Biologics for Psoriasis: Are They Right for You?
PsoriasisYour Psoriasis Skin and Beyond

Biologics for Psoriasis: Are They Right for You?

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Updated on July 31, 2025
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I f you’re unhappy with your psoriasis treatment, switching to a biologic may be an option. Biologics have been used in the United States to treat psoriasis for two decades. The first was approved by the U.S. Food and Drug Administration (FDA) in 2003.

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, you probably 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 prepare you for an informed discussion with your doctor.

Twelve biologic medications are FDA-approved to treat psoriasis.

IL-12/23 Inhibitor

  • ustekinumab (Stelara)

IL-17 Inhibitors

  • bimekizumab-bkzx (Bimzelx)
  • brodalumab (Siliq)
  • ixekizumab (Taltz)
  • secukinumab (Cosentyx)

IL-23 Inhibitors

  • guselkumab (Tremfya)
  • risankizumab (Skyrizi)
  • tildrakizumab (Ilumya)

TNF-alpha Inhibitors

  • adalimumab (Humira)
  • certolizumab pegol (Cimzia)
  • etanercept (Enbrel)
  • infliximab (Remicade)
Twelve biologic medications are FDA-approved to treat psoriasis.

How Biologics Work to Treat Psoriasis

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Psoriasis Is Much More Than a Skin Disease

On the surface, psoriasis is a skin disease, but plaques and other symptoms are caused by inflammation inside the body. So, 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. 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, the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City.

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 in two ways:

  1. 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.
  2. Unlike traditional systemic therapies, which broadly suppress the immune system, biologics target specific molecules linked to psoriasis.

7 Need-to-Know Facts When Considering Biologics for Psoriasis

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

Before prescribing any psoriasis treatment, your doctor may identify the severity of your condition as 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 affects your quality of life.

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

2. Biologics are administered by infusion or injection.

Different biologics are taken in different ways, but they all involve a needle. Some biologics are given by intravenous infusion in a clinical setting, while you administer others to yourself at home, using an auto-injector to give yourself a shot under the skin.

2. Biologics are administered by infusion or injection.

3. Most people have clearer skin within three to four months.

You may notice some decrease in psoriasis symptoms within the first two weeks after you start the medication, but you’ll see most of the benefits at around 12 weeks. Symptoms may continue to improve for months afterward.

3. Most people have clearer skin within three to four months.

4. Biologics may prevent related health conditions.

“While psoriasis plaques affect the skin, we know that psoriasis is a systemic inflammatory condition,” says Zeichner. “It’s associated with ... 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 progressive and permanent.

People who have psoriasis also have a higher risk of diabetes, heart disease, obesity, and Crohn’s disease.

Treatments that reduce psoriasis-related inflammation in the skin also lower inflammation in the rest of the body, which can reduce the likelihood you'll develop these related health risks.

4. Biologics may prevent related health conditions.

5. Over time, a biologic’s effectiveness may diminish.

After months or years of taking a certain biologic, it may become less effective for you. That’s because your immune system may develop antibodies to the drug, particularly if you’ve missed any doses. If this happens, you might notice plaques gradually coming back, and your doctor may recommend switching to another biologic.

5. Over time, a biologic’s effectiveness may diminish.

6. 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 and lymphoma. Psoriasis may also increase your risk of lymph node and blood cancers, according to research published in 2021.

Before you start a biologic, your doctor will run tests to make sure the drug is safe for you to take.

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

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

Biologics can cost anywhere from $1,700 to $80,000 per year in the United States. 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 can’t afford the biologic your doctor prescribes, talk to them (or your 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. You might qualify for lower copays or even get the medication for free.

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

Am I a Candidate for a Biologic?

If you’re struggling to get your psoriasis symptoms under control, there’s 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 — to meet your particular needs.

Before you try biologics, your doctor may suggest 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 work only on the surface, to treat the outward symptoms of psoriasis, but do not affect inflammation within the body.
  • Phototherapy (light therapy) and excimer laser: These therapies use natural light, artificial ultraviolet A light, or ultraviolet B light to slow skin cell growth and reduce inflammation.
  • 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 your 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.”

Common Questions About Biologics for Psoriasis

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

Quiz: How Much Have You Learned?

everyday health quiz

Test Your Knowledge of Psoriasis Treatment

Can you answer all 7 questions correctly?
By Katherine LeeMedically reviewed by Alexa Meara, MDPublished on February 22, 2021
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How to Talk With Your Doctor About Biologics for Psoriasis

At your next appointment, your doctor will likely ask if your current psoriasis plan is working. Take some time in advance to reflect on your needs and goals — and how your treatment is stacking up in comparison.

Self-Reflection

consumers-guide-psoriasis-next-steps-922x388

  1. Are you satisfied with your current psoriasis treatment?
  2. Has it improved your skin and overall health as well as you had hoped?
  3. Does psoriasis affect your emotional health and quality of life?
  4. Are you downplaying your symptoms when speaking to your doctor?
  5. Are you following your psoriasis treatment regimen as prescribed?
  6. Have you tried other treatment options?
Reflecting before your next appointment can help you go into it feeling prepared. If you decide it’s time to discuss a potential treatment change with your doctor, jot down some questions you’d like to ask. Here are a few conversation starters you can save to your phone and bring to your next appointment.

Doctor Discussion

consumers-guide-psoriasis-doctor-questions-922x388

  1. What can I do to improve my skin?
  2. Am I a good candidate for biologics?
  3. Which medication are you prescribing for me and why?
  4. What results do you expect?
  5. How long should I use this medication before I notice any progress? 
If you're unhappy with your current psoriasis treatment, it's worthwhile to bring it up to your provider and explore what options may be available, given your symptoms and needs. Each of the 12 biologics approved by the FDA to treat psoriasis targets different proteins in the body thought to be part of the immune response that causes the condition, so you may need to try a few before finding the right one for you. Keep an open dialogue with your provider about what's working and what can be improved in your care plan.

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