What Are The Side Effects Of Biologics
Specific side effects will depend on your medication, but certain side effects are possible with all biologics:
Injection site reactions: Some redness of the skin after injection is normal. But if the skin is red and swollen after every injection and the redness and swelling is getting bigger and lasting longer after each shot, this could be a sign of an allergy. Your provider might suggest some tricks to help with the reactions, but if those dont help, you might need a different medication.
Infections: Since biologics turn off one piece of your immune system, this means that they raise your chance of getting infections. The most common infections are the common cold and flu. But sometimes, biologics can lead to severe infections that need hospitalization.
To protect you from infection while on biologics, your provider will take some precautions, such as:
Testing you for hepatitis, HIV, and tuberculosis infections before starting biologics
Making sure that you are up to date on recommended vaccinations
Having you hold off on taking your biologic if you are sick until you feel better
Infusion Therapy Treatment For Psoriasis
Psoriasis is a common, chronic skin disease that causes itchy, scaly, red patches to develop throughout the body, often appearing on the scalp, elbows, and knees. Though the cause of psoriasis is not totally understood at present, the immune system and genetics both contribute to its onset. People with psoriasis generally experience flare-ups due to triggers such as stress, skin injury, medications, excessive consumption of alcohol, and infections. While psoriasis can make life very uncomfortable, infusion therapy can disrupt the inflammation cycle of the disease and provide a high degree of relief.
Is Wynzora Safe To Use While Pregnant Or Breastfeeding
- Available data with Wynzora Cream are not sufficient to evaluate a drug-associated risk for major birth defects, miscarriages, or adverse maternal or fetal outcomes.
- Although there are no available data on use of the calcipotriene component in pregnant women, systemic exposure to calcipotriene after topical administration of Wynzora Cream is likely to be low.
- There is no information regarding the presence of topically administered calcipotriene and betamethasone dipropionate in human milk, the effects on the breastfed infant, or the effects on milk production.
- Concentrations of calcipotriene in plasma are low after topical administration, and therefore, concentrations in human milk are likely to be low.
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Other Topical Agents For Psoriasis
Tree Bark Extracts
Anthralin is a synthetic form of a tree bark extract that is considered to be one of the most effective topical antipsoriatic agents available. However, it can cause skin irritation and staining of clothing and skin.
- How tree bark extract works: This medicine slows the production of excess skin cells.
- Who should not use these medications: Individuals with anthralin allergy or recent or excessively swollen patches should not use anthralin.
- Use: Apply a small amount of the cream, ointment, or paste to the patches on the skin. On the scalp, remove scales and rub into affected areas. Avoid the forehead, eyes, and any skin that does not have patches. Do not apply excessive quantities. Short applications of a high concentration for only 20 minutes, followed by washing with soap and water can be used to minimize skin irritation.
- Drug or food interactions: Anthralin is combined with salicylic acid in preparations used for psoriasis treatment.
- Adverse effects: Anthralin stains clothing or linens purple or brown. Use with caution if the individual has kidney disease. Care must be taken to apply this medication only to psoriasis patches and not to surrounding normal skin. Anthralin may cause skin discoloration and may burn or irritate skin. Do not use on the face, neck, skin folds , or genitals. Avoid contact with the eyes. Do not use on excessively irritated patches. This medication should only be used if the patient can comply with instructions for use.
Which Medication Works Best For Psoriasis
The American Academy of Dermatology and National Psoriasis Foundation published guidelines in 2018 for the treatment of psoriasis with biologics. A #1 biologic medication was not listed, since there really isnt one. Why is that?
First, everyone is different, and you have your own version of psoriasis. A medication that works for someone else might not work for you.
Second, there arent many studies that directly compare one medication to another. In other words, its hard to put medications in a foot race and see who wins. Sometimes, researchers compare study results to get an idea of which medication works best. For example, an ongoing study is comparing trials of systemic psoriasis medications. So far, it includes 158 different trials. Most recent data shows that medications in the IL-17 and IL-23 blocker family might work best. Remicade, an infusion in the TNF-alpha blocker family, also works well.
