Methotrexate is usually given once a week orally (pills) or occasionally by injection (with a needle). It helps control psoriasis affecting your skin, nail and joints. Side-effects include upset stomach, mouth ulcers, suppression of the bone marrow with low blood counts, and liver damage. Careful monitoring by your physician is essential on this medication. Liver biopsies may be required.


Acitretin is a retinoid with properties similar to vitamin A. For most patients, it does not appear to be as effective as methotrexate or cyclosporine in the treatment of plaque psoriasis. However, it works quite well for pustular psoriasis. Side-effects include dryness of the skin, lips, eyes and nose, elevation of the cholesterol and triglyceride levels, liver toxicity and bone changes. Since it may cause birth defects, it is used mainly in men, women who are post-menopausal or have had a hysterectomy. Monitoring by your doctor, and regular blood tests are required while taking this medication. Click here to view the A-Detail™ on Acitretin(Soriatane©).


Cyclosporine is an immunosuppressant psoriasis medication used in organ transplantation. It is very effective, but because of its cost and side-effects (kidney toxicity, high blood pressure, numbness and tingling, hair growth, skin cancer and lymphomas), it is usually reserved for people with severe, disabling, resistant disease. Careful monitoring by your doctor is required while taking this medication.