If you have moderate to severe psoriasis or other treatments haven't worked, your doctor may prescribe oral or injected systemic drugs. Because of the potential for severe side effects, some of these medications are used for only brief periods and might be alternated with other treatments. Usually administered weekly as a single oral dose, methotrexate Trexall decreases the production of skin cells and suppresses inflammation. It's less effective than adalimumab Humira and infliximab Remicade. It might cause upset stomach, loss of appetite and fatigue.
People taking methotrexate long term need ongoing testing to monitor their blood counts and liver function. Men and women should stop taking methotrexate at least three months before attempting to conceive. This drug is not recommended when you're breast-feeding.
Taken orally for severe psoriasis, cyclosporine Neoral suppresses the immune system. It's similar to methotrexate in effectiveness but cannot be used continuously for more than a year. Like other immunosuppressant drugs, cyclosporine increases your risk of infection and other health problems, including cancer. People taking cyclosporine need ongoing monitoring of their blood pressure and kidney function.
These drugs are not recommended when you're pregnant, breast-feeding or if you intend to become pregnant. These drugs, usually administered by injection, alter the immune system in a way that disrupts the disease cycle and improves symptoms and signs of disease within weeks. Several of these drugs are approved for the treatment of moderate to severe psoriasis in people who haven't responded to first-line therapies.
The therapeutic options are rapidly expanding. Examples include etanercept Enbrel , infliximab Remicade , adalimumab Humira , ustekinumab Stelara , secukinumab Cosentyx and ixekizumab Taltz.
These types of drugs are expensive and may or may not be covered by health insurance plans. Biologics must be used with caution because they carry the risk of suppressing your immune system in ways that increase your risk of serious infections. In particular, people taking these treatments must be screened for tuberculosis. Although doctors choose treatments based on the type and severity of psoriasis and the areas of skin affected, the traditional approach is to start with the mildest treatments — topical creams and ultraviolet light therapy phototherapy — in people with typical skin lesions plaques and then progress to stronger ones only if necessary.
People with pustular or erythrodermic psoriasis or associated arthritis usually need systemic therapy from the beginning of treatment.
The goal is to find the most effective way to slow cell turnover with the fewest possible side effects. A number of alternative therapies claim to ease the symptoms of psoriasis, including special diets, creams, dietary supplements and herbs.
None have definitively been proved effective. But some alternative therapies are deemed generally safe and might reduce itching and scaling in people with mild to moderate psoriasis. Other alternative therapies are useful in avoiding triggers, such as stress.
If you're considering dietary supplements or other alternative therapy to ease the symptoms of psoriasis, consult your doctor. He or she can help you weigh the pros and cons of specific alternative therapies. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. Coping with psoriasis can be a challenge, especially if the affected skin covers a large area of your body or is visible to other people.
Oatmeal baths can also be very helpful and soothing for plaque psoriasis. Light therapy involves exposing your skin to ultraviolet light under the supervision of a doctor. Ultraviolet light can help slow the growth of skin cells triggered by psoriasis.
This therapy often requires consistent and frequent sessions. Sitting in the sun for 10 to 15 minutes can also help reduce plaques. Too much sunlight can actually worsen psoriasis. Any chronic condition like psoriasis can be a source of stress , which in turn can worsen psoriasis symptoms.
In addition to reducing stress whenever possible, consider incorporating stress-reducing practices such as yoga and meditation.
Alcohol is a trigger for many people who have psoriasis. A study in found an increased risk of psoriasis among women who drank nonlight beer.
Turmeric has been found to help minimize psoriasis flare-ups. It can be taken in pill or supplement form, or sprinkled on your food.
Avoid tobacco. Smoking may increase your risk of psoriasis. Being overweight or obese puts you at a greater risk of developing psoriasis. Obesity is also associated with more severe psoriasis symptoms. Studies have found that losing weight can help improve these symptoms. Less common types of psoriasis affect the nails , the mouth, and the area around genitals. According to one study , around 7.
Plaque psoriasis is the most common type of psoriasis. The American Academy of Dermatology AAD estimates that about 80 percent of people with the condition have plaque psoriasis.
