When you have psoriasis, your overactive immune system¹ has busy “highways,” Dr. Adel Haque, a board-certified dermatologist in Pennsylvania, told MyPsoriasisTeam. “You have a lot of traffic going down these highways,” which leads to symptoms like skin plaques or joint pain, he said. To improve your symptoms and control your psoriasis, “we want to target the overactive portion of the immune system.” These busy “highways” of psoriasis can be treated with many different medications.

Enter biologics (one of the treatment options for psoriasis) — medicines produced from biological sources. These medications include treatments for a broad range of conditions, including moderate to severe psoriasis and active psoriatic arthritis.^2,3 Biologics have a very specific mode of action and target a particular area of the immune system that is mistakenly activated, while leaving others undisturbed.³ If traffic speeding down a specific “highway” in your immune system is causing your psoriasis, Dr. Haque said, “biologics put a tollbooth on that highway.”

If you’re wondering if biologics are right for you, read on for three reasons Dr. Haque would recommend biologics to people with moderate to severe psoriasis.

Biologic drugs that are approved for psoriasis have dosing schedules that can range anywhere from an injection once weekly to once every 12 weeks. Many can be administered at home, and some have the option to be given at a doctor’s office.⁴ Unlike topical treatments like creams or lotions, biologics don’t require daily or even more frequent application to your skin.^5,6

Biologic therapy provides “highly effective treatment that can last over a long period of time that you don’t have to take on a daily basis,” Dr. Haque said. Using a biologic can eliminate the need for a complicated or time-consuming regimen of topicals, he added.

The thought of regular injections may be nerve-wracking — if this describes how you feel, you’re not alone. Tell your dermatologist or another health care provider if you have a fear of needles. They can help you find ways to make the process less stressful.⁷

Psoriasis is caused by overactivity in the immune system. When your immune system gets triggered into action, this can lead to inflammation inside the body. This is beneficial when your immune system is fighting a cold or flu, but in the case of psoriasis, the body creates inflammation that results in symptoms like skin plaques. The inflammation that leads to skin symptoms may have effects throughout the body.¹

Biologics are systemic medications, meaning they treat inflammation throughout the body, as opposed to focusing only on a specific area where you might have skin plaques. A topical cream is applied on areas of the skin where there are psoriasis lesions. A topical is an example of a medication that’s used reactively, not used systemically.^8,9 “Unmanaged psoriasis … [is] inflammation in the body that’s not being treated,” Dr. Haque said. Biologics, he explained, “treat your disease systemically to help you get the inflammation under control,” including the inflammation “you can’t see.”¹⁰

While biologics are systemic medications, they’re also highly targeted. “We just want to target the overactive portion of the immune system and bring it back to normal,” Dr. Haque said. It’s important to talk to your doctor about the possible side effects of any treatment for psoriasis. They can help you understand the potential benefits and risks of any medication you might consider.

Psoriasis is associated with other health problems, including psoriatic arthritis and heart disease. The chronic inflammation associated with psoriasis may contribute to the development of these conditions.¹⁰

Biologic treatments address systemic inflammation, so it’s possible that they may reduce the chances of developing other health conditions associated with inflammation. For example, using a systemic therapy like a biologic may reduce the risk of stroke or heart attack, according to the American Academy of Dermatology.¹¹

Dr. Haque explained that there are still unknowns about how biologic treatment affects the development of psoriatic arthritis. Many biologics that are approved to treat psoriasis are also approved to treat psoriatic arthritis. “We know that biologics decrease systemic inflammation,” he said. “By decreasing inflammation, ideally, we’re decreasing the risk of progressing to psoriatic arthritis.”

Some study findings show that rates of psoriatic arthritis were lower in people with psoriasis who were treated with a systemic medication like biologics than those who were not.¹² However, this is an area that requires more study.¹⁰ Dr. Haque said he expects future research will offer more conclusive findings about the impact of biologic use on the chances of developing psoriatic arthritis.

If you’re concerned with your current treatment, you’re not alone: In a 2022 survey of over 300 MyPsoriasisTeam members, 34 percent of those with psoriasis reported being dissatisfied with their treatment. Among the respondents with psoriasis who reported using a systemic drug, including biologics and oral drugs, 84 percent indicated they were satisfied with their treatment.¹³

Your dermatologist can help you decide if a systemic treatment like a biologic is the right fit for you. The International Psoriasis Council released recommendations in 2020 for determining if a person is a candidate for systemic treatments such as biologics.¹⁴ Their recommendations are summarized in the chart below. Your dermatologist may use these criteria when considering what might be an effective treatment for you.