Informed patient

Making treatment decisions

If you and your doctor have trouble deciding which treatment is most appropriate, ask the following questions:

  • How long has this treatment been used for psoriasis?
  • What are the potential benefits of the treatment?
  • What are the potential risks?
  • What percent of people are on this treatment?
  • What percent of people improve on this treatment?
  • How quickly will the treatment work?
  • How long have you (the doctor) been prescribing this treatment?
  • What are the most common side effects of the treatment?
  • Will I be tested regularly for unwanted side effects? If so, what kinds of tests and how often?
  • Which side effects will go away if I stop taking the medication? Which side effects might be permanent?
  • Will I take or apply this drug continuously?
  • Will it make me more sensitive to sunlight?
  • Can I use/take this medicine for a short time, just to clear my psoriasis, then switch to a milder medication with fewer risks? Could I control my psoriasis this way?
  • Can this treatment be combined with another to make it more effective or decrease unwanted side effects?
  • Can this treatment be stopped suddenly, or do I need to stop it gradually?
  • Ordinarily, how long will the drug stay effective?
  • If it works but I have to stop using it, is it likely to work again if it is resumed?
  • What will the treatment cost?
  • If I decide against this treatment, what are my other options?

Special considerations for women:

One of the first principles of psoriasis treatment is to not create anything worse than the disease, according to Steve Feldman, M.D., Ph.D., professor of dermatology, pathology and public health sciences at Wake Forest University in Winston-Salem, N.C. "I tell my patients that if I recommend to them anything that they find worse than having the disease itself, they should ignore my advice," he says.

Staying with the treatment

Once you and your doctor settle on a plan, follow through with it. It is good to give a new treatment eight to 12 weeks to see if it will work. Half of all patients do not adhere to the treatment plan prescribed by their doctors. Taking methotrexate, for example, means no alcohol consumption. Phototherapy treatments can be very inconvenient. Some topical medications are messy, smelly and expensive. Still, using them properly–for example, twice a day as prescribed, instead of once–can make a significant difference in results in some cases. Sticking with a treatment takes time and commitment.

If you are on several medications, it can be difficult to keep all of the doctor's orders straight. Try to write down all of the directions in one place. Keep a journal of the various medications that you are on, when you need to take or apply them, and how you are reacting to the treatment. This journal will be helpful when you follow up with your doctor at your next appointment.