Medicines for psoriasis

Psoriasis is a chronic (ongoing) inflammatory skin condition. It causes rapid growth and shedding of skin cells. The excess cells build up into red, scaly patches on your skin.

A healthy lifestyle and self-care measures can help with the symptoms of psoriasis (see below). If doing these things isn't enough to relieve your symptoms, your doctor may prescribe medicines.

While there is no cure, various treatments are available that can help.

Different types of treatments can be used for psoriasis. These can include:

• topical medicines — creams and ointments that you apply to your skin
• ultraviolet light therapy
• medicines that you take by mouth or as an injection

Your doctor may prescribe one medicine or a combination of medicines. It depends on which parts of your body are affected and how severe your symptoms are.

Medicines for psoriasis work in different ways to help control your symptoms.

Topical medicines

Topical treatments are creams and ointments that you put onto your skin. These can be used regularly on the affected areas only. The aim is to reduce symptoms such as redness, scaliness and itch.

If you have mild to moderate psoriasis, your doctor may recommend one or more of these medicines to apply to your skin:

• moisturisers
• corticosteroids — such as hydrocortisone, betamethasone or mometasone
• calcipotriol (similar to Vitamin D)
• coal-tar based treatments
• salicylic acid

Ultraviolet (UV) light therapy

Your doctor or specialist may suggest using UV light therapy. This mimics the effect of sunlight and is used 2 to 3 times a week.

UV light therapy is sometimes called phototherapy. It works by slowing down the rate that your skin makes new cells.

You might combine UV light therapy with a medicine called psoralen. This medicine helps the UV light treatment work on deeper layers of your skin.

Oral or injected medicines

If your psoriasis symptoms are not controlled by topical treatments, your doctor or dermatologist (skin specialist) may suggest other medicines.

Some of these medicines work on your immune system to reduce the inflammation. You might need to take a tablet or have an injection under your skin.

If you have more severe psoriasis you might take an oral medicine (tablet) such as:

• acitretin — a 'retinoid' medicine that reduces inflammation and helps slow the rate that your skin makes new cells
• methotrexate — an immunosuppressant (medicine that works on your immune system)
• ciclosporin — an immunosuppressant medicine

Specialists can also prescribe medicines called 'biologic medicines' when other treatments are not working. Biologic medicines are also used to treat psoriatic arthritis.

All medicines can have side effects. Sometimes they are serious, but most of the time they are not.

The main concerns with topical medicines are:

• thinning of your skin
• skin irritation
• skin infections

Many of the oral or injectable psoriasis medicines can have a range of side effects. Some of them suppress your immune system. You may need to get vaccinations (like the flu shot) to prevent serious infections.

Ask your doctor or pharmacist about the possible side effects of medicines you are taking.

You should see your doctor if you have symptoms of psoriasis. Your doctor can discuss the best treatment for you, or refer you to a specialist.

Before taking any medicines, consider asking your doctor or pharmacist:

• What are the side effects of the medicines for psoriasis?
• What are the benefits?
• What should I do if I miss a dose?
• What should I do if I have side effects?

Talk to your doctor as soon as possible if you feel unwell when taking your medicines. Do not stop or change your medicines without talking to your doctor.

Psoriasis is a chronic (ongoing) condition that flares up and down over time.

You may not need medicines if you have mild symptoms that are not bothering you. But some people need to continue treatment for many years.

There are things you can do to ease some of the symptoms and reduce the chance of a psoriasis flare-up:

• Avoid anything that irritates your psoriasis.
• Use a soap free wash product or try an oatmeal bath.
• Moisturise your skin regularly.
• Lose weight, if you are living with obesity or overweight.
• Reduce your stress, and find ways to manage it.
• Avoid alcohol and smoking.
• Have some exposure to sunlight (while taking care to protect your skin from sunburn).

Psoriasis Australia has information and support for people with psoriasis in Australia and their families.

The Australasian College of Dermatologists has a video — Your guide to psoriasis. There is also information about phototherapy.

If you have questions about your medicines, talk to your doctor, pharmacist or other health provider. You can find out more about your medicine by reading the Consumer Medicine Information (CMI).

Call 1300 MEDICINE (1300 633 424) to speak with a pharmacist who can answer your questions about medicines.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.