Psoriasis is an autoimmune disease that causes red, itchy, scaly, or sore skin. Many people treat it with topical medications, which they apply directly to the skin. However, if a person’s psoriasis is moderate or severe, a doctor may prescribe oral medications.
An estimated 25 percent of all people with psoriasis have moderate or severe psoriasis. Many of these people require oral medication or phototherapy.
This article gives an overview of the different types of oral medication, their uses, and their possible side effects.
Oral medications for psoriasis are a type of systemic medication. This means that instead of just responding to the symptoms of psoriasis, they work throughout the body, trying to treat the underlying causes of psoriasis.
Psoriasis is an autoimmune disease, which means a person’s immune system is overactive and attacks healthy skin cells. Systemic medication aims to stop this autoimmune response from happening.
Although oral medications are not a cure, they are more effective than topical lotions at encouraging psoriasis to go into remission. Remission is when a person has few or no symptoms.
According to the American Academy of Dermatology (AAD), some systemic medications for psoriasis include:
Fumaric acid esters are another type of drug available in some European countries.
Methotrexate reduces inflammation, which can alleviate the swelling and itchiness a person with psoriasis experiences. Methotrexate can also reduce joint pain associated with psoriatic arthritis.
Methotrexate typically improves psoriasis symptoms in
- hair loss
- liver disease, although this is rare
A person should not take methotrexate if they:
- regularly drink a lot of alcohol
- have a liver or kidney disease
- have a stomach ulcer
Methotrexate is also not safe for women who are pregnant or breastfeeding. People should also avoid using it if they are trying to conceive.
Cyclosporine works by inhibiting a person’s immune system. According to 2013 research, cyclosporine is “one of the most effective and rapidly acting drugs” for psoriasis.
The AAD note that 80 to 90 percent of people see a rapid improvement of their psoriasis symptoms when taking cyclosporine.
According to the National Psoriasis Foundation (NPF), people taking cyclosporine may experience the following side effects:
- tingling skin, numbness, or pins and needles
- joint pain
- muscle twitching
- increased hair growth
- high blood pressure
People who have had kidney failure or cancer should avoid cyclosporine, as should those with high blood pressure and people who are pregnant or trying to get pregnant.
Fumaric acid esters
According to the journal
The U.S. Food and Drug Administration (FDA) have not approved fumaric acid esters as a treatment for psoriasis in America, although they are available in some European countries.
Possible side effects of fumaric acid esters include:
- stomach ache
- red and hot face
People should not take fumaric acid esters if they have stomach or bowel problems. Because of the lack of research, anyone who is pregnant or breastfeeding should also avoid taking them.
Apremilast is a new type of treatment that a doctor may prescribe if other oral medications do not work.
It is a targeted treatment that reduces the activity of an enzyme in immune cells that causes inflammation.
According to the ADD, clinical trials found that after 16 weeks, 20 percent of people taking apremilast for plaque psoriasis found their symptoms had cleared or had almost cleared, and over 40 percent of people with scalp psoriasis saw their symptoms improve or disappear.
According to the ADD, common side effects of apremilast include:
- chest infection
- weight loss
Biological drugs, or biologics, can also treat psoriasis, depending on the type and severity of symptoms.
Biological drugs are a very effective form of treatment, as approximately
According to the NPF, common side effects for biologics include:
- respiratory infections
- flu-like symptoms
- injection site reactions
Rarer side effects include:
- nervous system disorders
- blood disorders
- kidney or liver failure
- multiple sclerosis, or a family member who has it
- heart failure
- serious infection
Although oral medication for psoriasis can cause more side effects than topical medicines, they can also be more effective at encouraging a person’s psoriasis to go into remission.
If anyone who is taking any form of medication experiences adverse side effects, they should speak to their doctor. A doctor may be able to recommend ways to reduce or control side effects, or may change the type of medication a person is taking.