Psoriasis Treatment: Systemic Medications

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Psoriasis is a chronic autoimmune disorder that causes rapid new skin cell growth, resulting in raised, scaling, inflamed, and often painful patches on the skin. Affecting over 7 million Americans, psoriasis is thought to be a genetic condition that is triggered by external and environmental factors.

Even though there is no cure, psoriasis is not contagious and can be treated effectively in numerous ways. In addition to light therapy and topical treatments like retinoids and anthralin, there are also systemic medications that are highly effective in treating moderate to severe cases of psoriasis.

Systemic Treatment

Systemic drugs target the entire body and are usually in the form of pills or injections.


Cyclosporine was approved by FDA for the treatment of psoriasis in 1997 and is one of the most common systemic psoriasis medications. Taken orally in pill or liquid form on a daily basis, cyclosporine works by stopping the irregular immune system function that results in the rapid growth of new skin cells, providing fast relief from severe psoriasis symptoms in around two weeks.

The prolonged use of the drug, however, has the potentiality of leading to kidney damage. The side effects of cyclosporine include increased skin sensitivity, extreme hair growth, fatigue, high cholesterol, and burning or pain in the joints (especially in the legs and arms). Moreover, cyclosporine increases the risk of melanoma in people who are undergoing radiation or phototherapy (ultraviolet light therapy).


Approved by the FDA in the 1970s, methotrexate has been in use to treat severe cases of psoriasis since the ’50s. Methotrexate attaches itself to the enzyme responsible for inciting the fast growth of skin cells to impede its function. The systemic drug is taken orally once per week in a single dose or three doses spaced out over 24 hours.

Some doctors prefer a test run to see whether your body has an adverse reaction to it and then adjust and change the dosage accordingly. In most cases, methotrexate takes about 4-6 weeks to show results, but you may need to continue taking the medication for several months for optimum results.

Just as with cyclosporine, prolonged use of methotrexate increases the risk of liver damage. The side effects of methotrexate include but are not limited to fatigue, insomnia, headaches, fever, mouth sores, nausea, diarrhea, and vomiting.


Soriatane is an oral medication that contains a synthetic form of Vitamin A — retinoids. Even though we know very little about how Soriatane specifically targets psoriasis, retinoids regulate cell replication and promote healthy skin cell growth, so Soriatane impedes the rapid skin cell growth associated with psoriasis and gradually clears the skin.

Soriatane is taken daily in capsule form, and only your doctor can determine your dosage depending on the severity and recurrence rate of your symptoms. Pregnant women or those who are trying should not take Soriatane as it increases the risk of congenital disabilities. The side effects of Soriatane include dry skin, dry eyes and lips, hair loss, sensitivity to sunlight, headaches, and depression.

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