When you have psoriasis, the most important thing to keeping your condition under control is staying on track with treatment and seeing your doctor regularly. This also means making note of any changes in your symptoms and expressing them to your doctor.

It’s likely your psoriasis treatment will change over time. Some reasons your doctor might start you on a new medication include:

  • new research or treatment guidelines recommending different ways to manage symptoms
  • a change in or worsening of your psoriasis symptoms
  • a change in your overall health or new medical diagnosis

Never start on a new treatment without talking to your doctor first.

This article explores the different psoriasis therapies, as well as tips for a smooth transition if you need to change your treatment.

It’s important that you feel comfortable with any changes made to your treatment plan. You should feel free to ask your doctor any questions that come to mind.

It may be helpful to write down questions ahead of time. That way, you’ll have a list ready when it’s time to discuss the plan with your doctor. Consider some of the following questions:

  • How long does it take for the new medication to start working?
  • Does the treatment cause any side effects?
  • How often will I have to take the treatment? How often will I have doctor’s appointments?
  • Will the treatment interact with other medications I’m on?
  • Will the treatment affect my other health conditions?
  • Will I have to make any lifestyle changes while on the medication?

The ultimate goal is to find a treatment plan that improves your symptoms and makes you feel better. When switching medications, you might also want to look into whether the new drug is covered under your insurance plan. If it’s not, ask your doctor if there are other ways to help reduce the cost.

Oral drugs work throughout the body to lower inflammation. They also slow the production of skin cells. They can be especially helpful during a flare or if your psoriasis is widespread.

Some common oral drugs are:

  • Methotrexate. This drug is taken weekly. It reduces the immune response and slows down skin cell production. It’s a powerful medication that can be used when other treatments fail to improve psoriasis.
  • Cyclosporine. This drug suppresses the immune system to reduce psoriasis symptoms. Symptoms may start to improve within a few weeks, which is faster than with other therapies. It’s usually only used for 1 year due to potential risks associated with long-term use.
  • Oral retinoids. This class of drug lowers skin cell production to help reduce plaques. It doesn’t suppress the immune system, making it a better choice for some people.
  • Apremilast. This drug reduces inflammation, resulting in less swelling and skin scaling.

Biologic drugs are made from living cells. These drugs target very specific parts of the immune system to “turn off” the actions that cause psoriasis symptoms. Biologics are delivered through an injection or infusion. They usually cause fewer side effects than other psoriasis treatments.

Biologics are effective for a lot of people with psoriasis, but in some cases, the drug loses its effectiveness over time. If this happens, your doctor might switch you to a new biologic.

Topical treatments are applied to the affected area of your skin. Some are available over the counter and others need a prescription.

  • Corticosteroids. There are different strengths of corticosteroids available. They can reduce the redness and irritation associated with psoriasis. Mild corticosteroids can be bought without a prescription. More potent types are best for short-term use and need a prescription. Corticosteroids are quite effective, but they can thin your skin and increase the risk of damage. Follow your doctor’s advice to get the best results and to minimize any negative effects.
  • Synthetic vitamin D. These products slow skin cell growth and reduce inflammation. They may be used with strong corticosteroids to lessen those side effects.
  • Retinoids. These are a form of vitamin A applied directly to the skin. They help to reduce the thickening and redness of psoriasis patches.
  • Coal tar. This method for treating psoriasis has been around for about 100 years. It helps to reduce swelling and itchiness. Coal tar is thick, sticky, and black with a distinctive smell. It’s often combined with other ingredients in non-prescription shampoos, lotions, and ointments. Be aware that it can stain skin, clothing, and furniture.
  • Salicylic acid. Products containing salicylic acid help to remove and soften scales and plaques. This can help other topical products better reach and target the affected skin. Products containing a lower concentration of salicylic acid are available without a prescription. Stronger types need a prescription.

Phototherapy is when the skin is exposed to specific types of UV rays. It’s been used for many years to treat psoriasis.

Some people find exposing affected skin to sunlight improves their psoriasis. Others need more targeted therapy through regular appointments at a medical office. Sometimes, maintenance phototherapy is done at home after initial treatment in a clinic.

Like so many things, this treatment is about finding the right balance. Too much UV exposure can cause sunburn, which can make psoriasis worse.

There is no cure for psoriasis, but you can manage your symptoms through treatment and lifestyle adjustments. Your treatment plan will likely change over time. It may take some patience and effort to figure out the combination that works for you. With time, you’ll find a treatment plan that improves your skin and health.