There is currently no cure for psoriasis. But if you have the condition, there are many treatment options available. The trick is to find one that works for you.
Different people respond to different treatments, says Ashley Jenkins, MD, a dermatologist and adjunct professor of dermatology at the University of Missouri in Columbia. In some cases, a drug may be effective for a while and then stop working. Then it’s time to try something new.
If you have psoriasis, here’s what you need to know about your treatment plan.
What should the treatment do?
The goal of treating psoriasis is to get plaques on no more than 1% of your body. If you have symptoms in other parts of your body, such as pitted nails or inflamed joints, treatment should reduce these as well.
“It can take up to twelve weeks for a medication to fully work,” says Dendy Engelman, MD, a dermatologist at the Shafer Clinic in New York City. “If your symptoms aren’t [mostly cleared] Let your dermatologist know at that time.”
Most doctors start treatment with topical medications, such as corticosteroids, that you apply directly to your skin. “They have fewer side effects and can be effective, especially if you have mild to moderate psoriasis,” says Jenkins.
But if you have a lot of flaking on your skin, joint pain, or don’t get relief from topical remedies, your doctor may recommend a different treatment. This can be light therapy or ‘systemic treatments’. These are oral or injected medications that treat inflammation throughout your body. You can combine systemic medications with topical treatments or use them alone. They should start working within a few weeks.
Whatever your treatment, your doctor will examine your skin to determine if it’s working, says Joshua Zeichner, MD, dermatologist and director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City.
If you have psoriatic arthritis, “your doctor may also recommend tests like X-rays to see if you have joint damage,” says Zeichner.
Biological medications, a type of treatment that suppresses your immune system, can help. Your doctor may have you wait a few months to get your inflammation under control, Zeichner says, and then switch to another treatment, such as light therapy and topical medications.
What happens if the treatment doesn’t work?
Contact your doctor right away, Zeichner says, if you notice your psoriasis worsening or if you experience any side effect related to your treatment. These are signs that it’s time to try a new type of medicine. Sometimes combining treatments, such as an organic and a topical ointment or cream, produces better results.
“You’ll want to have a conversation with your dermatologist or doctor about what results you want and how aggressive you are willing to be with the treatment,” says Jenkins. There are dozens of different options, so don’t be afraid to speak up if you don’t like the plan your doctor suggests.
Having psoriasis means seeing your dermatologist or another member of your healthcare team regularly, especially when your symptoms flare up. Make sure your doctor looks at all aspects of your health, not just your skin.
“Psoriasis is a sign of inflammation in your body. That inflammation hinders your body’s ability to regulate your immune system,” says Engelman. The impact on your immune system can cause or contribute to many other health problems, including joint damage. Tests to measure your blood sugar, blood pressure, and weight can help your doctor detect and treat psoriasis-related health problems before they cause serious problems.
Effectiveness isn’t the only reason you might want to change medications. If you don’t like or can’t live with the side effects, or if you find a drug too difficult to use, you may want to switch. Depending on your health insurance, costs can also be an issue. Know that it’s okay to stop taking a medication, even if it’s working.
“It’s important to be your own advocate,” says Engelman. The key is that you are willing to try something different.
“Untreated, psoriasis can have a major impact on your health and daily life,” says Jenkins. “It’s important to work with your doctor and keep trying new approaches until you find a solution that works for you.”