Psoriasis is a chronic (ongoing), immune-mediated skin disease with no cure at this time. However, it’s possible to achieve remission (periods when you have no symptoms). Reaching remission — the goal of many comprehensive treatment plans — can improve your overall quality of life.
Current treatment options, including topical treatments, phototherapy, and systemic drugs, can dramatically improve psoriasis symptoms such as itchy plaques. Regular check-ins with your doctor about treatments and keeping note of what’s triggering your psoriasis flares can also help you achieve remission. Here’s what remission means and four facts about strategies to help you reach it.
Definitions of psoriasis remission vary depending on the type of psoriasis and the level of disease severity. In many cases, therapies aim to reduce the severity, frequency, and length of psoriasis flares.
Remission from plaque psoriasis, the most common form of psoriasis, is generally defined as complete skin clearance of discolored, scaly plaques. Psoriasis remission lasts anywhere from one month to a year, although the time varies from person to person. Remission can go from weeks to months, sometimes even continuing for years.
Psoriasis therapy goals can be based on the change in your Psoriasis Area and Severity Index (PASI) score from before and after treatment. A PASI score is a number doctors use to measure the extent of a person’s psoriasis. Scores are based on an evaluation of the color, thickness, and scaling of psoriasis lesions.
Although there are no specific clinical definitions for psoriasis remission, a treatment plan is considered successful (and should typically be continued) if it leads to at least a 75 percent reduction in PASI score. With several newer biologic medications, treatment plans may be able to achieve a 90 percent to 100 percent PASI reduction.
For people who develop psoriatic arthritis (PsA), remission definitions also vary. Some studies say that PsA remission means having a very low disease activity score, which indicates a small number of tender, swollen joints with minimal pain and a low PASI score.
Remission may be followed by periods of flare-ups. Close monitoring by a dermatologist, as well as an effective treatment plan, can help people achieve and stay in remission. Treatment with phototherapy, topical corticosteroids like creams and ointments, and systemic treatments such as methotrexate or biologics can help improve skin clearance. Below, we discuss four strategies that may help you achieve and stay in remission.
Biologic treatments are different from traditional systemic drugs in that they target specific parts of the immune system that contribute to psoriasis and PsA. Biologics can be used to treat moderate to severe plaque psoriasis and PsA, as well as other health conditions. Biologic drugs are always administered as either an injection or an IV infusion. Drugs that are given as an injection can generally be received at home.
Many biologic drugs are available to treat psoriasis. Some examples include:
Avoiding psoriasis triggers such as stress, skin injury, extreme weather, infection, and smoking can help keep your skin clear of psoriasis lesions. Moisturizing your skin, bathing in lukewarm water, and using a humidifier in dry weather are other at-home steps you can take to help care for your psoriasis.
It’s impossible to predict who will reach remission and how long remission will last. The National Psoriasis Foundation recommends working with your health care provider to find the right combination of psoriasis treatments that will reduce or eliminate symptoms. You and your doctor should also weigh potential medication side effects against potential remission benefits. Regular follow-ups with your dermatologist may help you manage psoriasis more effectively.
Treating psoriasis is a complex process. It’s important that you stick with your treatment plan and take medications exactly as your doctor prescribes. Even if you follow your doctor’s plan exactly, you may need different medications or therapies to keep your psoriasis in check. Be sure to tell your doctor about any improvements or side effects from medications so that they can help you find the best combination of treatments for your journey to and through remission.
Once you reach near or complete clearance, you may feel like stopping some or all psoriasis treatments. Depending on your health status, psoriasis history, and treatment plan, however, your dermatologist may recommend continuing therapy without making changes. The doctor may also suggest modifying dosages or stopping particular medications.
According to the American Academy of Dermatology, one of three things will happen if psoriasis treatment is stopped. Psoriasis may:
In general, dermatologists don’t recommend stopping biologic therapy. Long-term, continuous therapy is ideal for maintaining remission. Once you reach remission, you should discuss a maintenance plan with your dermatologist. You may need close monitoring and regular adjustments to your treatment plan to keep your psoriasis under control.
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