With so many options available, it is normal to feel a bit overwhelmed. Some factors that you and your provider will consider when choosing a medication include:
The type of psoriasis you have
The severity of your psoriasis
Your other health problems
Medication side effects
Your insurance coverage
If you dont have insurance or your insurance doesnt cover the medication you need, there are many programs to help you pay for medication.
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Psoralen And Ultraviolet A
Psoralens plus long wave ultraviolet A radiation, , can be applied to the whole body by giving an oral psoralen in tablet form 2 hours prior to treatment.
- Treatment can be localised to the hands and/or feet by using psoralen bath soaks or topical psoralens prior to treatment.
- Localised treatment is commonly used to treat thick plaques or moderate-to-severe hand and/or foot psoriasis, including palmoplantar pustulosis.
- persists for some hours following oral psoralen treatment therefore, patients are advised to avoid sun exposure, including wearing wrap-around sunglasses on the day of treatment.
- PUVA is more likely than narrowband UVB treatment to cause skin cancer, especially squamous cell carcinoma and is usually limited to a maximum of 100 to 200-lifetime treatments.
- Psoralens and therefore PUVA is not recommended during pregnancy or breastfeeding.
Emotional Impact Of Psoriasis
Because of the effect that psoriasis can have on physical appearance, low self-esteem and anxiety are common among people with the condition. This can lead to depression, especially if the psoriasis gets worse.
Your GP or dermatologist will understand the psychological and emotional impact of psoriasis, so talk to them about your concerns or anxieties.
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What Complementary And Alternative Treatments Help Psoriasis
Complementary and alternative therapies are sometimes used to improve symptoms of psoriasis.
Although most of these approaches are safe, you should talk to your doctor before trying any new treatment or technique.
Examples of complementary and alternative methods commonly used to treat psoriasis include:
Diet and Nutrition Some people report improved symptoms by altering their diets or taking certain supplements. You can also try avoiding specific dietary triggers that may increase inflammation and worsen your symptoms.11
Sunlight Exposure to small amounts of sunlight can reduce some symptoms of psoriasis. But too much sun can worsen outbreaks and increase your risk of skin cancer. Talk to your doctor about how much sunlight exposure is safe for your situation.
Daily Baths Soaking in mineral water baths may help hydrate and soften the skin. You can add colloidal oatmeal, Epsom salts, or Dead Sea salts to bathwater to help calm inflamed skin. But stay away from hot water and harsh soaps, which can worsen your symptoms.
Moisturizer Some people report fewer symptoms when they apply moisturizer to affected areas. Ointments can help lock in moisture better than creams.
Yoga and Meditation These practices can clear your mind and reduce stress, which may ease symptoms of psoriasis.
Exercise Physical activity increases the production of chemicals known as endorphins, which improve mood and energy. Exercise can also help you sleep better and reduce anxiety.
The Science Behind Plaque Psoriasis And Humira
The exact cause is unknown, but plaque psoriasis has been linked to the immune system and an excess of several proteins in the body, including one called TNF-alpha. Everybody produces TNF-alpha, but people with plaque psoriasis produce more than normal. Too much TNF-alpha may lead to faster growth of skin cells, which can lead to the plaquesred, flaky patchesyou see on your skin.
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Topical Medications For Psoriasis
Clobetasol , triamcinolone , fluocinolone , and betamethasone are examples of commonly prescribed corticosteroids.
- How corticosteroids work: Corticosteroids decrease skin inflammation and itching.
- Who should not use these medications: Individuals with corticosteroid allergy or skin infections should not use corticosteroids.
- Use: Apply a thin film to affected skin areas. These creams or ointments are usually applied two times a day, but dosage depends on severity of the psoriasis.
- Drug or food interactions: No interactions have been reported with topical use.
