Some psoriasis medications, such as steroid creams and retinoids, can cause skin irritation that’s difficult to deal with, according to the Mayo Clinic. While doctors generally recommend that you give these medications some time to take effect, Dr. Bierman says it’s best to immediately talk to your doctor if your skin becomes much worse, like if you develop a distinct skin rash, severe itchiness, or swollen skin. “You might have hypersensitivity to a particular component or ingredient,” she says.
Other psoriasis medications can potentially cause diarrhea, Dr. Leger says. If you’re constantly running to the bathroom—and it doesn’t let up—let your doctor know. While it’s entirely possible that your diarrhea could be due to something else, like a stomach bug, it could also be a side effect of your medication.
5. You’re planning to become pregnant.Talking to your doctor about having kids might not be one of your first thoughts during your psoriasis appointments. However, some psoriasis medications may increase the risk of fetal birth defects in people who are pregnant, so it’s important to check with your doctor to see if your medication is safe to take if you’re trying to conceive.
“You need to talk to your dermatologist about what the right decision is for you,” Dr. Zeichner says. This includes people of all gender identities, because some medications can be found in sperm and cause birth defects when a partner becomes pregnant, according to the Mayo Clinic. If you’re trying to start a family, your doctor can recommend effective medications to treat your psoriasis that are also safe to use while trying to conceive.
6. Infusion medication doesn’t work with your schedule.Some biologics are given through an intravenous (IV) infusion, which means you’d need to either go to a medical care center to receive it or pay for a home nurse to come to you and deliver it. That can be tough to make time for if you have a busy schedule. If your circumstances have changed and you’re always rescheduling your infusion visits, then it’s possible your treatment may not align with your lifestyle anymore.
Luckily, Dr. Rodney says there are a lot of biologics that come in injectable form, which means you give yourself a shot at home. “There are very effective injectable biologic medications for psoriasis,” she says. “If you’ve been on an infusion regimen, you can definitely switch to an injectable.”
7. You’re starting to feel joint pain.About 30% of people with psoriasis will develop psoriatic arthritis at some point, and unfortunately, this can happen at any time, according to the Cleveland Clinic.
“Even if your skin psoriasis is well-controlled on your current medication, you may also experience pain and swelling in your joints,” Dr. Rodney says. So, if your wrists start hurting when you do ordinary activities, like making dinner or brushing your hair, or if you start having really severe knee or ankle pain and can’t walk for an unexplained reason, then you should talk to your doctor. Even if you just have minor pain that’s unusual or bothersome, it’s really important to flag that to your doctor because treating psoriatic arthritis early can help prevent long-lasting joint damage.
If you do have psoriatic arthritis, which is diagnosed via a physical exam and imaging tests like an MRI, then you may need to switch up your medication. “Some injectable medications are better at treating both skin and joint psoriasis than others,” Dr. Rodney says. Your doctor can read through the research on psoriasis and psoriatic arthritis medications to recommend ones that may work best for you.
Overall, it’s important to work closely with your doctor if you feel like your psoriasis treatment just isn’t working for you.
It is totally possible to find relief from your symptoms—they’re not something you should just have to put up with because your current medication isn’t cutting it. “I’m always shocked when patients say they have a relative who is suffering from psoriasis,” Dr. Leger says. “We have so many great treatment options available. That should not be the case.”
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