Biologics for Psoriasis: A Consumer’s Guide

The Consumer’s Guide to Biologics for Psoriasis

Everything you need to know about biologic drugs, a type of targeted systemic treatment for moderate to severe psoriasis.

I f you’re unhappy with your psoriasis treatment, switching to a biologic may be an option. Biologics have been used in the United States to treat psoriasis for two decades. The first was approved by the U.S. Food and Drug Administration (FDA) in 2003.

How Biologics Work for Psoriasis

How Biologics Work for Psoriasis

Since then, this drug class has grown, changing the treatment landscape for psoriasis by helping more people find effective treatment and achieve clearer skin. In fact, you may have seen biologics for psoriasis advertised on TV or online or heard about them from someone else who has psoriasis.

If so, you probably have questions about how biologics work, what it’s like to take one (as most come in injectable form), and more. Learning as much as you can on your own will prepare you for an informed discussion with your doctor.

Psoriasis: A Disorder of the Immune System

On the surface, psoriasis is a skin disease, but plaques and other symptoms are caused by inflammation inside the body. So, the best way to treat moderate to severe psoriasis is often with systemic medications that block the immune system’s inflammatory response.

Why does your body create this inflammation? It’s part of your immune system’s natural defense against foreign invaders that might make you sick. With psoriasis, your immune system is overactive and causes excess inflammation, which activates skin cells to multiply too fast, leading to plaques on your skin.

In other words, psoriasis is an autoimmune condition in which your immune system gets “angry” at your skin, says Joshua Zeichner, MD, the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City.

How Biologics Treat Psoriasis From the Inside Out

Biologic medications are created using living cells that are similar to molecules in your immune system. They work within the body to target inflammation and psoriasis plaques at the source.

Biologics differ from other common psoriasis treatments in two ways:

  1. Rather than treating existing plaques (as topical therapies do), biologics get to the root of psoriasis by blocking the inflammatory process in your body before it even starts.
  2. Unlike traditional systemic therapies, which broadly suppress the immune system, biologics target specific molecules linked to psoriasis.

8 Essential Facts About Biologics for Psoriasis

Here are the basics you should know when deciding if biologics are right for you.

Is It Time to Try a Biologic to Treat Psoriasis Symptoms?

If you’re struggling to get your psoriasis symptoms under control, there’s good news. Today, there are more psoriasis therapies than ever before, and a dermatologist can help you find the right treatment — or combination of treatments — to meet your particular needs.

Before you try biologics, your doctor may suggest the following treatments.

  • Topicals: Topicals include topical corticosteroids, vitamin D analogues, anthralin, topical retinoids (vitamin A derivatives), salicylic acid, coal tar, and moisturizers. These creams and ointments are applied to the affected skin, so they work only on the surface, to treat the outward symptoms of psoriasis, but do not affect inflammation within the body.
  • Phototherapy (light therapy) and excimer laser: These therapies use natural light, artificial ultraviolet A light, or ultraviolet B light to slow skin cell growth and reduce inflammation.
  • Traditional systemics: Medications such as methotrexate and cyclosporine suppress the immune system on a broad level to reduce inflammation and prevent psoriasis symptoms and progression. They can be used alone or in combination with a biologic to treat psoriasis.

Treatment depends on your preferences and how severe your psoriasis is, Zeichner says. “In mild cases, topical creams may do the trick,” he says, “but if larger body surfaces are involved, then systemic medications, such as biologics, may be necessary.”

A Psoriasis Expert Answers Common Questions About Biologics

Do you still have questions about biologics? We got answers from Anna Guanche, MD, a board-certified dermatologist and the founder of Bella Skin Institute in Beverly Hills, California, to the most common questions she hears from patients.

Quiz: How Much Have You Learned?

everyday health quiz

Test Your Knowledge of Psoriasis Treatment

Can you answer all 7 questions correctly?
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Next Steps: Making Psoriasis Treatment Decisions

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Congratulations!

You’ve learned a lot about biologics. Take some time to think about your own psoriasis care and what you might want to discuss with your doctor.

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Self-Reflection

At your next appointment, your doctor may ask you these questions about your current treatment plan. Take some time in advance to reflect on your answers.

