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Overcoming the Fear of Self-Injections for Psoriasis

Updated on May 03, 2021
See how 339 members reacted on this article
Medically reviewed by
Diane M. Horowitz, M.D.
Article written by
Joan Grossman

  • Biologic medications for psoriasis can be safely self-injected at home.
  • Fear of self-injection is common but can be overcome with education and training.
  • Your doctor can teach you how to properly self-inject a biologic at home.

Biologic drugs used to treat psoriasis can be safely and conveniently self-injected at home, but some people are afraid to try this method. Many MyPsoriasisTeam members have shared their self-injection experiences, as well as their fears.

“I hate needles,” said one MyPsoriasisTeam member, voicing a fear of needles that many people share. Another member added: “I started Humira today. I was a little nervous about self-injections, but I did it. Now I'm praying I finally found something that works. I'm ready to be myself again,” she said.

When appropriate, self-injection is a popular alternative to clinically administered injections. If you’re afraid of giving yourself an injection, think about how it can cut down on doctor visits and offer more self-sufficiency with your treatment. Once people get over the fear, many prefer the flexibility and comfort of self-injection.

Knowing what to expect can help you overcome your fears. Here’s what to know so you can face your self-injections with confidence.

Why Do I Have To Inject?

Biologics need to be taken by injection — they consist of large molecules that cannot be properly absorbed in the gastrointestinal tract if taken orally.

Biologic drugs can be very effective in treating psoriatic disease (both psoriasis and psoriatic arthritis) and other autoimmune diseases such as rheumatoid arthritis. Biologics are often effective because they target specific agents in the immune system that can overreact and cause inflammation.

Your doctor may recommend a biologic drug, such as Cimzia (certolizumab pegol), Enbrel (etanercept), or Humira (adalimumab), as a treatment option for at-home use. There are many injectable biologics used to treat psoriasis and psoriatic arthritis.

Discuss the Types of Self-Injection

There are three main types of self-injection for administering biologic drugs at home. They each have their advantages and disadvantages, depending on your preference. Talk to your doctor about the option you feel most comfortable using to make self-injection less scary.

Prefilled Syringe

A prefilled syringe is a syringe and needle that has been filled with the appropriate dose of a medication. The dose is administered manually, and the user can control the speed of the injection. However, self-injection with a prefilled syringe can be difficult for people with psoriasis who have limited function with their hands.

Self-Injection Pen

A self-injection pen, also called an auto-injector, is prefilled with medication. It has a hidden spring-loaded needle, which is released by pressing a button when the device is pressed against the skin. Self-injection pens are easier to use for some people, but they may cause more swelling, bruising, or pain than a slower injection with a standard syringe.

E-Devices

E-devices are reusable auto-injectors that have enhanced technology. E-devices can provide control over the speed of injection, save an injection log, and have skin sensors that stop injection if contact with the skin is incorrect. However, some people might find e-devices too complicated.

Proper Training for Self-Injection

Before your first dose, talk to your doctor about self-injection. You can arrange for your first self-injection to take place at your doctor’s office to be supervised by a health care provider. You can ask them questions and be sure you are administering the injection safely. Your health care provider can also teach you how to store syringes or self-injectors properly, which need to be refrigerated.

Research shows that both trained and untrained people with psoriasis can effectively administer self-injection. Nonetheless, one study indicated that people who were trying self-injection performed better with training and education materials, and were more satisfied with self-injection.

Training with a health care professional will put you at ease and give you confidence that you are doing the procedure correctly. As one MyPsoriasisTeam member said after learning how to self-inject, “I am now so much more confident that I will be able to manage the weekly injections myself.”

One member described her experience with learning to administer self-injections of methotrexate, a nonbiologic drug that is also sometimes injected. “I had my first injection yesterday,” she said. “After stressing and worrying about how painful the injections would be, I was pleasantly surprised that after the nurse in the clinic explained how to administer it, I literally felt nothing!”

