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Psoriasis Decision Aid

  • 1. Introduction

    Learn more about psoriasis.

  • 2. My Options

    Read about available treatments.

  • 3. My Skin

    Learn about your psoriasis.

  • 4. My Values

    Express what is important to you.

  • 5. My Trade-offs

    Compare treatments with your values.

  • 6. My Decision

    Your results and next steps.

My Options

Select the options you wish to compare

Severity
x
No Treatment
x
Complementary & Alternative Treatments
x
Topical Treatments
x
Light Treatments
x
Systemic Treatments
x
Biologic Treatments
SeverityWhat is it and how does it work?
No Treatment

Psoriasis can clear or flare up on its own over time. You can choose to wait and see if your psoriasis clears.

Complementary Treatments

There are many types of supplements and herbal options. Some do not have strong enough research to list here. Talk to your doctor about other treatments you would like to try. Some research has been found for these treatments:

  • Fish Oils
  • Moisturizers (Emollients)
  • Natural or Artificial Salt Baths (Balneotherapy)
  • Sunlight (Climatotherapy)
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Topical Treatments

These are treatments applied to the skin. They slow skin cell growth and reduceĀ inflammation. They come as lotions, gels, creams, and foams.

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Light Treatments

These treatments involve shining light on the skin. They slow skin cell growth. These are often done in a clinic. Some can be done at home with personal light kits.

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Systemic Treatments

These are treatments taken by mouth. (One, called Methotrexate, can also be taken by injection). They travel through your blood stream and affect different parts of your body. Some of these treatments slow shedding and growth of skin cells. Others reduceĀ inflammation.

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Biologic Treatments

Biologics are drugs that bind to the proteins which affect psoriasis. These treatments are given through injection or intravenous infusion (IV).

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SeverityWhat types are there?
No Treatment

None.

Complementary Treatments
  • Fish Oils
  • Moisturizers (Emollients)
  • Natural or Artificial Salt Baths (Balneotherapy)
  • Sunlight (Climatotherapy)
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Topical Treatments
  • Combination treatments
  • Corticosteroids
  • Tazarotene
  • Vitamin D Analogues

These can be used alone, or with other topical or systemic treatments.

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Light Treatments
  • Ultraviolet B (UVB) Broadband light
  • Ultraviolet B (UVB) Narrowband light
  • PUVA - Ultraviolet A (UVA) light and a pill, cream, or bath called Psoralen.
  • Targeted Phototherapy
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Systemic Treatments
  • Acitretin
  • Apremilast
  • Cyclosporine
  • Methotrexate

These can be used alone or with other treatments.

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Biologic Treatments
  • Adalimumab (e.g. Humira)
  • Brodalumab (e.g. Siliq)
  • Certolizumab (e.g. Cimzia)
  • Etanercept (e.g. Enbrel)
  • Guselkumab (e.g. Tremfya)
  • Infliximab (e.g. Remicade)
  • Ixekizumab (e.g. Taltz)
  • Risankizumab (e.g. Skyrizi)
  • Secukinumab (e.g. Cosentyx)
  • Tildrakizumab (e.g. Ilumya)
  • Ustekinumab (e.g. Stelara)
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SeverityWho is this for?
No Treatment

Anyone with psoriasis can choose no treatment.

Complementary Treatments

Anyone with psoriasis.

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Topical Treatments

Mild to moderate psoriasis.

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Light Treatments

Anyone with psoriasis. Often used if topical treatments have not worked.

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Systemic Treatments

Moderate to severe psoriasis.

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Biologic Treatments

You may not be able to use some of these treatments if you

  • have certain health problems
  • are taking certain drugs
  • are sensitive to these drugs or to latex
  • are having surgery
  • are not up to date on your vaccines.

Talk to your doctor to find out if any of these treatments are right for you.

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SeverityWho is this not for?
No Treatment

People with more severe psoriasis may not want to wait for it to clear on its own.

Complementary Treatments
  • Sunlight: This is similar to phototherapy. People may not be able to take this if they:
    • have sensitivity to sunlight
    • have high risk of or history of cancer
    • suppress their immune system
  • Natural or Artificial Salt Baths: Anyone with psoriasis can use this treatment.
  • Moisturizers: Anyone with psoriasis can use this treatment.
  • Fish oils: People with fish allergies should talk to their doctor.

Talk to your doctor about your health history to find out if any of these treatments are right for you.

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Topical Treatments

You may not be able to take Vitamin D treatments if you have high levels of calcium or vitamin D. Talk to your doctor to find out if this is right for you.

