“Psoriasis has many treatment options, and the right one for you will depend on several factors. You and your doctor will talk about your specific condition and lifestyle to decide what will work best.
What Doctors Consider
Your doctor will look at the amount of skin your psoriasis covers, also known as body surface area, and which parts of your body are involved. If you have other conditions—what doctors call comorbidities—your doctor will take those into account, too. “We also have to account for factors such as medications’ side effects and interactions with other medications, your functional status or ability to follow complex regimens, response to prior treatments, skin type, alcohol and substance use, insurance coverage, ability to travel for labs or routine follow-up, and ability to pay for medication,” says Stephen Matlock, MD, dermatologist at U.S. Dermatology Partners in Joplin, MO.
Common Choices
One category of treatment for psoriasis is topical creams, gels, or ointments you spread on your skin or scalp. The most common treatment doctors turn to first for psoriasis is topical corticosteroids. “Almost all patients will be given a prescription of one or more of these medications, but if the patient’s skin involvement is more extensive, then the effectiveness of these medications is limited by the hassle of applying a cream or ointment twice a day,” Matlock says. Phototherapy, a treatment that exposes your skin to UV light, is another option. Often you use a topical cream in combination with these lights. Systemic medications come in pill, injection, or infusion. These medications go throughout your whole body to treat your psoriasis. Biologics are systemic medications that work with your immune system to reduce inflammation. A systemic may be best for you if you have moderate to severe psoriasis. “Most people will require more than one medication at some point, but the good news is there are tons of combinations that can result in improvement, and often near control, of psoriasis,” Matlock says.
Questions to Ask
When talking through treatment options with your doctor, you’ll want to be sure you have the whole picture so you can make an informed choice. Matlock suggests asking questions such as:
- How and how often do I take the medication?
- How does it work?
- What are the possible risks and side effects?
- What happens if my insurance denies coverage of the medication?
- How have your other patients done on this medication?
In the end, the best choice tends to be the one that’s convenient enough for you to follow it, says Matlock. “If you’re not comfortable with treatment, you won’t use it, and your disease won’t improve,” he says.”
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