A: There is no one perfect treatment for psoriasis, hence, there are multiple treatments for psoriasis. One of the responsibilities that doctors have is to “not make the treatment worse than the disease.” With psoriasis, we use what we call a “therapeutic ladder.” On the bottom rung of the ladder, the treatments are very safe, with very few side effects, and these are used for the mild cases of psoriasis. As you ascend the ladder, going higher and higher, each rung of the ladder represents treatments that are more powerful, but also have more side effects. Traditionally, the more powerful medicines you treat psoriasis with have been what we call anti-metabolites, such as methotrexate. If used correctly, these can be extremely safe, however, they should only be used by someone experienced with anti-metabolites and a physician who is careful and monitors therapy. In recent years, we’ve received the “biologics,” which are engineered molecules that usually work by altering the immune system response. Some of these are extremely safe, however, again, they should be only used in the more serious cases of psoriasis.