How to get a prescription for psoriasis medication?

Table of Content:
Prescription creams and ointments | Psoriasis pills | Psoriasis injections | Over the counter creams for psoriasis

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Psoriasis medications have evolved significantly in recent years with the development of newer treatments that offer more targeted and effective approaches. These psoriasis medications, often referred to as immunomodulatory drugs and biologic medications, specifically address the immune system dysregulation underlying psoriasis. 

Dr. Alpana Mohta, a board certified dermatologist, says that while biologics and systemic medications have been at the forefront of treating moderate to severe psoriasis, topical medications and lifestyle changes continue to be essential for managing mild to moderate forms of the condition. 

This dermatologist’s guide dives into the different types of medications used to treat psoriasis including over-the-counter, topical, oral and injectable medications. This guide aims to help you and your online dermatologist make an informed decision over your psoriasis treatment plan.

Do you need a prescription to get psoriasis medication?

Yes, most psoriasis medication require a doctor’s prescription. The type of medication (oral, topical or injectables) you get will depend on the severity of your symptoms.

What is the best medicine for psoriasis?

Topical medications for psoriasis

Many individuals with psoriasis prefer to try a psoriasis cream or ointment, before taking oral medications, since topical treatments have less and milder side-effects. Dr. Alpana Mohta gives a comprehensive list of the best psoriasis creams available.

Topical steroids

Topical corticosteroids are often the first-line treatment for mild to moderate psoriasis. They can help reduce inflammation and control symptoms. However, long-term use should be avoided on the face due to the risk of skin thinning¹.

Topical calcineurin inhibitors

Two psoriasis creams often prescribed by dermatologists are tacrolimus ointment and pimecrolimus cream,  topical immunomodulators that can be used on the face, they help control inflammation without the risk of skin thinning associated with steroids².

Topical Vitamin D analogs

Topical creams containing vitamin D analogs, such as calcipotriene cream, can be effective in managing facial psoriasis by slowing down the growth of skin cells³.

Coal tar

Coal tar creams for psoriasis can help alleviate itching and scaling, but they have a strong odor and may be less cosmetically acceptable for use on the face.

Zithranol 

Zithranol (having anthralin as the active ingredient) is a topical cream highly efficient in the treatment of psoriasis. It has been used for many years to manage symptoms, particularly in the form of a cream, ointment, or paste applied directly to the affected skin areas⁵.

Vtama

Vtama cream (having tapinarof as the active ingredient) functions as an anti-inflammatory agent by modulating the activity of certain proteins involved in the skin’s inflammatory response. The FDA recently approved its use as a safe and effective treatment option for patients aged 12 and above. The recommended concentration for Vtama is 1% cream, and it’s applied once daily to the affected skin areas. 

Zoryve

Zoryve (having roflumilast as the active ingredient) is another recently FDA-approved topical cream for psoriasis treatment, functions as a phosphodiesterase-4 (PDE-4) inhibitor. Its mechanism involves suppressing inflammatory cytokines, thereby reducing inflammation associated with psoriasis. It comes in a concentration of 0.3% in cream or ointment form. 

Oral medications for psoriasis

Yes, there are several psoriasis oral medications (pills) prescribed for severe condition for individuals who do not respond to other treatments. These drugs target specific aspects of the immune system and can be effective in managing psoriasis symptoms.

RediTrex

Reditrex (having methotrexate as the active ingredient) is a medication available as a pill or in liquid form used for autoimmune diseases like rheumatoid arthritis and moderate to severe psoriasis. It works by suppressing the immune system and inhibiting rapid cell growth⁶. It is available in different forms and requires careful medical supervision due to potential side effects.

Cyclosporine

Cyclosporine is an immunosuppressive medication available as a pill or in liquid form, often prescribed to manage certain autoimmune conditions such as psoriasis and rheumatoid arthritis. Cyclosporine helps reduce inflammation and prevent the immune system from attacking healthy tissues⁷. This medication is typically used for short-term treatment due to the risk of side effects and requires close medical monitoring during its administration.

Acitretin

Acitretin is primarily used in the treatment of severe psoriasis and other disorders characterized by excessive skin cell growth. It is a synthetic retinoid that works by regulating skin cell proliferation and differentiation. Acitretin is particularly effective for treating psoriasis when other treatments have not provided satisfactory results⁸. It is typically prescribed for short-term use due to the potential for side effects. Close medical supervision is essential when using Acitretin.

Otezla

Otezla tablets (having apremilast as the active ingredient) are used in the treatment of psoriasis, a chronic skin condition characterized by red, scaly patches. Unlike many other psoriasis medications, Otezla is not a biologic but rather a phosphodiesterase-4 (PDE-4) inhibitor. It works by modulating the immune system and reducing the production of inflammatory chemicals⁹. Apremilast is typically prescribed for individuals with moderate to severe psoriasis and can provide relief from symptoms like redness and scaling. It offers a convenient oral treatment option, making it a choice for patients who prefer not to use injections. 

What is the best treatment for severe psoriasis?

