There are a lot of treatments available for psoriasis (Pso), so it may feel a bit overwhelming to think about them all.1 Different treatments work in different ways and are suitable for different situations,1 so it’s important to work with your healthcare professional to find what’s right for you. Here are the four main treatment groups - find out more about what’s available. To figure out whether your Pso is mild, moderate or severe, take a look at the Pso severity checker.
Topical therapy is usually the first treatment used for mild Pso.1 There is a wide variety available, including:2
Topical treatments containing emollients may hydrate the skin and stop it drying out, or contain other ingredients, like vitamin D, coal tar or corticosteroids, but can take time to apply.1 If you’re taking corticosteroids, these can cause side effects, like thinning of the skin, so ask your healthcare professional whether you should take breaks from applying these.2
If your Pso has not improved as much as you or your healthcare professional would like with treatments applied to your skin, you may be offered short wave ultraviolet B (UVB) phototherapy 2-3 times a week.3 Another type of phototherapy you could be offered is long wave ultraviolet A (UVA) light in combination with a chemical called psoralen in tablet form.3 This is called P-UVA and is often used to treat pustules on the palms and soles of the feet, although it can’t be used in pregnant women or some people who are at a higher risk for skin cancers.45
The first systemic therapy you would usually be offered is methotrexate,6 which suppresses inflammation in psoriasis.1 If you and your healthcare professional decide that methotrexate isn’t appropriate, or it isn’t effective, some other options may include:
Your dose will probably be started low and slowly increased until you reach the dose that helps you with your symptoms.6
Biologic medications are a type of treatment for Pso that work throughout your body.6 They target specific parts of the immune system.8 These should only be prescribed by a specialist doctor with experience treating Pso or PsA, although your symptoms and side effects may be monitored by a clinical nurse specialist.16
There are a number of different types of biological treatment that the treatments above fall into:
If you’re going to be taking a biologic, you will probably need to be tested for tuberculosis (TB) and have blood tests before and during treatment.8
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