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Light Treatments

These treatments may not be right for people:

  • taking certain medications
  • with certain health problems
  • with very sensitive skin
  • who are sensitive to heat
  • who cannot stand for a long time.

Talk to your doctor to find out if these are right for you.

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Systemic Treatments

Some people may be allergic or sensitive to these drugs. Some of these treatments should not be taken if you have or have had certain health problems. Talk to your doctor to find out if this is right for you.

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Biologic Treatments

You may not be able to use these treatments if you

  • have certain health problems
  • are taking certain drugs
  • are sensitive to these drugs or to latex
  • are having surgery
  • are not up to date on your vaccines.

Talk to your doctor to find out if any of these treatments are right for you.

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SeverityWhat are the possible side effects?
No Treatment

Without treatment psoriasis may get better, worse, or stay the same. Psoriasis can be itchy, uncomfortable, and painful. Some people may feel embarrassed, depressed, or anxious.

Complementary Treatments
  • Fish Oils: No serious side effects. Talk to your doctor about a safe amount of fish oils to take.
  • Moisturizers (Emollients): No serious side effects. There is generally no risk to do this while pregnant or breastfeeding.
  • Natural or Artificial Salt Baths: No serious side effects. There is generally no risk to do this while pregnant or breastfeeding.
  • Sunlight: There may be some risk of cancers. Otherwise, no serious side effects. There is generally no risk to do this while pregnant or breastfeeding.
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Topical Treatments

There is a low risk of possibly serious side effects. It may irritate your skin where it is applied. Some of these are not safe for pregnant or breastfeeding women.

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Light Treatments

Most have no serious side effects. They may irritate your skin or make you sensitive to sun.

PUVA has been linked to skin cancers. PUVA may not be safe to take while pregnant or breastfeeding.

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Systemic Treatments

Some risk of serious side effects. Other mild side effects can include discomfort, stomach ache, hair changes, and dry skin, lips and eyes.

Some are not safe for pregnant or breastfeeding women.

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Biologic Treatments

There is some risk of serious and non-serious side effects.

You may have irritation or reactions at the injection site.

Many of these treatments may be safe during pregnancy. They may not be safe while breastfeeding. Talk to your doctor to find out if these treatments are right for you.

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SeverityWill it inconvenience me?
No Treatment

Choosing no treatment does not take effort and is not inconvenient. Until psoriasis clears, some may have pain, embarrassment, depression, or anxiety.

Complementary Treatments
  • Fish Oils: These are pills or liquid. Topical fish oil can be rubbed into the skin.
  • Moisturizers (Emollients): These are rubbed into the skin. They can be applied as often as you like.
  • Natural or Artificial Salt Baths: Not everyone can travel to a natural spa. Artificial salts can be added to a bathtub.
  • Sunlight: Some people may be able to simply go outside. Others may have to travel to sunny climates. How often and how long to spend in the sun varies.
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Topical Treatments

Topical treatments are less practical when psoriasis covers a lot of skin or is hard to reach. It may be time consuming to apply on a regular basis.

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Light Treatments

Most need to be done by a health professional at a clinic. It might be hard for people to visit the clinic often. For home treatments, it may be hard to use on a regular basis.

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Systemic Treatments

These treatments need to be taken daily or weekly. They are usually a pill but can also be an injection.

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Biologic Treatments

These treatments use needles and may involve regular visits to a clinic.

With some treatments, you can give yourself injections at home after practice at a clinic. You will still need to visit a clinic for check-ups. Infliximab is given by IV and so must be given by a health professional.

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SeverityHow much does it cost?
No Treatment

No cost.

Complementary Treatments
  • Fish Oils: Fish oils can be found in many forms in health food stores. Oily fish can be found anywhere fish is sold.
  • Moisturizers (Emollients): They are affordable and available without a prescription.
  • Natural or Artificial Salt Baths: Travel to a natural spa may be expensive. Artificial bath salts are less expensive.
  • Sunlight: This is free. Travel to a sunny climate may be expensive.
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Topical Treatments

Prices vary depending on the treatment and how much of your skin has psoriasis. They may range from $200 - $2,400 USD/year. Corticosteroids can be as cheap as $10.

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Light Treatments

Prices vary by the type and number of treatments needed. They typically range around $300 - $600 USD/year, or $600 - $2,300 for home devices.

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Systemic Treatments

Prices vary by the drug and how much of your skin has psoriasis. They typically range from $200 - $11,300 USD/year. Apremilast can cost as much as $33,700.

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Biologic Treatments

These treatments can range from $32,000 - $135,000 USD/year.

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References can be found here. Many of these treatments are also available in other regions. Talk to your doctor to find out what is available for you.

Last Updated: May 2017