Injections are a common treatment for moderate to severe psoriasis. Doctors may recommend them if pills, topicals, or phototherapy haven’t helped enough. Topicals are creams or ointments you apply to your skin. Phototherapy uses special light to treat psoriasis.

Some members of MyPsoriasisTeam have wondered about the effectiveness of injectable medications for psoriasis. “Has anyone been on psoriasis injections?” one member asked. “Is it a lifelong treatment? Does it clear the skin for good or just manage it?”

This article explores different types of injectable medications available for psoriasis and how they work.

Understand the Differences in Injectable Medications

“Is the injection a good move or a bad one?” one MyPsoriasisTeam member asked.

The answer depends on several factors. Injectable medications are used to treat different forms of psoriatic disease, and your doctor may need to run some tests to find the right option for you.

Injectable medications for psoriasis provide relief by tackling different factors that contribute to inflammation.

Injectable medications for psoriasis can include:

• Corticosteroids (steroids) — Reduce inflammation and help calm flare-ups
• Immunomodulators — Change how the immune system works to reduce inflammation
• Biologics — Made from living cells that target specific parts of the immune system

They vary in how they work and how they’re given. Depending on the medication, you might get it as a shot under the skin or as an infusion into a vein.

Subcutaneous Injection

Subcutaneous injections are given just under the skin and can often be administered at home. This makes them convenient for people who want more control over their treatment routine. These injections are usually easy to use and help people stay on schedule without needing to visit their healthcare provider often.

Intravenous Infusion

Some medications are given through an intravenous (IV) infusion, which delivers medicine directly into a vein. You’ll need to make an appointment at a doctor’s office or an infusion center. Because the dose is given intravenously, it may be an option for people with more severe or hard-to-treat psoriasis.

Intralesional Injection

Intralesional injections deliver corticosteroids directly into a psoriasis plaque to treat a stubborn spot. These local injections can offer quick relief for specific areas of skin. When choosing a treatment plan, it’s important to consider the delivery method, frequency, and how it fits into your daily life. Your healthcare provider can help you find the best option for your needs.

How Do Injectable Medications Work?

Psoriasis is caused by a problem with the immune system. In people with psoriasis, the immune system is overactive and causes inflammation. Injectable medications provide relief by tackling different factors that contribute to this inflammation. This is called the medication’s mechanism of action.

There are ways to make injections less painful. Letting the medication reach room temperature, rotating injection sites, and practicing mindfulness techniques can help reduce discomfort.

Getting the Injection

Some injections need to be given by a healthcare provider, while others you can give yourself at home. Although giving yourself an injection can be nerve-racking, many members of MyPsoriasisTeam have learned to feel comfortable with this. If you’re worried that it will hurt, there are ways to make it less painful. Letting the medication reach room temperature, rotating injection sites, and practicing mindfulness techniques can help reduce discomfort.

Now, let’s explore the medications and how they work in the body.

1. Corticosteroids

Corticosteroid injections are sometimes injected directly into psoriasis lesions when topical treatments haven’t worked well enough or when a spot is hard to treat with creams, such as on the scalp. When the immune system responds, it makes cytokines. Cytokines are small proteins that can trigger inflammation. Corticosteroids block the production of these cytokines, reducing inflammation and providing relief from painful, swollen joints or skin plaques.

Corticosteroids are usually used for a short time to avoid side effects, and topical corticosteroid treatment is often the first choice for psoriasis. An example of an intralesional corticosteroid is triamcinolone.

2. Methotrexate

Methotrexate is a common disease-modifying antirheumatic drug (DMARD) used to manage both skin and joint symptoms of psoriasis and psoriatic arthritis. DMARDs are medicines that help slow down certain diseases and protect the joints and tissues from damage. Methotrexate can be taken by mouth or injected.

Methotrexate works by calming the immune system’s overactive response, which is what causes inflammation in psoriasis. Methotrexate targets multiple immune pathways, making it an effective treatment for many people. However, regular checkups are important because methotrexate can cause side effects, including liver toxicity, which means the medicine can harm the liver.

