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6 Ways to Reach Your Psoriasis Treatment Goals

By Claire Gillespie
Reviewed by Allison Truong, M.D.
September 27, 2021

While there’s no cure for psoriasis, a range of treatments can improve visible and uncomfortable symptoms. But it’s an extremely unpredictable disease—what works for one person won’t necessarily work for the next. And treatment often involves trying a few different methods before finding what really works.

The National Psoriasis Foundation recommends doctors set a goal of either reducing a patient’s psoriasis down to covering 1 percent or less of their body surface, or achieving a 75 percent reduction in psoriasis symptoms, within three months of starting the treatment. This is based on the results of a study published in the Journal of the American Academy of Dermatology in 2016. (One percent of body surface equals about the size of the palm of the person’s hand.)

Your personal goal may be the same as this, or it may differ, but the important thing to know is that there are some things you can do to help boost the odds of achieving it.

Set Realistic Goals

First of all, don’t set yourself up for additional stress. There’s no doubt that almost everyone with psoriasis wants clear skin—it’s the dream. But it might be better to start with a more realistic personal goal.

A good initial goal would be to understand how to apply or take your treatment proactively and properly, says Ava Shamban, M.D., a board-certified dermatologist at Ava MD in Santa Monica, California. For instance, topical corticosteroids—often the first-line treatment for mild to moderate psoriasis—come in different categories based on strength, and in different formulations, like ointments and foams. It’s important to know how, when, and how often to apply a topical corticosteroid to minimize side effects and get the best results.

Other realistic goals to set may be improving your quality of life, eliminating discomfort, and improving the appearance of your skin, Shamban says. Once you’ve achieved a smaller goal, you might feel empowered to set a new one.

Make Sure Your Treatment Is Right for You

Many people with psoriasis don’t meet their treatment goals. According to a review of 60 studies and articles published in Archives of Dermatological Research, people with psoriasis only reported “modest” satisfaction with their current psoriasis treatment. It’s interesting to note that those treated with biologics did report higher satisfaction than those treated with topicals, phototherapy, or oral therapies.

Part of the problem may be that some recent innovations in treatment have been aimed at those with moderate to severe psoriasis, meaning those with milder forms of the disease may not benefit from them, write the authors of an article published in Dermatology and Therapy.

One of the most successful newer therapies for psoriasis are biologics, injectable drugs that target the immune-system cells and proteins responsible for the inflammation associated with psoriasis. With these newer drugs, doctors and their patients can realistically strive for a 95 to 100 percent clearance rate as a goal, says board-certified dermatologist Todd Minars, M.D., of Minars Dermatology in Hollywood, Florida.

“Biologics will not ‘cure’ the patient forever, but they can provide fantastic results and notable improvements to their self-esteem and quality of life while maintaining treatment, which is a big win in my book,” Minars says.

If your current treatment isn’t working the way you want it to, ask your doctor what the alternatives are and if you should make a switch. It may take a few tries to find the best plan for you.

Keep Up with Follow-Up Appointments

Keeping your psoriasis under control tends to be an ongoing process, involving regular appointments with your dermatologist. “It’s important to have a plan for both the short- and long-term,” Shamban says.

You are responsible for your own treatment plan, of course, but your doctor also plays a crucial role.

Your doctor needs to carry out ongoing analysis of your current therapy, make recommendations, and assess your treatment’s benefits and results, Shamban says. If you have any concern—be it medical, emotional, financial, or something else—your doctor should be available to help you address each one.

Stick to Your Treatment Plan

If you stick to your treatment plan, it has the best chance of success—and that means no exceptions. Take your medication as your doctor has directed, and keep up with any skincare or lifestyle instructions they’ve given you.

“Focus on following the rules,” Shamban says. “For instance, an oatmeal bath three times a week doesn’t mean once a week. And eliminating alcohol doesn’t mean drinking only on the weekends.”

Identify Your Personal Triggers

Throughout your treatment plan, it’s important to identify what your personal triggers are. When you know what these are, you can avoid them, Shamban says. She suggests tracking everything, from foods to lifestyle factors, that worsen or improve your symptoms.

Some of the most common psoriasis triggers are stress, injury to the skin, illness, and cold weather. Some people find that drinking alcohol excessively and/or smoking cigarettes makes their psoriasis symptoms worse. And although there’s very little supporting scientific evidence to say certain foods are triggers, many people find that their symptoms improve when they avoid foods that can cause inflammation in the body, such as dairy and refined sugar, or those they have sensitivities to.

Find Ways to Reduce Stress

Living with psoriasis can be an emotional roller-coaster. Symptoms often come and go unexpectedly, and can flare unpredictably. Because having a chronic disease can be stressful in itself, patients sometimes find themselves caught in a vicious cycle of psoriasis and poor mental health. Research has shown that psoriasis can contribute to or exacerbate mental health conditions like anxiety, depression, and eating disorders. And it can be a vicious cycle, as there are also studies showing that major stressful life events can result in the new onset of psoriasis symptoms.

In fact, a systematic review, published in the Journal of Clinical and Aesthetic Dermatology, looked at 57 studies on the connection between psoriasis and different mental health conditions and found that psychological stress and depression can boost the release of pro-inflammatory cytokines as part of the immune response. And this inflammation may be instrumental in symptoms of psoriasis and mental health conditions like depression.

Regular exercise and mindfulness techniques like meditation can help reduce stress, and if you’re really concerned, you may want to talk to a therapist or counselor, for extra help. While stress is often unavoidable, you just might find that managing it better gets you a few steps closer to reaching your psoriasis goals.

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