Tips for Giving Yourself an Injection

Always follow your doctor’s instructions for self-injections. The following tips can make the process easier.

Prepare

Start by preparing a clean, uncluttered area to do your self-injection. Wash your hands and have an alcohol wipe handy for the injection site. Some people are comforted by having a family member or friend with them.

The cold, refrigerated medication may be uncomfortable when injected. It is sometimes safe to take the filled injector out of the refrigerator for an hour or two before using it, so that the medication comes to room temperature. Some people warm the syringe or auto-injector in their hands before using it. Check with your doctor first about protocols for your specific medication.

Choose the Right Location

Self-injections are typically administered to the arms, abdomen, or thighs. For many people, self-injection in the thigh is the easiest area to reach and the least painful. Consider rotating through different injection sites to avoid a single site getting sore over time or building up scar tissue.

Decrease Any Pain

An ice pack can also be used to numb the injection site before performing the injection, and ice can be used after the injection to reduce any pain or swelling. Pinching the skin around the injection site before and during the injection is also recommended.

Possible Self-Injection Side Effects

Whether or not an injection is administered by a clinician or self-injected, you may experience side effects at the site of the injection. Pain, redness, itching, or swelling are side effects that commonly occur and sometimes stop after a few injections. Discuss these injection site reactions with your health care provider.

MyPsoriasisTeam members sometimes talk about the side effects of self-injection. One member said, “The injections hurt but are well worth the pain.” Another member wrote, “I give myself an injection every six weeks. It works great. There are no side effects for me, and my skin is clear.”

In addition to side effects at the injection site, be prepared for other side effects the medication may cause, such as nausea, flushing, or headaches. Talk to your health care team about potential side effects when you self-inject a biologic drug. Contact your doctor immediately if you experience an allergic reaction to a self-injection, with symptoms such as shortness of breath, itchy eyes, a full-body rash, fever or chills.

Learn more about starting a biologic treatment.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis or psoriatic arthritis and their loved ones. On MyPsoriasisTeam, more than 91,000 members come together to ask questions, give advice, and share their stories with those who understand life with psoriasis.

Are you nervous about self-injection, or do you have questions about it? Share your thoughts in the comments below, or start a conversation with others on MyPsoriasisTeam.

References

  1. Biologics — National Psoriasis Foundation
  2. Recent Advances in the Oral Delivery of Biologics — The Pharmaceutical Journal
  3. A Portfolio of Biologic Self-injection Devices in Rheumatology: How Patient Involvement in Device Design Can Improve Treatment Experience — Drug Delivery
  4. Correct Performance of Subcutaneous Injections in Plaque Psoriasis: Comparison of Trained and Untrained Patients With Different Application Systems in Routine Clinical Care — Journal of Dermatological Treatment
  5. Self-Injection Education Improves Patient Confidence, Satisfaction — Dermatology Times
  6. The Patient’s Guide to Psoriasis Treatment. Part 3: Biologic Injectables — Dermatology and Therapy
  7. How To Give Yourself Biologic Injections: Tips From Patients and Doctors — CreakyJoints
  8. Subcutaneous Injection of Drugs: Literature Review of Factors Influencing Pain Sensation at the Injection Site — Advances in Therapy
  9. Injection Site Reactions With the Use of Biological Agents — Dermatology Therapy
  10. Side Effects of Biologic Medications — Johns Hopkins Arthritis Center

A MyPsoriasisTeam Member said:

I take Humira in a pen and my husband gives me the injection. I am so afraid of needles that I just can't push the button. I just freeze. My husband is also good at reminding me since I get the… read more

posted 3 months ago

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Diane M. Horowitz, M.D. is an internal medicine and rheumatology specialist. Review provided by VeriMed Healthcare Network. Learn more about her here.
Joan Grossman is a freelance writer, filmmaker, and consultant based in Brooklyn, NY. Learn more about her here.

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