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If you live with psoriasis, you know it’s not just “dry skin.” This condition can itch, sting, crack, and affect how you feel about your appearance. For a long time, treatment mostly meant creams, ointments, and light therapy. These can help, but they don’t always control moderate to severe disease.
Today, doctors understand something important: Psoriasis starts inside the immune system. This discovery led to powerful new treatments called interleukin (IL) inhibitors. These medications target specific immune signals that drive psoriasis. When those signals are turned down, skin symptoms often improve significantly.
This article discusses what interleukins are, how they affect psoriasis, and which medications target them.
Your immune system protects you from infections. To do this, immune cells send messages to each other. These messages are carried by small proteins called interleukins.
Think of interleukins as text messages between cells. Each one has a number, like IL-17 or IL-23, and each tells the immune system to do something specific.
Inflammation is one of the main processes that interleukins control. Inflammation helps your body fight germs and heal injuries. However, in psoriasis, the immune system sends too many inflammatory messages. This extra inflammation causes skin cells to build up too quickly, leading to discolored, scaly patches.
Psoriasis is an autoimmune disease. That means the immune system mistakenly attacks healthy tissue.
IL-23 and IL-17 pathways play a key role in psoriasis. Here’s how it works: The immune system releases IL-23. IL-23 activates a group of immune cells called T helper 17 cells. These cells then produce IL-17, and IL-17 tells skin cells to grow and divide very quickly.
Usually, skin cells take about a month to grow and shed. In psoriasis, this cycle can happen in just a few days. Skin cells build up too quickly, forming thick plaques. Blocking IL-17 or IL-23 can interrupt this process and calm the disease.
Interleukin inhibitors are a type of biologic therapy. Biologics are medications made using living systems and are designed to target specific parts of the immune system.
Instead of suppressing the entire immune system, these drugs block key signals. Some block IL-17 directly. Others block IL-23, which acts earlier in the inflammatory pathway. When these signals are blocked, skin cell buildup slows down. Discoloration fades. Scaling improves. Many people may also notice less itching.
Clinical trials show that these drugs can lead to major improvements in moderate to severe psoriasis. Doctors measure this improvement using the Psoriasis Area and Severity Index (PASI). The PASI score is a tool doctors use to measure how much of the body is affected by psoriasis and how severe the discoloration — which may appear red, purple, or brown, depending on skin tone — thickness, and scaling are. Higher numbers mean more severe disease. For example, PASI 75 or PASI 90 means a 75 percent or 90 percent improvement from the starting score after treatment. PASI 100 means the skin is completely clear.
Many IL-17 and IL-23 inhibitors help a large percentage of people reach PASI 90 or even 100. That level of improvement can make a big difference in comfort, confidence, and daily life.
These medications block IL-17, a protein that signals skin cells to multiply too quickly. All available IL-17 inhibitors are given by injection. IL-17 inhibitors often work fast, so this class may appeal to people looking for quicker relief.
Secukinumab (Cosentyx) was one of the first IL-17 inhibitors approved by the U.S. Food and Drug Administration (FDA) for plaque psoriasis. Clinical trials show that many people reach PASI 90 or higher by week 12 of treatment. It is also approved for psoriatic arthritis.
Ixekizumab (Taltz) is another IL-17 inhibitor. Studies comparing it to older biologics showed very high skin clearance rates. Many people achieve near-complete or complete skin clearing. It also works quickly, which can be encouraging for people who have visible plaques.
Brodalumab (Siliq) works a little differently. Instead of blocking the IL-17 protein itself, it blocks the IL-17 receptor, which prevents IL-17 from delivering its signal. Brodalumab has shown strong effectiveness in clinical trials. Because of rare mental health risks seen in early studies, it carries a special warning and requires monitoring.
Bimekizumab-bkzx (Bimzelx) blocks two related inflammatory signals, IL-17A and IL-17F. Because it targets both, it can be very effective for plaque psoriasis. In clinical trials, many people reached near-clear or completely clear skin.
IL-23 inhibitors work earlier in the inflammatory pathway. By blocking IL-23, they reduce the production of IL-17 and calm inflammation upstream. IL-23 inhibitors are often valued for their longer dosing intervals and lasting results.
Ustekinumab (Stelara) targets both IL-12 and IL-23. It was one of the earlier biologics approved for psoriasis and helped establish the importance of these pathways. It is given by injection and has strong long-term safety data.
Guselkumab (Tremfya) specifically targets the IL-23 p19 subunit. Clinical trials show high rates of PASI 90 responses. Many people maintain clear or almost clear skin for extended periods with continued treatment.
Risankizumab-rzaa (Skyrizi) is another selective IL-23 inhibitor. It’s given as an injection, typically every few months after starting therapy. Studies show very high skin clearance rates and durable results.
Tildrakizumab-asmn (Ilumya) also targets IL-23. It’s given at longer intervals than some other biologics. Clinical trials show meaningful improvement in moderate to severe plaque psoriasis, with a favorable safety profile.
A new oral IL-23 inhibitor called icotrokinra (Icotyde) has been approved by the FDA. Most IL-23 inhibitors are injections, but icotrokinra is an oral medication. This selective IL-23 receptor antagonist blocks IL-23 signaling in a targeted way.
According to clinical trial results and updates from psoriasis research organizations, icotrokinra has shown promising improvements in skin clearance. The FDA has approved icotrokinra for the treatment of moderate to severe plaque psoriasis in adults and certain adolescents, although long-term safety data is still being studied. This medication may provide an important option for people who prefer a pill instead of injections.
Interleukin inhibitors are generally well tolerated, but side effects can happen. Common side effects include upper respiratory infections (such as colds), headaches, fatigue, and injection-site reactions like discoloration or soreness.
IL-17 inhibitors can increase the risk of yeast infections because IL-17 helps protect against fungal infections. Certain IL-17 inhibitors may worsen inflammatory bowel disease in some people.
IL-23 inhibitors may also slightly increase infection risk, but they’re considered targeted therapies and don’t broadly suppress the immune system like older drugs.
Serious infections are rare but possible. Doctors usually screen for tuberculosis before starting treatment and monitor people regularly.
Interleukin inhibitors are usually recommended for people with moderate to severe plaque psoriasis. They may also be used for people who haven’t responded well to topical treatments or traditional systemic medications.
These treatments can be especially helpful for people who also have psoriatic arthritis. A dermatologist or rheumatologist will review your medical history, other conditions, and personal preferences before recommending one of these medications.
Interleukin inhibitors have changed how doctors treat psoriasis. By targeting specific immune signals like IL-17 and IL-23, these medications can provide high rates of skin clearance and long-term control.
With continued research and new therapies, including oral IL-23 inhibitors, treatment is becoming more personalized and more effective. For many people living with psoriasis, this means clearer skin and a better quality of life may be more achievable than ever.
On MyPsoriasisTeam, people share their experiences with psoriasis, get advice, and find support from others who understand.
What would it feel like to look in the mirror and see your psoriasis finally under control? Let others know in the comments below.
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