Psoriasis Tablets, Injections and Light Therapy: What the NHS Offers
The specialist treatments for psoriasis when creams aren't enough, and how to get a dermatology referral in the UK.
Part of our psoriasis guide.
Get urgent help first. Call 999 or go to A&E if your skin suddenly becomes red and inflamed over most of your body, or you have widespread pus-filled spots, especially with a fever, chills or feeling very unwell. These can be signs of erythrodermic or generalised pustular psoriasis, which are emergencies. See a GP soon if you have painful, swollen joints. Online treatment isn't suitable in these situations.
Key fact: if creams and ointments don't control psoriasis, or it covers a large area or badly affects your life, NICE recommends light therapy or tablets or injections, started by a dermatologist.
Adults only online, and not in pregnancy or breastfeeding. Access Doctor's online psoriasis service is for adults aged 18 and over, and can't supply treatment if you're pregnant or breastfeeding: your GP or midwife can help. Children with psoriasis should see their GP.
When creams aren't enough
Most psoriasis is controlled with treatments applied to the skin. NICE advises that people should be offered light therapy or a systemic treatment (tablets or injections) if psoriasis can't be controlled with topical treatments, is extensive (for example more than 10% of the skin), or has a large impact on physical, psychological or social wellbeing. These treatments are started by a dermatologist, usually through an NHS referral from your GP.
Access Doctor doesn't supply tablets, injections or light therapy for psoriasis. If you think you need them, ask your GP for a referral to a dermatologist. This guide explains what to expect.
Light therapy (phototherapy)
Light therapy uses carefully measured doses of ultraviolet (UV) light to slow skin cell growth and calm inflammation. It's given in hospital dermatology departments.
| Type | How it works | Typical course |
|---|---|---|
| Narrowband UVB | The main type used. You stand in a cabinet for a few minutes. | 2 to 3 sessions a week for several weeks |
| PUVA | UVA light combined with a medicine called psoralen. Used if UVB hasn't worked. | Usually 2 sessions a week; limited lifetime number because of skin cancer risk |
| Hand and foot units | Smaller machines for palmoplantar psoriasis. | Similar schedules |
Light therapy is available on the NHS through a dermatologist. Side effects include redness like sunburn, dryness and, with long-term use, a higher risk of skin ageing and skin cancer, which is why the number of treatments is tracked. Sunbeds aren't a substitute and aren't recommended. Home units are used only in some specialist services.
Tablets for psoriasis
| Medicine | What to know |
|---|---|
| Methotrexate | The usual first systemic treatment, taken once a week (never daily). Needs regular blood tests. Avoid heavy drinking. Not used in pregnancy, and must be stopped well before trying for a baby. |
| Ciclosporin | Works quickly; used for shorter periods because of effects on blood pressure and the kidneys. |
| Acitretin | A vitamin A-based tablet, useful for pustular and hand and foot psoriasis. Must not be used in pregnancy, and pregnancy must be avoided for 3 years after stopping. |
| Apremilast, dimethyl fumarate and newer oral treatments | Used when standard tablets aren't suitable or haven't worked, following NICE criteria. |
Biologic injections
Biologics are injections that target specific parts of the immune system involved in psoriasis. They're very effective, including for nail psoriasis and psoriatic arthritis. Most are injected under the skin at home every 1 to 12 weeks, depending on the medicine. On the NHS they're prescribed by a dermatologist, generally for severe psoriasis that hasn't responded to, or can't be treated with, other systemic treatments and light therapy, following NICE criteria. Biosimilars (lower-cost versions of established biologics) are widely used.
Because biologics affect the immune system, you'll be checked for infections such as tuberculosis before starting, and advised about vaccinations.
Which treatment is best?
There isn't one best treatment for everyone. The choice depends on how severe your psoriasis is, where it is, whether you have psoriatic arthritis, other health conditions, your plans for pregnancy, and your preferences. A dermatologist will talk through the options. Your specialist will check how well each treatment is working, usually after about 3 to 4 months for tablets and injections, and change it if it isn't working well enough.
How to get a referral
- See your GP and explain how much skin is affected and how psoriasis affects your sleep, work, relationships and mood.
- Take photos of flares and a list of treatments you've tried, for how long and what happened.
- Mention any joint pain, stiffness or swelling, which may point to psoriatic arthritis.
- Ask whether you meet the criteria for light therapy or systemic treatment.
UK safety and reporting side effects
Prescription psoriasis treatments are only supplied after a GPhC-registered pharmacist independent prescriber reviews your consultation, including where your psoriasis is, how much skin it covers and what you have used before. Always read the patient information leaflet. Since 2024, UK steroid packs show their strength on the front (mild, moderate, strong or very strong). The MHRA advises using topical steroids for the shortest time needed, and to tell a healthcare professional if your skin flares badly after you stop a steroid you have used for a long time, which can be a topical steroid withdrawal reaction.
If you think you've had a side effect, tell your pharmacist or doctor. You can also report it to the MHRA through the Yellow Card scheme.
Treatments applied to the skin from Access Doctor
While you wait for a specialist, or if your psoriasis is mild to moderate, treatments applied to the skin can help. See our treatment options guide or our psoriasis treatment page for what our pharmacist prescribers can supply online.
Frequently Asked Questions
Is there a tablet for psoriasis?
Yes. Methotrexate is the usual first tablet, taken once a week. Others include ciclosporin, acitretin and apremilast. They're started by a dermatologist when treatments applied to the skin haven't worked or psoriasis is extensive.
Is light therapy available on the NHS for psoriasis?
Yes. Narrowband UVB light therapy is available through NHS dermatology departments, usually 2 to 3 times a week for several weeks. You need a referral from your GP.
What are biologics for psoriasis?
Biologics are injections that target parts of the immune system involved in psoriasis. On the NHS they're used for severe psoriasis that hasn't responded to other systemic treatments or light therapy, following NICE criteria.
Can I buy psoriasis tablets online?
Not from Access Doctor. Psoriasis tablets and injections need specialist assessment and regular monitoring, so they're prescribed by a dermatologist. We can help with treatments applied to the skin.
How do I get referred to a dermatologist for psoriasis?
See your GP and explain how much skin is affected, how it affects your life and what you've tried. Mention any joint pain. Your GP can refer you if psoriasis is severe, widespread or not responding to treatment.
References
- NICE. Psoriasis: assessment and management (CG153). nice.org.uk
- NICE Clinical Knowledge Summaries. Psoriasis. cks.nice.org.uk
- NHS. Psoriasis. nhs.uk
- British Association of Dermatologists. Psoriasis: an overview (patient information leaflet), August 2023. skinhealthinfo.org.uk
Medical disclaimer: This article is for information only and isn’t medical advice. Prescription psoriasis treatments need a clinical consultation before they can be supplied. If your skin is red all over, you have widespread pus spots, a fever or you feel unwell, seek medical advice the same day. In a medical emergency, call 999.