Choosing the Right Psoriasis Treatment: A Dermatologist’s Advice

The decision is individualized and takes in several factors.

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“Psoriasis is a chronic and relapsing condition,” says Suzanne Friedler, MD, dermatologist in New York City. “There are times when patients do get frustrated with their medications, and they may relapse at those times.”

For example, you might be less inclined to commit to your prescribed treatments if you feel like it’s not working, or if you’re worried about possible side effects. When you and your doctor work together to find the most effective treatment for psoriasis possible, you’ll probably be more likely to stick to your treatment and enjoy the results.

“Typically, when a psoriasis treatment is working, you’ll see a decrease in redness, a decrease in thickness of lesions, a decrease in scale, and a decrease in body surface area,” says Dr. Friedler.

So how *do* you find that effective treatment option for psoriasis? There are a number of factors to consider, such as your type of psoriasis, the severity of psoriasis, and how much the psoriasis symptoms are impacting your quality of life—to name just a few.

“Topical steroids are a mainstay of therapies, regardless if [the psoriasis symptoms are] mild, moderate, or severe,” says Dr. Friedler.

These topical creams and ointments can be very effective at reducing psoriasis plaques, and for some people, this is the only treatment they will need. However, topical steroids aren’t perfect: Some individuals find ointments messy or sticky, for example, and they may enjoy creams or foams instead.

“In moderate and severe patients, we’ll add on other types of therapies,” says Dr. Friedler. Treatment options for moderate to severe psoriasis include phototherapy (or UV light therapy), oral systemic therapy, and biologic therapy.

These treatment options do more than just relieve psoriasis symptoms. “Biologics can have a great role in preventing psoriatic progression onto psoriatic arthritis. It can prevent joint damage,” says Dr. Friedler. If your doctor believes you have a risk of developing psoriatic arthritis, biologic therapies may be a great option.

“Most therapies should show some improvement within two to three months, and most likely by four months,” says Dr. Friedler. “If something isn’t working by three to four months, it may be time for a change.”