The Consumer’s Guide to Biologics for 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

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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:
- 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.
- 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.
1. There are 12 biologic medications approved specifically for treating psoriasis.
Each of the 12 biologics targets different pathways thought to cause psoriasis, which is why you may need to try multiple types of biologics before you find the right one to control your condition.

IL-12/23 inhibitor
- ustekinumab (Stelara)

IL-17 inhibitors
- bimekizumab-bkzx (Bimzelx)
- brodalumab (Siliq)
- ixekizumab (Taltz)
- secukinumab (Cosentyx)

IL-23 inhibitors
- guselkumab (Tremfya)
- risankizumab (Skyrizi)
- tildrakizumab (Ilumya)

TNF-alpha inhibitors
- adalimumab (Humira)
- certolizumab pegol (Cimzia)
- etanercept (Enbrel)
- infliximab (Remicade)

2. Biologics are usually prescribed to treat moderate to severe psoriasis.
Before prescribing any psoriasis treatment, your doctor may identify the severity of your condition as one of three categories, depending on how much of your body is covered in skin lesions.
- Mild: Covers less than 3 percent of your body
- Moderate: Covers 3 to 10 percent of your body
- Severe: Covers greater than 10 percent of your body
Even if psoriasis covers only a small part of your body, it could still be considered severe if it greatly affects your quality of life.

3. Biologics are administered by infusion or injection.
Different biologics are taken in different ways, but they all involve a needle. Some biologics are given by intravenous infusion in a clinical setting, while you administer others to yourself at home, using an auto-injector to give yourself a shot under the skin.

4. Most people have clearer skin within three to four months.
You may notice some decrease in psoriasis symptoms within the first two weeks after you start the medication, but you’ll see most of the benefits at around 12 weeks. Symptoms may continue to improve for months afterward.

5. Biologics may prevent related health conditions.
“While psoriasis plaques affect the skin, we know that psoriasis is a systemic inflammatory condition,” says Zeichner. “It’s associated with ... a condition called psoriatic arthritis. So, if you have joint aches, it is important to treat them early.” Left untreated, joint damage from psoriatic arthritis is progressive and permanent.
People who have psoriasis also have a higher risk of diabetes, heart disease, obesity, and Crohn’s disease.
Treatments that reduce psoriasis-related inflammation in the skin also lower inflammation in the rest of the body, which can reduce the likelihood you'll develop these related health risks.

6. Over time, a biologic’s effectiveness may diminish.
After months or years of taking a certain biologic, it may become less effective for you. That’s because your immune system may develop antibodies to the drug, particularly if you’ve missed any doses. If this happens, you might notice plaques gradually coming back, and your doctor may recommend switching to another biologic.

7. They’re considered safe but do have potential side effects.
The most common side effects of biologics are pain and skin reactions at the site of the injection. It’s also possible to have an allergic reaction that leads to a rash, itchiness, shortness of breath, or dizziness.
Since biologics work by suppressing your immune system, they increase your susceptibility to infections, such as bacterial and fungal infections, and may increase your risk of tuberculosis and lymphoma. Psoriasis may also increase your risk of lymph node and blood cancers, according to research published in 2021.
Before you start a biologic, your doctor will run tests to make sure the drug is safe for you to take.

8. Biologics are expensive, but you likely won’t pay for all of it out of pocket.
Biologics can cost anywhere from $1,700 to $80,000 per year in the United States. Most insurance companies cover at least a portion of that, but how much you’ll pay out of pocket and which drugs are covered depends on your insurance plan.
If you can’t afford the biologic your doctor prescribes, talk to them (or your pharmacist) about your options. Your state may have a drug plan to assist with medication costs. You can also check the drug manufacturer’s website for their patient assistance program. You might qualify for lower copays or even get the medication for free.

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?
Test Your Knowledge of Psoriasis Treatment

Next Steps: Making Psoriasis Treatment Decisions

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.

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

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.
- What can I do to improve my skin?
- Am I a good candidate for biologics?
- Which medication are you prescribing for me and why?
- What results do you expect?
- 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
- Cleveland Clinic: Biologics: The Solution for Psoriasis?
- Mayo Clinic: Psoriasis
- National Psoriasis Foundation: Biologics
- American Academy of Dermatology Association: Psoriasis Treatment: Biologics
- National Center for Biotechnology Information: Biologics in Psoriasis: Updated Perspectives on Long-Term Safety and Risk Management
- About Psoriatic Arthritis. National Psoriasis Foundation. September 29, 2023.
- Abrouk M et al. The Patient’s Guide to Psoriasis Treatment. Part 3: Biologic Injectables. Dermatology and Therapy. September 2016.
- Biologics. National Psoriasis Foundation. December 14, 2022.
- Biosimilars. National Psoriasis Foundation. November 21, 2023.
- Chen BK et al. Why Biologics and Biosimilars Remain So Expensive: Despite Two Wins for Biosimilars, the Supreme Court’s Recent Rulings Do Not Solve Fundamental Barriers to Competition. Drugs. November 2018.
- Current Biologics on the Market. National Psoriasis Foundation.
- Depression. National Psoriasis Foundation.
- Felis-Giemza A et al. Measurement of Anti-Drug Antibodies to Biologic Drugs. Rheumatology. August 2015.
- Financial Assistance. National Psoriasis Foundation.
- Harkiewicz A et al. A Survey of Nurse Practitioner and Physician Assistant Advanced Practice Providers Uncovers a Need for Precision Medicine in Psoriasis Management. Journal of Dermatology for Physician Assistants. June 2023.
- Liu J et al. Effects of Biologics on Mental Health and Health-Related Quality of Life in Patients With Psoriasis: A Repeated Cross-Sectional Survey in Chinese Population. International Journal of Dermatology and Venereology. December 2023.
- Menter A et al. Joint AAD-NPF Guidelines of Care for the Management and Treatment of Psoriasis With Biologics. Journal of the American Academy of Dermatology. February 2019.
- Kusti M. Overview and Manufacturing of Biologics. American Journal of Managed Care. August 11, 2020.
- Papp KA et al. Onset of Action of Biologics in Patients With Moderate-to-Severe Psoriasis. Journal of Drugs in Dermatology. March 2018.
- Psoriasis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. October 2023.
- Psoriatic Disease and the Immune System. National Psoriasis Foundation. November 1, 2023.
- Psoriasis Treatment: Biologics. American Academy of Dermatology Association. June 6, 2022.
- Related Conditions of Psoriasis. National Psoriasis Foundation. December 22, 2023.
- Thatiparthi A et al. Biologic Treatment Algorithms for Moderate-to-Severe Psoriasis with Comorbid Conditions and Special Populations: A Review. American Journal of Clinical Dermatology. April 2021.
- Treating to Target. National Psoriasis Foundation.
- Treatments for Psoriatic Disease. National Psoriasis Foundation.
- Vaengebjerg S et al. Prevalence, Incidence, and Risk of Cancer in Patients With Psoriasis and Psoriatic Arthritis: A Systemic Review and Meta-Analysis. JAMA Dermatology. February 2020.
- Psoriasis Severity and Location. Psoriasis Speaks.
- Olmstead SC. Can Costs and Benefits of Psoriasis Treatments Be Better Aligned? Dermatology Times. February 26, 2024.

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
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.
