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Some patients choose a numbing cream beforehand, but most are comfortable throughout and report only mild sensation

The standard escalation protocol increases your dose in stages over 16 to 20 weeks, giving your body time to adapt to each level before moving to the next

However, patients with low BSA psoriasis and burdensome symptoms who are candidates for biologic therapy (according to the clinicians judgement) may not meet a payers criteria for eligibility to receive advanced psoriasis treatment options [4, 9, 23, 28] Current International Psoriasis Council (IPC), American Academy of Dermatology, and National Psoriasis Foundation treatment guidelines recommend that indicators of psoriasis disease burden beyond BSA, including involvement of high-impact sites and failure of topical therapies, be considered when determining whether patients are eligible for systemic treatment [3, 4]

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