- Adverse effects: Corticosteroids may cause adverse effects to the body if used over large areas. They can also cause local thinning of the skin. Do not use for long periods of time. It is best not to put bandages over the treated skin unless directed by the physician because too much of the medicine may be absorbed into the body.
Creams and Ointments Related to Vitamin D
Calcipotriene is a relative of vitamin D-3 that is used to treat moderate psoriasis.
- How vitamin D medications work: Calcipotriene slows the production of excess skin cells.
- Who should not use these medications: Individuals with the following conditions should not take calcipotriene:
- Allergy to calcipotriene cream
- Vitamin D toxicity
Psoralen Plus Ultraviolet A
For this treatment, you’ll first be given a tablet containing compounds called psoralens, or psoralen may be applied directly to the skin. This makes your skin more sensitive to light.
Your skin is then exposed to a wavelength of light called ultraviolet A . This light penetrates your skin more deeply than ultraviolet B light.
This treatment may be used if you have severe psoriasis that has not responded to other treatment.
Side effects include nausea, headaches, burning and itchiness. You may need to wear special glasses for 24 hours after taking the tablet to prevent the development of cataracts.
Long-term use of this treatment is not encouraged, as it can increase your risk of developing skin cancer.
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Adverse Effects Of Biologic Drugs
More common side effects include:
Long-term methotrexate treatment can lead to:
- liver damage
- changes to red and white blood cell production
A doctor should inform a person who is receiving psoriasis injections about the possible side effects and their symptoms. Anyone who experiences new or worsening symptoms after taking a drug should contact their doctor.
There are several different types of psoriasis, and they may need different approaches.
When prescribing a treatment a doctor will consider:
- the psoriasis type
- how severe the symptoms are
How Is Plaque Psoriasis Diagnosed
Plaque psoriasis is diagnosed as mild, moderate, or severe based on both the percentage of skin affected and the location and severity of the plaques.
While plaques usually show up on the hands, feet, elbows, knees, and back, they can also show up in the form of scalp psoriasis or genital psoriasis.
Its important to speak with your doctor and receive an accurate diagnosis before beginning treatment.
Severe Plaque Psoriasis
One of the first things your dermatologist will want to know is what percentage of your bodys skin surface shows the redness, thickness, and scaling of plaque psoriasis. As a point of reference, your handprint is about the same size as 1% of your skins surface.*A treatment like SKYRIZI is not meant to treat cases of mild psoriasis.
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Are There Any Side Effects Of Psoriasis Medication Treatment
Psoriasis is a well-known condition. This ubiquity has granted this disease a fair amount of research from dermatologists. Consequently, these researchers have come up with a veritable smorgasbord of treatments. These treatments, while many in number, and effective in their application, are not fully without risks. The side effects at a time tend to outweigh the rewards of its effectiveness. These medications and their side effects include the following:
What Are The Risk Factors For Psoriasis
While anyone can develop psoriasis, the following factors can increase your risk:
Family History Having one parent with psoriasis increases your risk, and having two parents with the condition puts you at greater risk.
Infections People with HIV are more likely to develop psoriasis. Additionally, strep throat has been linked with the development of a certain type of psoriasis, called guttate psoriasis. This causes small, round, scaly rashes to develop, usually on the trunk and arms. Kids and young adults with this type of recurring infection may be at increased risk.
Stress Since stress can impact your immune system by causing inflammation, high stress levels may increase your risk of psoriasis.
Obesity Being overweight or obese increases your risk, and psoriasis often develops in the creases and folds of skin.
Smoking Smoking tobacco increases your risk and the severity of psoriasis, and may initiate the development of the disease.
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Oral Medications For Psoriasis: List And Side Effects
Psoriasis is an autoimmune disease causing skin to become red, itchy, scaly to sore. Some people treat it with topical medicines which directly apply to the skin. Nevertheless, if a person has moderate to severe psoriasis a doctor can prescribe oral medicines.
The article provides an overview of the various types of oral medications, their uses and their possible side effects.
