If your symptoms are particularly severe or not responding well to treatment, your GP may refer you to a skin specialist (dermatologist). Apremilast and dimethyl fumarate are medicines that help to reduce inflammation. They are taken as daily tablets. These medicines are only recommended for use if you have severe psoriasis that has not responded to other non-biological treatments. Further information It's applied to your skin (by someone wearing gloves) and left for 10 to 60 minutes before being washed off. The main benefit of emollients is to moisturise the skin and reduce itching and scaling. Some other topical treatments are thought to work better on moisturised skin. Wait at least 30 minutes before applying another topical treatment after an emollient.

Methotrexate can cause nausea and may affect the production of blood cells. Long-term use can cause liver damage. People who have liver disease should not take methotrexate, and you should not drink alcohol when taking it. Salicylic Acid: A gentle exfoliant that softens and eliminates scalp scales, minimising inflammation. Treatment for psoriasis usually helps to keep the condition under control. Most people can be treated by their GP. Moisturizing and Nourishing: This shampoo moisturizes your hair, regardless of its texture (straight, curly, or coiled), leaving it soft, shiny, and well-hydrated. Exfoliating and Healing: Salicylic Acid gently exfoliates the scalp, lifting and eliminating scales, while Comfrey provides exceptional hydration and aids in exfoliation. Urea enhances the healing penetration of multivitamins to restore dry, bumpy, and flaky scalps.Long-term use of this treatment is not encouraged, as it can increase your risk of developing skin cancer. Combination light therapy The main side effect of etanercept is a rash where the injection is given. However, as etanercept affects the whole immune system, there's a risk of serious side effects, including severe infection.

Calcineurin inhibitors, such as tacrolimus and pimecrolimus, are ointments or creams that reduce the activity of the immune system and help to reduce inflammation. They're sometimes used to treat psoriasis affecting sensitive areas, such as the face, the genitals and folds in the skin, if steroid creams are not effective. It may be used to treat psoriasis affecting the limbs, trunk or scalp if other topical treatments are not effective. Your treatment for psoriasis may need to be reviewed regularly. You may want to make a care plan – an agreement between you and your health professional – as this can help you manage your day-to-day health.They're recommended for people who have severe psoriasis that has not improved with other treatments or when other treatments are not suitable. Further information Dermatologically Tested: Formulated for both men and women, our shampoo has been dermatologically tested to ensure its safety and effectiveness. Vitamin D analogue creams are commonly used along with or instead of steroid creams for mild to moderate psoriasis affecting areas such as the limbs, trunk or scalp. They work by slowing the production of skin cells. They also have an anti-inflammatory effect. Acitretin can be very harmful to a developing baby, so it's important that women use contraception and do not become pregnant while taking this drug, and for at least 3 years after they stop taking it. However, it's safe for a man taking acitretin to father a baby. Other drugs

UVB phototherapy uses a wavelength of light invisible to human eyes. The light slows down the production of skin cells and is an effective treatment for some types of psoriasis that have not responded to topical treatments. There are 2 main types of systemic treatment, called non-biological (usually given as tablets or capsules) and biological (usually given as injections). Non-biological medications Methotrexate Each session only takes a few minutes, but you may need to go to hospital 2 or 3 times a week for 6 to 8 weeks. Psoralen plus ultraviolet A (PUVA) For this treatment, you'll first be given a tablet containing compounds called psoralens, or psoralen may be applied directly to the skin. This makes your skin more sensitive to light. There is an increasing number of biological treatments that are given as injections. These include guselkumab, brodalumab, secukinumab, ixekizumab, bimekizumab and risankizumab.

Phototherapy

Emollients are moisturising treatments applied directly to the skin to reduce water loss and cover it with a protective film. If you have mild psoriasis, an emollient is probably the first treatment your GP will suggest. Infliximab is given as a drip (infusion) into your vein at the hospital. You'll have 3 infusions in the first 6 weeks, then 1 infusion every 8 weeks. If there's no improvement in your psoriasis after 10 weeks, the treatment will be stopped.