How Effective Is Methotrexate for Psoriasis?

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  • Written By: B. Chisholm
  • Edited By: O. Wallace
  • Last Modified Date: 16 October 2019
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Methotrexate for psoriasis may be effective. Psoriasis is found in various forms and grades of severity and the decision of whether to treat and how to treat it will be made by the attending doctor. The doctor will take into consideration the type of psoriasis, symptoms and severity. Methotrexate is one of a number of treatments used to treat this debilitating skin condition.

The exact cause of psoriasis is not known, although it seems to be genetically inherited. It causes itcy red patches on the skin which dry and scale. Some people have large areas of psoriasis, while others may only develop small patches. Arthritis may also be associated with psoriasis in a condition called psoriatic arthritis.

Psoriasis is incurable but goes through periods of remission and flare-ups. These may be of unknown cause or can be caused by triggers such as some medications, infections like strep throat or the ingestion of large quantities of alcohol. The treating doctor may prescribe methotrexate for psoriasis during severe flare-ups.


There are a number of topical treatments that will probably first be attempted before the doctor uses methotrexate for psoriasis. These may include both creams or ointments and, in some cases, light or PUVA therapy. Should the psoriasis not improve with these measures, systemic therapy may be prescribed. Again, there are a number of different classes of drugs that have successfully treated the symptoms of psoriasis. Methotrexate is thought to work by suppressing the formation of skin cells and acting as an anti-inflammatory.

When using methotrexate for psoriasis, it is normally given as a weekly or three times a week dose and, in general, for as short a time as possible. This is to minimize the risk of unwanted side effects. Methotrexate may cause diarrhea, loss of appetite and tiredness. When used long term it may cause liver damage and blood cell abnormalities. The prescribed dosage and duration of therapy should never be exceeded. In many cases systemic treatment will be given short-term to control a flare, allowing a return to topical therapy once remission is achieved.

If the prescribing doctor chooses to use methotrexate for psoriasis, it is important that the patient informs them about any other medications they are taking, including complementary, homeopathic and over-the-counter treatments, as these may interact with the methotrexate. Pregnancy, desired pregnancy and lactation should also be discussed. The intake of alcohol should be avoided while taking methotrexate.


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