Are there any prescription therapies for psoriasis?
A number of prescription therapies are available for psoriasis, and are usually tried when over-the-counter treatments don't help, or when symptoms are moderate to severe. Steroid creams and ointments such as triamcinolone and betamethasone can help reduce psoriasis symptoms. They are effective for flare-ups, but shouldn't be used on a continuous basis unless directed by your doctor.
Psoriasis creams and ointments
A prescription ointment or cream containing calcipotriene (Dovonex®) is effective in treating moderate plaques, and has been shown to work better than over-the-counter products. The topical retinoid, tazarotene (Tazorac®) is a type of vitamin A product that is used specifically for psoriasis. Skin irritation can occur similar to other topicals. Hydroxyurea can be used in combination with light therapy for psoriasis. Anthralin (Psoriatec®) can be used on a short-term basis to reduce inflammation in psoriasis.
Topical immunomodulatotors (TIMs)
A newer class of medicines called topical immunomodulators (TIMs) are sometimes prescribed for psoriasis that does not respond to other treatment. This would be an off label use since they are indicated for atopic dermatitis. TIMs work by regulating the activity of the immune system. Medicines in this class include pimecrolimus (Elidel®) and tacrolimus (Protopic®). Although initial studies have been promising, more medical research needs to be done to determine the effectiveness of these prescription medicines for psoriasis.
Ultraviolet-A light (UVA) in combination with methoxsalen (Oxsoralen®) is a very effective treatment, and is often the fastest way to clear the plaques of psoriasis. Ultraviolet-B light has been shown to work as well as ultraviolet-A therapy. UV therapies are administered in the doctor's office in carefully controlled doses. This form of treatment can cause nausea, itching, and swelling of the treated areas.
Oral medicines are available by prescription for people whose psoriasis is severe. These medicines include cyclosporine (Neoral®, Sandimmune®), acitretin (Soriatane®), and methotrexate.
Drugs called biologics such as etanercept (Enbrel®), infliximab (Remicade®), adalimumab (Humira®) and Alefacept (Amevive®) can be used in severe cases of psoriasis when other medicines fail to provide relief. There can be some potentially serious side effects with these drugs because they affect the immune system.