Finding the right psoriasis treatment may require trial and error. Talk with your doctor about timelines, alternatives, and lifestyle changes that can help in treatment. Keep your doctor informed if symptoms persist.
Depending on your symptoms, medical history, and treatment preferences, your doctor might recommend changes to your treatment plan.
Here are some questions that you can ask to learn about your options.
Some treatments work more quickly than others to reduce symptoms of psoriasis.
Before you give up on your current treatment plan, ask your doctor how long it typically takes for your prescribed treatment to work.
Your doctor might advise you to wait a few weeks or months before making any changes to see whether your symptoms improve.
If your current treatment plan isn’t providing enough relief, your doctor might advise you to:
- increase the prescribed dosage of your current treatment
- stop your current treatment and try a different one
- add another treatment to your current plan
Many treatments are available to help manage psoriasis, such as:
- Phototherapy: This treatment is also known as light therapy. It involves exposing your skin to narrowband ultraviolet light under the supervision of a healthcare professional. Types include narrowband ultraviolet therapy (UVB), as well as psoralen and UVA (PUVA) and excimer laser.
- Topical treatments: These treatments include prescription and over-the-counter creams, lotions, ointments, and gels. They may contain corticosteroids, synthetic vitamin D3, vitamin A, or other active ingredients.
- Biologic medications: These mostly injectable medications may help reduce inflammation in moderate to severe cases of psoriasis. They include certain types of tumor necrosis factor (TNF) inhibitors, interleukin 12 and 23 (IL-12/23) inhibitors, IL-17 inhibitors, IL-23 inhibitors, and T-cell inhibitors.
- Oral small molecule medications: These oral medications may also help limit inflammation in moderate to severe cases of psoriasis. They include tofacitinib (Xeljanz) and apremilast (Otezla).
- Traditional systemic medications: These medications may be taken orally or by injection. They include medications such as acitretin (Soriatane), cyclosporine (Neoral), and methotrexate (Otrexup).
In some cases, your doctor might recommend a combination of multiple treatments. For example, they may prescribe an oral or injectable medication in combination with phototherapy and topical treatments.
Before you try a new treatment for psoriasis, ask your doctor about the potential benefits and risks of that treatment approach.
Trying a new treatment might help get your symptoms under control. But each treatment also carries some risk of side effects. The specific risks vary from one treatment to another.
Some treatment plans may also be more convenient, comfortable, or affordable than others. Your doctor can help you weigh the potential benefits and downsides of different treatments.
Before you stop taking any treatment, ask your doctor whether it’s safe to stop taking it all at once.
Suddenly stopping certain treatments, such as steroids, may raise your chance of developing more severe symptoms of psoriasis. This is known as rebound.
Your doctor may advise you to gradually discontinue your current treatment to help prevent rebound.
To help limit symptoms of psoriasis, it’s important to identify and minimize your psoriasis triggers.
Common psoriasis triggers include:
- sunburns, scratches, or other skin injuries
- certain types of medication, such as lithium and antimalarial drugs
- bacterial or viral infections
Although more research is needed, it’s possible that certain foods may also trigger psoriasis flares in some people.
Your doctor can help you learn more about psoriasis triggers, including the steps you can take to identify and limit your triggers.
Is psoriasis treated by rheumatology or dermatology?
You’d most likely see a dermatologist to treat psoriasis, as it’s a condition that affects the skin, nails, and joints.
That said, 30% of people living with psoriasis also develop psoriatic arthritis (PsA). In many cases, people need to be treated by both a rheumatologist and a dermatologist.
How do I tell if my psoriasis treatment isn’t working?
If you’re still experiencing symptoms at a time when your doctor believes you should be seeing relief, this may be a sign you need to change your treatment.
How do I cure my psoriasis permanently?
There’s no cure for psoriasis, and it’s a chronic condition. However, treatment can help you manage your symptoms.
Many treatments are available to manage symptoms of psoriasis. If your current treatment plan isn’t working well, let your doctor know.
They may adjust the prescribed dosage of your current treatment, switch you to a different treatment, or add another treatment to your plan.
Your doctor can help you understand the potential benefits and risks of different treatment approaches.