These 4 Warning Signs Mean You Need To Change Your ​Psoriasis Medication

Dr. Khor Yek Huan (Consultant Dermatologist)

4 Signs Your Psoriasis Medication Isn’t Working

Are you getting more and more frustrated with worsening psoriasis symptoms?

Has this made you give up styling your hair, dressing to the nines to go out on a special occasion, or just, living life to the fullest?

Maybe you have tried different types of psoriasis treatments without success. Discover four warning signs that tell you it is time to switch your psoriasis medication.

1. Failure To Meet Treatment Goals

You had a treatment plan to meet skin clearing goals. Your doctor suggested that you should be clear of plaques.

You have done everything your doctor told you to do. You have counted the days. Three months later, your skin is still covered with psoriatic plaques. It is time to try a different approach.

Ideally, achieving lesions clearance is the ultimate treatment goal. However, this may not be 100% achievable at your first attempt. Different types of skin lesions may require different timelines to resolve, depending on the severity of your disease and treatment type.

Discuss with your dermatologist to set a minimal target and duration before assessing the effectiveness of a treatment.

Below is a useful rule of thumb for minimal target and duration of treatment options:1

4 Signs Your Psoriasis Medication Isn’t Working
4 Signs Your Psoriasis Medication Isn’t Working

2. More Flare-ups Than Before

Nothing is more frustrating than routinely applying treatments on your skin and then getting more flare-ups than ever.

Do not be alarmed. These flare-ups may be temporary. Psoriasis could worsen with certain medications, stress, infection, injury to skin,2 smoking and alcohol.3

Getting flare-ups more often could mean that your medication is losing its efficacy. Let your dermatologist know if you are not pleased with how often you are flaring up.

Inform him/her about specific difficulties, especially when these flare-ups get in the way of you having a normal life: performing your best at work, walking a short distance, or showering and dressing each day. Your dermatologist may advise you to cycle through treatment options to curb the loss of efficacy.

3. Your ​Psoriasis Symptoms​ Change

Your psoriasis symptoms start to express themselves differently than how they have in the past: getting a different type of skin lesion, anything appearing on other parts of your body, or changing from scaly red patches to pustular form.

If you experience joint pain, it is a sign of psoriatic arthritis (a form of joint inflammation that may affect up to 30% of psoriasis patients and cause severe joint deformities).4 A switch from topical-only treatment to systemic or biologic treatment may be needed to counter the risk of permanent joint damage.5

Discuss other treatments with your doctor immediately when you notice these psoriasis symptoms. A change in treatment plan is imminent.

4. Your Side Effects Become Unbearable

Every individual may react to treatments differently. Talk to your dermatologist if you experience any discomfort or side effect after starting your medication.

These side effects may be minor or severe. Some side effects may require a change in treatment dosage or termination.

Ask your doctor about treatment benefits, risks, and potential side effects.

Psoriasis Warning Signs: Ignorance Is Not Bliss

Stay positive and have faith in trying new treatment options.

Being attuned to warning signs that your psoriasis treatment has stopped working may be the best place to start getting clear skin.

Keep working with your dermatologist to find the right treatment for you. The right psoriasis medication for you is out there.

4 Signs Your Psoriasis Medication Isn’t Working

“I can 't change the direction of the wind, but I can adjust my sails to always reach my destination”

— ​Jimmy Dean, American Actor

4 Signs Your Psoriasis Medication Isn’t Working

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See also: Biologic Treatment For Psoriasis: 4 Things You Need To Know


  4. Helliwell P, Marchesoni A, Peters M, Barker M, Wright V. A re-evaluation of the osteoarticular manifestations of psoriasis. Br J Rheumatol1991;30:339–45.
  5. Arthritis Rheumatol. 2016 May;68(5):1060-71. doi: 10.1002/art.39573.

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Dr. Peter Ch’ng Wee Beng

Dr Ch’ng obtained his specialty training from the Royal College of Physicians in London. Subsequently, he obtained his Advanced Masters in Dermatology from the National University of Malaysia. He was previously the Head of Dermatology of the State of Pahang and Hospital Sungai Buloh.

His call to dermatology started way before he even contemplated doing medicine. His father suffered from severe psoriasis, and was in and out of hospital a lot in the late 1970s. His father’s condition made him see that skin disease is not just an aesthetic problem, as it can cause the patient and the entire family so much grief. His practice today reaffirms his belief, with many patients expressing deep relief and gratitude after their treatment.

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Dr. Ch'ng Chin Chwen

Dr. Ch'ng is a NSR registered consultant dermatologist. She graduated as a gold medalist from Univeristy Malaya in 2006. She obtained Membership of the Royal Colleges of Physician of the United Kingdom in 2010 and joined dermatology team in University Malaya in the same year. She completed Advanced Master in Dermatology (UKM) in 2014 and a visiting fellowship in Cutaneous Laser Surgery in Mahidol University (Thailand) in 2017. Her special interest include acne, psoriasis, urticaria, contact dermatitis/eczema and procedural dermatology.

Dr. Ch'ng started her instagram account @cccskindoc providing free skin care tips and education to public. She believes everyone deserves up-to-date and accurate information on skin care to embrace the skin that he or she is in.

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Dr. Khor Yek Huan

Dr Khor graduated from National University of Malaysia (UKM), Kuala Lumpur in 2002. He obtained his Internal Medicine specialty training from the Royal College of Physicians of London in 2007 and further subspecialized in Dermatology by obtaining his Advanced Master in Dermatology from UKM in 2013. Dr Khor served as the Head of Dermatology service for Perlis from 2013 to 2015 before transferring back to Penang. Currently, he is the Deputy Head of Department of Dermatology in Hospital Pulau Pinang. He is also a visiting consultant dermatologist at KPJ Penang Specialist Hospital and Northern Skin Specialist Clinic.

Dr Khor is active in academic activities, performing as an honorary lecturer for Allianze University College of Medical Sciences and Penang Medical College. He is active in research as well with the publication of original papers in dermatological journals and serves as a reviewer for Malaysian Journal of Dermatology. His dedication to the profession earned him Excellent Service Award from the Ministry of Health in 2009 and 2017.

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Articles by Dr. Khor Yek Huan
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