10 Questions to Gauge When Considering Treatment Options

Are you trying to figure out what psoriasis treatments will work best for you? Check out these 4 different treatment types and the pros and cons that come with each to decide which is best for you based on your lifestyle. This list is based off my experience and conversations with hundreds of people living with psoriasis. Please remember everyone's experience will vary and it's best to talk to your doctor about these details to ensure you are making the best choice for you when picking a treatment.

Topical Treatments

These are treatments which come in a tube, tub, or can which can be rubbed on the surface of the body in affected areas. Topicals target annoying symptoms of psoriasis (flaking, itching, cracking, and pain.)

• Cost: Compared to the other treatment options, topical treatments are usually the cheapest option and can range from a couple of dollars to a few hundred dollars
• Frequency of use: 2-3 times a day
• How easy is it to use: Very easy, just slather your body down 2-3 times a day
• When should you see a difference in your skin: With consistent use, a few weeks to a couple of months
• Effectiveness: Depends on the individual.
• Should you use if you have mild, moderate, or severe psoriasis:  Is best fitted for someone with a mild to moderate case of psoriasis.
• Patient assistance: In my experience, many topicals don't have patient assistance programs, but some do. It's best to speak with your doctor about payment options.
• The ease of being approved for treatment by a doctor or insurance: Very easy
• The ease of traveling with treatment: Easy. If you are traveling on an airplane with your topical treatments be sure to place them in the bags you check opposed to putting them in your carry on bag. Most psoriasis topical treatments are not going to come in the TSA regulation size.
• Convenience: Moderate. You can conveniently pick up this medicine at your local pharmacy but the frequency of use (2-3 a day) can be a big inconvenience and mess for some.
• How many refills per month: This depends on your weight, areas of the body affected, and the amount of cream the doctor prescribes, but typically those with psoriasis will need 1-2 refills a month.
• How many options: 15+ many options have different benefits that help the symptoms of psoriasis in specific ways.

Biologic Treatments

Biologics are injection treatments that are received via needles. Regulates the immune system.

• The Cost: Very expensive, could cost anywhere from $3,000 to $13,000 per injection
• Frequency of use: Once a week, once a month, or once every 3 months
• How easy is it to use: Fair. Keep in mind this depends on the person. If needles don't scare you then this option should be fairly easy for you, but if you are a person who hates needles this option can be tough!
• When should you see a difference in your skin: 1-6 months
• Effectiveness: Depends on the individual but some biologics can clear psoriasis up to 100%. Most claim to improve psoriasis by at least 50% or more.
• Should you use if you have mild, moderate, or severe psoriasis: Moderate to severe
• Patient assistance: Most biologics have patient assistance programs, which will help you pay for your drugs completely or leave you with a very low copay of $10 to $20.
• The ease of being approved for treatment by a doctor or insurance: Difficult. Some insurance companies require step therapy before agreeing to pay for these drugs. Some insurance companies refuse to cover these drugs regardless.
• The ease of traveling with treatment: Difficult. Most of these drugs require refrigeration and will be an inconvenience to travel with.
• Convenience: Moderate. You usually have to pick up these drugs from your doctor's office, which is money and time. Or you may have to schedule a drop off time with the delivery service, which can cause you to have to readjust your schedule.
• How many refills per month: Depends on the biologic, but most times 1 refill every month or 1 every 3 months.

Phototherapy

Special light therapy which exposes the skin to UVA or UVB which helps aid in slowing down skin cell production.

• The Cost: Expensive, could cost hundreds per month depending on frequency
• Frequency of use: Several times a week
• How easy is it to use: Easy. You simply get inside a UVA/UVB light box and stand there for the required time decided by your doctor.
• When should you see a difference in your skin: Possibly a few days to a few months
• The effectiveness: Depends on the individual
• Should you use if you have mild, moderate, or severe psoriasis: Mild, moderate, or severe
• Patient assistance: N/A Speak with your doctor about options
• The ease of being approved for treatment by a doctor or insurance: Moderate
• The ease of traveling with treatment: Difficult; If you have a home light box you won't be able to travel with it due to its size.
• Convenience: I would say difficult. If you don't have a light box at home this means you will have to travel to your doctor's office several times a week, which is costly and time-consuming.
• How many refills per month: You will have to go several times a month for this option to be effective.

Oral Treatments

Oral treatments you take by mouth which targets specific areas of the immune system that cause psoriasis.

• The Cost: Typically expensive but some options are cheaper than others
• Frequency of use: At least once a day
• How easy is it to use: Easy, just pop the pill as directed by your doctor
• When should you see a difference in your skin:  Some find that they have reduction in symptoms after a couple months of treatment.
• The effectiveness: Depends on the individual, but these drugs should work faster than topical treatments
• Should you use if you have mild, moderate, or severe: Moderate to severe</li>
• Patient Assistance: Yes
• The ease of being approved for treatment by a doctor or insurance: Moderate
• The ease of traveling with treatment: Easy
• Convenience: Easy
• How many refills per month: At least once a month depending on which medicine