“You may need to give it about three to six months to see how it’s working because everyone responds so differently,” notes Dr. Garshick. She notes that even if someone hasn’t seen complete resolution, it may help to supplement with topical and other treatments before throwing in the towel and trying a different class of biologics.
Switching biologics is a big deal.
It may take some trial and error to figure out which class of biologics is going to give you the best result. Emphasis on may, here: Switching between these medications isn’t as easy as, say, swapping Tylenol for Advil. “You don’t really want to keep jumping around from different ones because we don’t know if doing so will eventually limit their efficacy,” says Dr. Garshick.
Dr. Baruch says your dermatologist will ask lots of questions about your symptoms, your family history, and other health conditions that you have before getting you started. Your answers will help your doctor have a good chance at getting the medication right the first time.
Lifestyle changes won’t make biologics work better.
There are no specific lifestyle changes you can make to increase the efficacy of biologics. Either a drug works for you, or it doesn’t. But keep in mind that there are some habits that your doctor might recommend to keep your psoriasis under control. “Anything that’s going to help your whole body to be healthier is going to help your psoriasis,” says Dr. Baruch.
Eating a healthy, nourishing diet, decreasing stress where you can, limiting alcohol, and abstaining from smoking have all been shown to help with psoriasis treatment — with or without biologics in the picture.
Side effects are different for everyone.
Both Dr. Baruch and Dr. Garshick hesitate to generalize about what the side effects of biologics will be like. Temporary redness and irritation at the site of your injection are pretty common, but the other side effects are harder to predict and distinct to the medication.
It’s good practice to ask your dermatologist specific questions about side effects so you know what to expect. “You should ask everything you want to ask so that when you inject this medicine into your body, you feel like you know what’s going to happen,” advises Dr. Baruch. “Ask about how common certain side effects are, and ask about interactions with other medications.”
With all that being said, some side effects you should be aware of include:
- Signs of an allergic reaction, such as shortness of breath or hives
- Headaches, diarrhea, or nausea
- Blurry eyes or visual disturbances
- Signs of an upper respiratory infection (such as a cough)
With any biologic treatment, Dr. Garshick encourages her patients to think in terms of risk versus reward. In many cases, controlling your psoriasis isn’t just about your skin. It also might help reduce joint pain and improve your mental health; things that can add years to your life in the long run. For many people, the potential side effects pale in comparison to the chance at stopping their psoriasis from progressing.
Visit SELF’s My Way to Well information hub for more on Psoriasis.