Oral Treatments


I like to call this the granddaddy treatment in psoriasis. It was first used by dermatologist for psoriasis in the mid 1900’s and has been the staple in the treatment of psoriasis, psoriatic arthritis, rheumatoid arthritis and other autoimmune disorders. It is a chemotherapy medications used to treat various cancers. Dermatologist and rheumatologist use it to treat various autoimmune disorders by suppression of the immune system. Side effects are many including liver toxicity, bone marrow suppression, fatigue and nausea along with a long list of other conditions that you should discuss with a dermatologist. However, it is a drug that we have used for many years and we are unlikely to encounter an unknown side effect since doctors have had many years of experience with the medication. In addition, it is an inexpensive medication and can treat both the psoriasis and psoriatic arthritis. I use methotrexate in many of my patients. You should discuss this closely with your doctor including other issues like alcohol and possible liver biopsy in the future.


Acetretinin, a retinoid, is a vitamin A derivation that can be beneficial in the treatment of psoriasis. Unlike other therapies, this medication does not suppress the immune system. Like tazarotene ( a topical treatment), it functions by making cells mature and cause the skin to peel. It can be effective at thinning the plaques. However as with tazarotene, it is a medication that at high doses can be difficult to tolerate. It can also affect the liver and your cholesterol levels and should not be used in women of child bearing ages. Speak to your doctor about this medication


Cyclosporine is a very powerful medication that has the benefit of quick onset of action. It is currently mostly used to treat patients with transplanted organs and thus is a very powerful immunosuppressive medication. It contains many side effects including kidney toxicities and elevated blood pressure. It is usually uses in circumstances where patients are uncomfortable and need something quickly to help with the symptoms. Again this is something you will need to speak with your doctor about.