The best treatment for severe psoriasis are the newly developed biologic medications that administered by self-injection when more traditional treatments, like topical creams or oral medications, have proven ineffective. Here are the 9 biologic medications available for psoriasis: Enbrel, Humira, Remicade, Cosentyx, Taltz, Siliq, Tremfya, Skyrizi, and Stelara.

Biologic medications (injections) for psoriasis

Biologic medications (psoriasis injections) are drugs designed to target specific proteins or molecules in the immune system that play a role in inflammatory diseases, such as psoriasis.

Biologics (psoriasis injections) work by dampening the immune response, reducing inflammation, and thus alleviating the symptoms of psoriasis, which include redness, scaling, and itching. These medications offer a targeted approach with fewer systemic side effects compared to some other systemic treatments¹⁰. 

While biologic medications are highly effective in managing psoriasis, they are typically administered via injection in a healthcare clinic due to potential risks and side effects.

Enbrel

Enbrel (having etanercept as the active ingredient) is a biologic medication administered as an injection used to treat severe psoriasis. It works by inhibiting the factor-alpha (TNF-alpha), a cytokine involved in the inflammatory processes that contribute to psoriasis. By reducing inflammation, Etanercept helps alleviate the symptoms of psoriasis, including scaling and redness, and may also slow down the progression of the disease¹¹. It is typically administered as a subcutaneous injection and is often prescribed when other treatments have proven ineffective or when psoriasis is severe and significantly impacting a patient’s quality of life. 

Humira

Humira (having adalimumab as the active ingredient) is another biologic medication administered by injection used in the treatment of severe psoriasis. This medication works very similarly to Etanercept  and is also administered as an injection¹².

Remicade 

Remicade (having infliximab as the active ingredient) is another biologic medication administered as an injectable used in the treatment of psoriasis. It works similar to the previous medications reducing inflammation, and helping alleviate the symptoms of psoriasis, including scaling and redness¹³. 

Cosentyx

Cosentyx (having secukinumab as the active ingredient) is a biologic injection utilized in the treatment of psoriasis. Cosentyx works by targeting interleukin-17A (IL-17A), a pro-inflammatory cytokine involved in the development of psoriasis symptoms. By blocking the action of IL-17A, this medication helps reduce inflammation and alleviate the hallmark features of psoriasis, such as redness and scaling¹⁴.

Taltz

Taltz (having ixekizumab as the active ingredient) is a biologic medication that works by targeting and neutralizing interleukin-17A (IL-17A) inhibitors which reduces inflammation, alleviates redness and scaling, and improves overall skin appearance¹⁵. 

Siliq 

Siliq (having brodalumab as the active ingredient) is another interleukin-17 (IL-17) inhibitor used in the treatment of psoriasis. It helps reduce inflammation, relieve redness, scaling, and itching, and improve the overall appearance of the skin¹⁶. 

Tremfya

Temfya (having guselkumab as the active ingredient) is a biologic medication administered by injection employed in the treatment of psoriasis. Tremfya is specifically classified as an interleukin-23 (IL-23) inhibitor and works by targeting and blocking IL-23, a cytokine involved in the development of psoriasis symptoms. By inhibiting IL-23, Guselkumab helps reduce inflammation, alleviate redness and scaling, and improve overall skin appearance¹⁷.

Skyrizi

Skyrizi (having risankizumab as the active ingredient) is a different interleukin-23 (IL-23) inhibitor administered by injection that helps reduce the symptoms of psoriasis¹⁸.

Stelara

Stelara (having ustekinumab as the active ingredient) works by targeting and blocking two specific proteins in the immune system, interleukin-12 (IL-12) and interleukin-23 (IL-23), which are involved in the inflammation and immune response seen in psoriasis. By inhibiting these proteins, Ustekinumab helps reduce inflammation, alleviate redness, scaling, and itching, and improve the overall appearance of the skin¹⁹.

Over the counter treatment for psoriasis

Over the counter treatment for psoriasis can help manage mild to moderate symptoms and provide relief from itching and scaling. However, it is important to note that while over the counter creams can be beneficial, they may not be as effective as prescription medications for more severe cases of psoriasis. Here are some OTC creams to manage mild symptoms of psoriasis.

• Moisturizers with ceramides, glycerin and hyaluronic acid
• White soft paraffin and liquid paraffin
• Coal tar products
• Salicylic acid
• Lactic acid
• Urea
• Hydrocortisone
• Capsaicin cream
• Aloe vera gel
• Oatmeal baths
• Calamine
• Camphor
• Menthol

The takeaway

Although psoriasis is a chronic and autoimmune condition by using stress-coping techniques, identifying and managing your triggers, and adequate treatment, you can more less stay symptom-free most of the time. Talk to your online dermatologist, or find a dermatologist in your area to get the treatment plan for you. 

Did you know that psoriasis can also affect the face, causing redness and scaling? For more details on managing facial psoriasis, check out our in-depth article “Psoriasis on face: What is it and how to get rid of it?“

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