Psoriasis is an unpredictable condition that may present with mild, moderate, or severe symptoms. Treatment duration depends on the individual, but treating psoriasis can help improve symptoms and reduce flare-ups.

Psoriasis is a skin disorder that affects approximately 3% of adults in the United States. It’s the manifestation of cutaneous (affecting the skin) inflammation caused by psoriatic disease, an immune-mediated condition that causes a state of body-wide inflammation.

The exact underlying causes of psoriasis are not known, but an overactive immune response causes your skin cells to multiply too quickly. This can lead to a buildup of scaly plaques and areas of red, itchy, irritated skin.

The subtypes of psoriasis have different appearances, but the progression and severity are all unpredictable. Your symptoms may never get worse, or your symptoms may be severe from the start. This means treatment options have to be adaptable.

There’s no cure for psoriasis, but it can be treated with medication and lifestyle changes.

Mild to moderate symptoms respond well to topical products such as:

  • corticosteroids
  • topical calcineurin inhibitors (TCIs)
  • vitamin-D medications
  • coal tar
  • retinoids
  • keratolytics
  • anthralin

These products work to soothe your skin and decrease thickening and scale by addressing symptoms directly at the site of your irritation.

When larger areas of the body are affected or symptoms are severe, your doctor can add injectable or oral medications that work to reduce inflammation inside or suppress the immune response causing your symptoms.

Phototherapy, which is treatment with ultraviolet light, is also an option when larger areas of your body are affected. It may be used in combination with retinoids to help slow the production of skin cells and reduce inflammation.

Lifestyle changes

Lifestyle changes can help prevent psoriasis from worsening and can improve current symptoms.

Changes dermatologists recommend include:

  • weight management
  • reducing alcohol intake
  • smoking cessation
  • limiting prolonged sun exposure
  • keeping skin well-moisturized

It’s common to notice patterns with psoriasis flare-ups. Keeping a journal can help you identify possible triggers like cold exposure, stress, injuries, medications, or illnesses.

Psoriasis is a lifelong condition. How long you keep up treatment depends on your symptoms and current medication routine. Some medications, like topicals, are stopped when there are no active psoriasis patches.

Your doctor may recommend you continue other medications even without symptoms to help reduce the chances psoriasis will return with more severe symptoms.

Psoriasis is unpredictable and can flare up, clear unexpectedly, and flare up again.

Treating psoriasis aims to keep the condition stable at a mild or clear baseline while reducing the frequency of flare-ups.

How quickly psoriasis treatments work depends on your medications and your symptom severity.

You may notice improvement with topical products as soon as 1 to 2 weeks. You may see less psoriasis in 4 to 6 weeks. With stronger medications for moderate or severe psoriasis, like the immune suppressant methotrexate, it may take up to 6 months for you to reach complete clearing.

There’s no way to know what will happen if you stop your psoriasis treatment.

Psoriasis affects everyone uniquely. Many factors can play a role in recurrence, including existing comorbid conditions or the number of risk factors you meet for psoriasis.

If you’re in remission, a time when symptoms are absent, your symptoms might never return.

It’s just as possible that you’ll experience a relapse, where symptoms return but appear improved or the same.

Sometimes psoriasis rebounds, which means it returns worse than it was before remission.

Talking with your doctor as soon as you notice psoriasis symptoms is recommended. Treating psoriasis early may increase the chances of stabilizing the condition, even in severe cases.

A 2019 retrospective study following clinical outcomes over 15 years found the majority of people who stopped systemic treatments had to be placed on them again within 12 months to three years.

However, early systemic treatment resulted in a lower risk of relapse for people living with moderate to severe psoriasis.

Because of the unpredictability of psoriasis, communicating with your doctor regularly can help ensure the best outcomes. Your doctor can provide guidance about treatment plans, new therapies, and how (or if) you should stop psoriasis treatment.

There’s no guarantee that living with psoriasis means you’ll develop psoriatic arthritis (PsA). Both are part of psoriatic disease, but they are separate conditions.

Approximately 80% of people living with PsA develop psoriasis first, but you don’t need to have psoriasis to develop PsA.

There’s no evidence that stopping treatment for psoriasis will cause PsA. However, severe psoriasis is a risk factor for PsA.

There’s no cure for psoriasis, but skin plaques and lesions can heal. Your symptoms may resolve totally, and psoriasis can go into remission.

Some people enter remission for long periods of time, experiencing years where symptoms are completely absent. Most episodes of remission last between 30 days to a year.

There’s no way to completely ensure your psoriasis won’t return, but there are steps you can take to help reduce the frequency of flare-ups, including:

  • stress reduction/coping techniques
  • avoiding other skin irritants, like scratching, sunburns, bug bites, or abrasions
  • treating skin injuries as soon as possible
  • eliminating alcohol consumption
  • avoiding cigarette smoke
  • smoking cessation
  • using warm water to shower instead of hot
  • applying moisturizer regularly
  • adding a humidifier to your personal space
  • covering your skin from cold weather
  • staying far enough away from sources of direct heat, like fireplaces
  • avoiding heavily fragranced or harsh skin products
  • wearing sunscreen
  • using a moisturizing product for shaving
  • discussing body art and modifications with your dermatologist

Psoriasis is an immune-mediated skin condition that’s unpredictable — but treatable.

Your course of therapy depends on your symptoms, type of psoriasis, and any comorbid conditions you’re experiencing.

Treating psoriasis can help stabilize the condition, improving symptoms and reducing the frequency of flare-ups. While some psoriasis treatments can be stopped when symptoms go into remission, the absence of symptoms doesn’t mean you should stop being proactive about psoriasis management.

Treating psoriasis early, keeping up with lifestyle changes, and following the guidance of your dermatologist can help ensure the best outcomes in this lifelong condition.