It causes red, inflamed patches that cover areas of the skin. These patches are often covered with whitish-silver scales or plaques. These plaques are commonly found on the elbows, knees, and scalp. Guttate psoriasis is common in childhood. This type of psoriasis causes small pink spots. The most common sites for guttate psoriasis include the torso, arms, and legs. These spots are rarely thick or raised like plaque psoriasis. Pustular psoriasis is more common in adults. It causes white, pus-filled blisters and broad areas of red, inflamed skin.
Pustular psoriasis is typically localized to smaller areas of the body, such as the hands or feet, but it can be widespread. Inverse psoriasis causes bright areas of red, shiny, inflamed skin. Patches of inverse psoriasis develop under armpits or breasts, in the groin, or around skinfolds in the genitals.
Erythrodermic psoriasis is a severe and very rare type of psoriasis. This form often covers large sections of the body at once. The skin almost appears sunburned. Scales that develop often slough off in large sections or sheets.
Check out pictures of the different types of psoriasis. Psoriasis symptoms differ from person to person and depend on the type of psoriasis. Areas of psoriasis can be as small as a few flakes on the scalp or elbow, or cover the majority of the body.
Not every person will experience all of these symptoms. Some people will experience entirely different symptoms if they have a less common type of psoriasis. The condition may cause severe symptoms for a few days or weeks, and then the symptoms may clear up and be almost unnoticeable. Then, in a few weeks or if made worse by a common psoriasis trigger, the condition may flare up again.
Sometimes, symptoms of psoriasis disappear completely. Doctors are unclear as to what causes psoriasis. However, thanks to decades of research, they have a general idea of two key factors: genetics and the immune system. Psoriasis is an autoimmune condition. Autoimmune conditions are the result of the body attacking itself. In the case of psoriasis, white blood cells known as T cells mistakenly attack the skin cells. In a typical body, white blood cells are deployed to attack and destroy invading bacteria and fight infections.
This mistaken attack causes the skin cell production process to go into overdrive. The sped-up skin cell production causes new skin cells to develop too quickly. This results in the plaques that are most commonly associated with psoriasis. The attacks on the skin cells also cause red, inflamed areas of skin to develop. Some people inherit genes that make them more likely to develop psoriasis.
If you have an immediate family member with the skin condition, your risk for developing psoriasis is higher. However, the percentage of people who have psoriasis and a genetic predisposition is small. Approximately 2 to 3 percent of people with the gene develop the condition, according to the National Psoriasis Foundation NPF. Read more about the causes of psoriasis. Most doctors are able to make a diagnosis with a simple physical exam. Symptoms of psoriasis are typically evident and easy to distinguish from other conditions that may cause similar symptoms.
During this exam, be sure to show your doctor all areas of concern. In addition, let your doctor know if any family members have the condition. If the symptoms are unclear or if your doctor wants to confirm their suspected diagnosis, they may take a small sample of skin. This is known as a biopsy. The examination can diagnose the type of psoriasis you have. It can also rule out other possible disorders or infections.
Your doctor will likely inject a local numbing medication to make the biopsy less painful. They will then send the biopsy to a lab for analysis. This type of treatment plan has many benefits. It can relieve symptoms like itch. It can help you see clearer or clear skin. It can also prevent psoriasis from worsening.
To diagnose psoriasis, a dermatologist will examine your skin, nails, and scalp for signs of this condition. Your dermatologist will also ask if you have any:. Sometimes, a dermatologist also removes a bit of skin. By looking at the removed skin under a microscope, a doctor can confirm whether you have psoriasis. If you have psoriasis, a dermatologist can create a treatment plan to meet your individual needs. To create this plan, your dermatologist will consider the:. Your treatment plan may include medication you apply to your skin, advice to help you care for your skin, and tips to help prevent flare-ups.
To control psoriasis, some people also need light treatments or medication that works throughout the body. You can find out about the different treatments for psoriasis at: Medications and light treatments for psoriasis.
Your dermatologist will want to see you for follow-up appointments. These appointments can be very helpful because your dermatologist can:.
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