Since then, this drug class has grown, changing the treatment landscape for psoriasis by helping more people find effective treatment and achieve clearer skin. In fact, you may have seen biologics for psoriasis advertised on TV or online, or heard about them from someone else who has psoriasis.

If so, it’s likely you have questions about how biologics work, what it’s like to take one (as most come in injectable form), and more. Learning as much as you can on your own will help prepare you to have an informed discussion with your doctor.

Psoriasis: A Disorder of the Immune System

On the surface, psoriasis is a skin disease, but because plaques and other symptoms are caused by inflammation inside the body, the best way to treat moderate to severe psoriasis is often with systemic medications that block the immune system’s inflammatory response.

Why does your body create this inflammation? It’s part of your immune system’s natural defense against foreign invaders that might make you sick. But with psoriasis, your immune system is overactive, and causes excess inflammation, which activates skin cells to multiply too fast, leading to plaques on your skin.

In other words, psoriasis is an autoimmune condition in which your immune system gets “angry” at your skin, says Joshua Zeichner, MD, director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York.

How Biologics Treat Psoriasis From the Inside Out

Biologic medications are created using living cells that are similar to molecules in your immune system. They work within the body to target inflammation and psoriasis plaques at the source.

Biologics differ from other common psoriasis treatments for two reasons:

Rather than treating existing plaques (as topical therapies do), biologics get to the root of psoriasis by blocking the inflammatory process in your body before it even starts.
Unlike traditional systemic therapies, which broadly suppress the immune system, biologics target specific molecules linked to psoriasis.

8 Essential Facts About Biologics for Psoriasis

Here are the basics you should know when deciding if biologics are right for you.

2. Biologics are usually prescribed to treat moderate to severe psoriasis.

Before prescribing any psoriasis treatment, your doctor may identify the severity of your condition in one of three categories, depending on how much of your body is covered in skin lesions:

Mild: covers less than 3 percent of your body
Moderate: covers 3 to 10 percent of your body
Severe: covers greater than 10 percent of your body

Even if psoriasis covers only a small part of your body, it could still be considered severe if it greatly impacts your quality of life.

2. Biologics are usually prescribed to treat moderate to severe psoriasis.

5. Biologics may help prevent related health conditions.

“While psoriasis plaques affect the skin, we know that psoriasis is a systemic inflammatory condition,” says Dr. Zeichner. “It’s associated with arthritis — a condition called psoriatic arthritis — so if you have joint aches, it is important to treat them early.” Left untreated, joint damage from psoriatic arthritis is permanent and progressive.

People who have psoriasis are also at higher risk for cardiovascular disease, diabetes, and Crohn’s disease.

According to the National Psoriasis Foundation, reducing inflammation in the skin also reduces inflammation in the rest of the body, which in turn can help reduce the likelihood of developing these related health risks.

5. Biologics may help prevent related health conditions.

7. They’re considered safe but do have potential side effects.

The most common side effects of biologics are pain and skin reactions at the site of the injection. It’s also possible to have an allergic reaction that leads to a rash, itchiness, shortness of breath, or dizziness.

Since biologics work by suppressing your immune system, they increase your susceptibility to infections, such as bacterial and fungal infections, and may increase your risk of tuberculosis (TB) and lymphoma; however, having psoriasis may also increase your risk of blood and lymph node cancer, according to a review published in April 2021 by the American Journal of Clinical Dermatology.

Still, before starting a biologic, your doctor will run tests to make sure the drug is safe for you to take.

7. They’re considered safe but do have potential side effects.

8. Biologics are expensive, but you likely won’t pay all of it out of pocket.

Biologics can cost between $10,000 and $30,000 per year, and potentially up to $500,000 for the most expensive options. Most insurance companies cover at least a portion of that, but how much you’ll pay out of pocket and which drugs are covered depends on your insurance plan.

If you cannot afford the biologic you’re prescribed, talk to your doctor or pharmacist about your options. Your state may have a drug plan to assist with medication costs. You can also check the drug manufacturer’s website for their patient assistance program (PAP): You might qualify for lower co-pays or even be able to get the medication free.

8. Biologics are expensive, but you likely won’t pay all of it out of pocket.

Is It Time to Try a Biologic to Treat Psoriasis Symptoms?

If you’re struggling to get your psoriasis symptoms under control, there is good news: Today, there are more psoriasis therapies than ever before, and a dermatologist can help you find the right treatment — or combination of treatments — that meets your particular needs.

Before trying biologics, your doctor may suggest trying the following treatments.

Topicals: Topicals include topical corticosteroids, vitamin D analogues, anthralin, topical retinoids (vitamin A derivatives), salicylic acid, coal tar, and moisturizers. These creams and ointments are applied to the affected skin, so they only work on the surface to treat the outward symptoms of psoriasis and do not impact inflammation within the body.
Phototherapy (light therapy): Light therapy uses natural or artificial ultraviolet light to slow skin cell growth and reduce inflammation. Phototherapy includes natural sunlight or artificial ultraviolet A (UVA) or ultraviolet B (UVB) light.
Traditional systemics: Medications such as methotrexate and cyclosporine suppress the immune system on a broad level to reduce inflammation and prevent psoriasis symptoms and progression. They can be used alone or in combination with a biologic to treat psoriasis.

Treatment depends on your preferences and how severe the psoriasis is, Zeichner says. “In mild cases, topical creams may do the trick,” he says, “but if larger body surfaces are involved, then systemic medications such as biologics may be necessary.”

A Psoriasis Expert Answers Common Questions About Biologics

Do you still have questions about biologics? We talked to Anna Guanche, MD, a board-certified dermatologist and founder of Bella Skin Institute, about the most common questions she hears from patients and got answers.