If you’ve been living with psoriasis for some time, you likely know that your symptoms can come and go. Starting a new treatment can help control your symptoms and encourage your skin to heal, but how do you know when a therapy is working? Although you might be eager for quick relief from psoriasis, it may take some time for your skin to begin clearing.

In this article, we’ll cover the three signs that show your psoriasis treatment is working. We’ll also explain how your dermatologist (skin specialist) measures how well your treatment plan is working. Together, you and your dermatologist can find the best approach to keeping your skin clearer for longer.

How Are Psoriasis Flares Treated?

Psoriasis is a chronic inflammatory skin condition. That means it lasts a long time and can keep coming back. It often goes through flares (when symptoms get worse) and remission (when symptoms ease). Psoriasis is also an autoimmune disease, which means the immune system mistakenly attacks healthy skin. During a flare, you may have dry, scaly patches of skin, itchiness, or rashes. The symptoms you have depend on your type of psoriasis.

For example, plaque psoriasis causes dry, scaly skin patches known as plaques. Guttate psoriasis causes small, round, or teardrop-shaped discolored bumps. Erythrodermic psoriasis leads to peeling rashes with intense burning and itching.

Some psoriasis flare-ups can last several weeks or months and then go away for a while.

According to the American Academy of Dermatology (AAD), cold temperatures, stress, smoking, and skin injuries all raise the risk of a psoriasis flare. You can help prevent psoriasis flare-ups by avoiding your psoriasis triggers.

Examples of Psoriasis Treatments

Your dermatologist can prescribe treatments to help control and limit flare-ups.

Common treatment options include:

• Corticosteroids — Medications that help control immune system activity and skin inflammation
• Vitamin D analogs — Human-made forms of vitamin D that slow the growth of skin cells
• Biologics — Laboratory-made treatments that target immune system proteins to treat skin inflammation
• Immunosuppressant therapy — Drugs that calm down the immune system to control skin inflammation
• Phototherapy (light therapy) — Treatment with ultraviolet light that slows skin cell growth

How Can Dermatologists Tell if a Treatment Is Working?

When your dermatologist prescribes topical treatments — like creams, lotions, or ointments — or an injectable biologic, your symptoms should improve.

During a follow-up appointment, your dermatologist will likely ask if you’re experiencing less inflammation, discoloration, and flaking. Be ready to tell them about any changes you’ve noticed since starting your treatment — whether your symptoms are better or worse and if new ones have developed.

Some MyPsoriasisTeam members turn to others for help when looking for signs of healing. One said, “I’m shedding like crazy from every skin surface. I’m not sure if this is a stage in the healing after two weeks of medication or something new in my psoriasis bag of tricks. Any ideas?”

Your dermatologist can help figure out whether your skin is healing or if you may be reacting to your treatment. To learn more about the side effects of your psoriasis treatments, talk to your healthcare provider. They can offer medical advice about possible side effects for all of the treatments available.

Measurements of Psoriasis Severity

Dermatologists use a few measurements to track how severe psoriasis is and whether the treatment is working.

Body Surface Area

Body surface area (BSA) refers to the amount of skin affected by psoriasis. The National Psoriasis Foundation defines severity based on how much of the body is covered by psoriasis:

• Mild — Less than 3 percent
• Moderate — 3 percent to 10 percent
• Severe — More than 10 percent

The Location of Psoriasis

Another way to judge how severe psoriasis is involves looking at where it shows up on the body, because some areas can affect daily life more than others.

Studies have found that people with psoriasis in these areas often report a lower quality of life, are more likely to have mental health issues like depression, and may be less likely to socialize. These areas include the face, genital area, scalp, soles of the feet, and palms of the hands.

Psoriasis Area and Severity Index

A tool called the Psoriasis Area and Severity Index (PASI) can help tell your dermatologist if your current treatment plan is effective. This scoring system takes several factors of your psoriasis into account. One factor is intensity, which is based on how discolored, scaly, and thick your skin is. Your PASI score also uses your BSA measurements. Your dermatologist will grade these factors on a scale and add them up to get your PASI score. The higher your PASI score, the more severe your psoriasis is.

What’s the Timeline for Skin Healing With Psoriasis?

If you’ve recently started psoriasis treatment, you’re likely wondering when you’ll notice healing. The time it takes for treatments to work can depend on both your type of psoriasis and your specific treatment. For example, it may take up to six weeks to notice any improvement when using topical medications.

If you have severe psoriasis or psoriatic arthritis, which can cause joint pain, stiffness, and a rash, your doctor may prescribe an immunosuppressive medication like methotrexate. Methotrexate is a drug that calms down the immune system to reduce inflammation. It usually starts working within four to six weeks, but it may take up to six months for your skin to clear completely.

3 Signs Psoriasis Is Healing

Now that you have a better understanding of how dermatologists measure symptom improvement, we’ll cover three signs that your skin is healing from psoriasis.

1. You Have Fewer Patches of Psoriasis

As your skin begins to heal, you’ll likely notice that less is affected by psoriasis. When researchers study new psoriasis treatments, they use the PASI score to measure how well they work. This means they look for the treatments that help clear skin the most.

MyPsoriasisTeam members have shared that certain treatments helped clear their skin. One member wrote, “Today is a good day. The cream seems to be helping — no scaling, burning, or itching. Three of my spots are barely noticeable, and the six large patches aren’t really that bad.”

Another shared their success with a biologic: “My skin is slowly but surely clearing up. Except for some discoloration, there’s no more peeling and flaking.”

2. Your Skin Is Less Itchy and Flaky

During a psoriasis flare, your skin may become intensely itchy, but does psoriasis itch when healing? In some cases, it might, but once your psoriasis treatment starts working, you’ll likely feel less itchy. Scratching might feel good for a moment, but it can make your itching worse over time.

You may also notice less flaking once your skin begins to heal. In psoriasis, skin cells build up on the surface of plaques that flake off. When you treat the inflammation, which causes rapid skin cell growth, you can also reduce the flaking.

Some MyPsoriasisTeam members have noticed that healing skin means symptom relief. “Been on treatment for less than two weeks — my elbows and hands are healing,” one member said about their healed psoriasis. “I have new pink skin coming through, and my itching is under control.”

3. Your Skin Tone Becomes More Even

Inflammation from psoriasis can affect your skin tone. Some people with darker skin develop discoloration where they used to have plaques or rashes. This is called post-inflammatory hyperpigmentation. A sign your skin is healing from psoriasis may be that your skin tone evens out. According to the AAD, it can take between three and 12 months for these lighter or darker patches to clear.

MyPsoriasisTeam members have also found that skin color improves over time. “The biologic I’ve been on for two-plus years has worked wonders, and the plaques on my legs have faded into the sunset, with only light discoloration where they once were,” shared one member.

Keeping Your Psoriasis Under Control

Once you see your skin healing, you may be tempted to stop treatment. However, it’s important to keep up your treatment plan so your skin stays healed. The AAD notes that when you stop treatment, your symptoms of psoriasis may return and even be worse than before (known as a rebound).

Because psoriasis is a lifelong condition, it usually requires lifelong treatment. After your skin has healed, talk with your dermatologist about your next steps. You may need maintenance treatment, or you may be able to adjust some of your medications as your dermatologist sees fit. The overall goal is to help you stay in remission as long as possible and improve your overall quality of life.

Join the Conversation

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

How do you know psoriasis is healing? Let others know in the comments below.