  1. Are you satisfied with your current psoriasis treatment?
  2. Has it improved your skin and overall health as well as you had hoped?
  3. Does psoriasis affect your emotional health and quality of life?
  4. Are you downplaying your symptoms when speaking to your doctor?
  5. Are you following your psoriasis treatment regimen as prescribed?
  6. Have you tried other treatment options?
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Doctor Discussion

If you decide it’s time to discuss a potential treatment change with your doctor, jot down some questions you’d like to ask. Here are a few conversation starters you can save to your phone and bring to your next appointment.

  1. What can I do to improve my skin?
  2. Am I a good candidate for biologics?
  3. Which medication are you prescribing for me and why?
  4. What results do you expect?
  5. How long should I use this medication before I notice any progress? 

The Takeaway

  • Biologics can be an option if you’re unhappy with your current psoriasis treatment.
  • It’s important to know that 12 biologics are approved as treatments for psoriasis and that their effectiveness may diminish over time.
  • No matter what, talk with your doctor if you are considering taking biologics for psoriasis.

Resources We Trust

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Mohiba Tareen, MD

Medical Reviewer

Mohiba Tareen, MD, is a nationally acclaimed board-certified dermatologist. She practices medical, surgical, and cosmetic dermatology at her Minnesota medical practice, Tareen Dermatology. Dr. Tareen takes joy in providing comprehensive dermatologic care to the entire family — from acne, to skin cancer, hair loss, and anti-aging, she provides her expertise to patients at all stages of their lives. Cosmetically, Tareen believes in subtle and natural aesthetic enhancements.

Personally, she is proud of her husband, a fellow caring physician, and her active brood of five children.

Debra Fulghum Bruce, PhD

Author
Deb Fulghum Bruce, PhD, is an award-winning medical writer and health literacy expert. An editorial consultant for various health websites, she has written more than 2,800 feature health articles for magazines such as Prevention, Life Extension, Figure, Reader’s Digest, Woman’s Day, Parents, Natural Health, and Success.

Dr. Bruce has written 85 health trade books with publishers such as Time Warner, Penguin Books, Harper Collins, Holt, Rodale, Random House, Ballantine, Bantam, Macmillan, Dell, Simon & Schuster, Berkley, Avon, Little Brown, Norton, John Wiley, Morrow, Dutton, and Kensington.

Features and excerpts from Bruce's many health trade books have appeared in such publications as Esquire, Forbes, Baby Talk, The New York Times, The Washington Post, The Wall Street Journal, Prevention, Redbook, New Choices, Martha Stewart Living, Men's Health, McCall's, U.S. News and World Report, Glamour, Vogue, Cosmopolitan, Shape’s Cook, Woman’s Day, USA Today, and Woman's World. Bruce has appeared on CNN News, ABC News, CBS News, CBS's The Early Show, NBC News, and NBC's Today, as well as myriad radio and television talk shows.

Bruce resides with her husband, Rudy, in South Tampa and was awarded Alumnus of the Year at the University of South Florida for medical writing contributions. Some popular health trade books are Bipolar II with Ronald R. Fieve, MD; The NEW Arthritis Diet and Strong Women Live Longer with Harris H. McIlwain, MD; and The Sleep Doctor's Diet Plan with Michael Breus, PhD.

Bruce has also written for WebMD.com, Oprah.com, AolHealth.com, LivingHealthy.com, Sharecare.com, RealAge.com, LifeExtension.com, iVillage.com, Sears Shop Your Way Health, Nemours Clinic, University Hospitals (Cleveland), Johns Hopkins, University of Michigan Comprehensive Cancer Center, The Orthopedic Hospital (Kentucky), WinFertility.com, AttainFertility.com, and many more.
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Alyssa Etier

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As Head of The Well Programs, Alyssa manages content strategy and delivery for marketing campaigns. She started at Everyday Health as an intern in 2006 and worked her way up to her current role. Alyssa studied print journalism at the University of Illinois in Urbana-Champaign. In her free time, you’ll find her doing yoga, cooking at home with her husband, catching live music, and trying new foods. She also loves to walk just about everywhere.