How Will I Know It’s Time to Switch to a New Psoriasis Treatment? A Q&A with Dr. Truong

By Beth W. Orenstein
March 13, 2023

This article is part of a Q&A series in which a healthcare professional in our community answers your frequently asked questions.

We asked: “I’m on a psoriasis treatment plan, but it’s not getting better. How will I know when it’s time to try something else?”

Allison Truong, M.D.: Psoriasis can be a tricky condition to treat. Fortunately, there are many treatments available to choose from, including:

The best treatment approach often depends on the severity of your psoriasis and where the plaques are on your body. Not all medications work for everyone, so finding the right treatment—or combination of treatments—requires some trial and error.

It’s best to start with the lowest-risk treatment that could work, such as topicals or light therapy. If that’s not successful or doesn’t work for your lifestyle, you might need to move on to a different option.

Many medications take time to show their maximum benefit. For example, most topicals take at least two weeks to show improvement. Biologics may take at least three months to start working to their full potential.

Remember, you must take your medication or apply your topical exactly as directed to be able to judge whether or not it’s effective. If you don’t use it as directed, it won’t work properly. Be sure to also tell your doctor about any other medicines you are taking—even those that are over the counter—to help avoid any potential drug interactions.

Once enough time has passed after starting the new medication, if you see little or no improvement, talk to your doctor about switching to a different treatment. For example, if one biologic doesn’t work for you, there are others you can try instead, as each one works slightly differently.

Even if a particular psoriasis treatment doesn’t clear your skin completely, if you see significant improvement, it’s considered a success. Sometimes, too, people may find that a treatment works well for quite some time, but after a while, it stops working as well as it used to. That’s when you and your doctor might consider moving on to a different treatment option.

Remember, it’s always a good idea to stay in touch with your dermatologist throughout treatment, even if it’s going well. Most insurance plans require a new prescription before refilling a medication, and certain medications may require laboratory monitoring at least once a year.

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