help relieve dry, red, and itchy skin. Topical treatments are available in both over-the-counter and prescription forms. You can purchase them at most local pharmacies and supermarkets. Certain prescription topical treatments can cause side effects such as irritation and thinning of the skin. They also may interact poorly with existing medications, so make sure to talk with your doctor before starting any new topical treatments.

Light therapy, sometimes called phototherapy, is the exposure of skin to ultraviolet light at regular intervals. The easiest way to treat your psoriasis with light therapy is to spend controlled intervals of time in natural sunlight. You can also get this type of treatment in a doctor’s office or from the comfort of your own home using a phototherapy device.

There are a number of different phototherapy options, including PUVA, UVB, and excimer laser treatments. Be advised that a tanning bed is not a suitable substitute for a phototherapy device, as indoor tanning increases your risk of developing skin cancer. Talk to your doctor about whether light therapy is a good option for you.

Systemic treatments are typically used for more severe cases of psoriasis, due to the high risk of serious side effects. Systemics enter the bloodstream and affect your entire body, selectively targeting molecules inside your immune cells to reduce inflammation. They usually come in oral form (pill or tablet), but certain systemics are administered through injection. Each kind of systemic treatment may be accompanied by unique side effects, such as nausea, numbness, dry skin, and flushing. Consult your doctor about whether systemic options are right for you.

Biologic drugs are intravenous or injectable psoriasis treatments produced in a lab using living cells. Biologic treatments are different than systemic treatments because rather than impacting the entire immune system, they target specific areas involved in the development of psoriasis. Biologics are quickly becoming one of the most popular forms of psoriasis treatment.

They do have a few downsides, however. There’s an increased risk of infection in certain patients, and your psoriasis symptoms are likely to return if you don’t keep up with treatment. Biologics are also expensive. Talk to your doctor about the different biologic drugs available, and whether you’re a fit for this type of treatment.

Making certain lifestyle changes can often help to manage your psoriasis symptoms. If you’re a smoker, try to quit as soon as possible. Not only is it bad for your heart and lungs, but it can also be a trigger for psoriasis flare-ups. Similarly, drinking too much alcohol can make you dehydrated and worsen your psoriasis symptoms. You can enjoy a glass of wine or a beer now and then, but moderation is the key.

Making changes to your diet may also affect your psoriasis. Try to cut down on foods that are believed to cause inflammation, like red meat, dairy, and nightshade vegetables such as tomatoes, peppers, and potatoes. Stock up on foods high in omega-3 fatty acids such as olive oil, walnuts, and pumpkin seeds.

Stress is also a major trigger for most people with psoriasis. Try practicing yoga or joining a therapy group specific to psoriasis to help you reduce and manage your stress levels.

If you’ve already tried the treatment options mentioned above and your symptoms still seem to be getting worse, talk to your doctor about the benefits and risks of combining multiple treatments.