Oral psoriasis medicines are one form of systemic medicine. It means they operate throughout the body instead of just reacting to the psoriasis symptoms, trying to treat the underlying causes of psoriasis.
Psoriasis is an autoimmune disease which means that an individuals immune system is overactive and attacks healthy cells in the skin. Systemic medicine is designed to stop it autoimmune response from occurring.
Although oral medicines are not a remedy, they are more effective at inducing psoriasis to go into remission than topical lotions. Remission is when an person has few symptoms or no.
According to the American Academy of Dermatology , some systemic medications for psoriasis include:
Another type of drug available in some European countries is the fumaric acid esters.
Psoriasis Creams And Shampoos
Topical treatments are creams or ointments that you apply directly to the skin. If you have mild psoriasis, a topical treatment may be all you need. For moderate to severe psoriasis, topical treatments can be used in combination with other medications .
There are some remedies you can try at home for mild psoriasis or in combination with prescription medicines. Below are some examples:
Moisturizers relieve dry, itchy, red skin and can be helpful for everyone with psoriasis.
is a low-dose, over-the-counter steroid that decreases itching and inflammation. Its great for very mild psoriasis affecting a small area.
Products with salicylic acid can soften and remove the scale seen in plaque psoriasis.
Coal tar-containing products relieve symptoms and slow the rapid growth of skin cells.
Products with calamine, camphor, or menthol can help itching.
Topical psoriasis treatments that require a prescription include:
Corticosteroids: These medications reduce inflammation, redness, and itching. There are many topical steroids, but two common ones are and .
Vitamin D analogues : These decrease skin growth, which helps control psoriasis. They may be used in combination with steroids. Examples are and .
Calcineurin inhibitors : These medications are used for sensitive areas like the face. They include and . Both of these medications are considered off label for psoriasis treatment.
Keratolytics: These decrease skin growth and break down thick plaques. Examples are and .
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The Mental Side Effects Of Psoriasis
Kristina Gorbatenko-Roth, a professor of psychology at the University of Wisconsin-Stout.
One of the mental health challenges with skin conditions is that theyre observable illnesses. People may stare, and that can make a patient feel stigmatized. Some patients may expect people to react negatively, so they might decide theyre not going to go out, or they cant go swimming.
The amount of distress is often but not always connected to how objectively severe psoriasis is. A relatively new area of research in dermatology hypothesizes that if you had really bad psoriasis at a young age and were socially isolated, it can impact your social life later on, even if your skin improves.
If we could help a patient manage stress and correctly interpret the social interactions theyre dealing with because of their skin, hypothetically they may have more mental energy to follow their treatment plan which can often be very involved and difficult which could, in turn, lead to a better chance of improving their condition. Giving a patient empathy and space to talk about their skin condition and how it has impacted their life makes them feel validated.
This story originally appeared in the August 2020 issue of Allure. Learn how to subscribe here.
Now read more stories about mental health:
How Do You Pick The Best Treatment Option
Once you are diagnosed with psoriasis, your healthcare provider will help you decide the best treatment for you. Your primary care provider can usually treat mild psoriasis. In some cases, you might need to see a specialist called a dermatologist.
Psoriasis is different for everyone, but treatment generally proceeds as follows:
If you have mild psoriasis involving a small area of your body, you can try a topical treatment or targeted phototherapy first. If that doesnt work, systemic treatment with an oral medication or biologic is the next step.
If you have moderate or severe psoriasis involving a larger area of the body or a sensitive area like the palms or soles a systemic treatment with or without phototherapy is recommended as first-line treatment.
Systemic treatment is also needed if you have both psoriasis and psoriatic arthritis.
Finding the right treatment isnt always easy. Its not easy to predict how someone will respond to treatment, and sometimes you have to try a few medications before you find one that works for you. You may even need more than one medication, too. This process can be frustrating, but your healthcare provider can guide you through the process.
If you have already been diagnosed with psoriasis and need prescription refills, it may help to know that there are several services that can provide a consultation and prescription online.
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