3. Biologics

Biologics are treatments that target specific proteins or cells in the immune system that contribute to psoriasis. Biologics are medicines made from living cells. They target specific parts of the immune system that cause inflammation in psoriasis. Biologics work in the body in different ways and can be given in different forms.

People with psoriasis often produce too many cytokines, including tumor necrosis factor-alpha (TNF-alpha) and specific interleukins (ILs). Inhibitors of these proteins help reduce inflammation.

TNF-Alpha Inhibitors

TNF-alpha inhibitors are a group of biologic drugs that target TNF-alpha, a key protein that plays a big part in inflammation. These biologics have improved treatment for moderate to severe psoriasis. TNF-alpha inhibitors usually need to be injected regularly, from weekly to every other month, depending on the specific drug.

Here are some commonly prescribed TNF-alpha inhibitors approved by the U.S. Food and Drug Administration (FDA) for the treatment of psoriasis, all given subcutaneously except for infliximab, which is administered intravenously:

• Adalimumab (Humira)
• Certolizumab pegol (Cimzia)
• Etanercept (Enbrel)
• Infliximab (Remicade)

Interleukin Inhibitors

Interleukin inhibitors target specific interleukins like IL-12, IL-17, and IL-23, which contribute to the overactive immune response seen in psoriasis. These biologics focus on specific immune system pathways and may help when other treatments haven’t brought enough relief.

These are some commonly prescribed interleukin inhibitors approved by the FDA for treating psoriasis, all administered subcutaneously:

• Bimekizumab-bkzx (Bimzelx) — IL-17A/IL-17F inhibitor
• Brodalumab (Siliq) — IL-17 inhibitor
• Guselkumab (Tremfya) — IL-23 inhibitor
• Ixekizumab (Taltz) — IL-17 inhibitor
• Risankizumab-rzaa (Skyrizi) — IL-23 inhibitor
• Secukinumab (Cosentyx) — IL-17 inhibitor
• Tildrakizumab-asmn (Ilumya) — IL-23 inhibitor
• Ustekinumab (Stelara) — IL-12/IL-23 inhibitor

4. T-Cell Inhibitors

T-cell inhibitors target T cells, which are responsible for triggering the immune response that leads to inflammation in psoriasis. By blocking T cells, these inhibitors help reduce inflammation and lessen symptoms. One FDA-approved T-cell inhibitor is abatacept (Orencia), which is used to treat psoriatic arthritis, not psoriasis, and can be given either as a shot under the skin or as an IV infusion.

5. Biosimilars

Biosimilars are FDA-approved biologic medicines based on an existing biologic (called a reference product). They work the same way and often cost less. There are several biosimilars available. If you’re interested in learning more, talk to your dermatologist.

Know the Side Effects and Risks of Injectables

Because injected medications for psoriasis suppress parts of the immune system, they come with risks and potential serious side effects. Your dermatologist can provide medical advice to help you choose the right injectable. They can also tell you about common side effects to expect and which side effects are serious.

It’s important to discuss any other over-the-counter or prescription drugs you take with your doctor. This can help them advise you about any potential interactions. Also, talk to your doctor about family planning. Some medications may not be safe if you’re pregnant, breastfeeding, or planning to become pregnant.

Talk to Your Doctor

Injectable treatments can be an effective option for people with moderate to severe psoriasis, especially when other treatments haven’t worked well enough. Because these medications differ in how they work, how they’re given, and their potential risks, the best choice depends on your symptoms, lifestyle, and overall health. Talking openly with your dermatologist can help you decide whether an injection is right for you and which option makes the most sense.

Join the Conversation

On MyPsoriasisTeam, people share their experiences with psoriasis and psoriatic arthritis, get advice, and find support from others who understand.

Are you using an injectable medication for psoriasis? Let others know in the comments below.