June 30, 2022
3 min. read

Is Methotrexate Effective for Psoriasis? Let’s Dive Into This Treatment


In the United States, approximately 7.5 million people in the United States have psoriasis, a skin disease that causes a rash with itchy, scaly patches, most commonly on the knees, elbows, trunk, and scalp. Psoriasis is a common, long-term skin condition that can range from a nuisance to downright debilitating. While there is no cure for psoriasis, there are treatments available. 

Treatment for psoriasis usually involves a combination of topical therapies, light therapies, and oral or injected medications, all of which aim to stop skin cells from growing so quickly and to remove scales. One such oral medication is methotrexate, which can help decrease the production of skin cells and suppress inflammation. 

Why is methotrexate prescribed? 

Methotrexate, also known as Rheumatrex or Trexall, is prescribed to treat severe psoriasis that is unresponsive to other types of treatment. It works by slowing the growth of skin cells in order to stop scales from forming. It is also used to treat rheumatoid arthritis (RA), which is a condition where the body attacks its own joints, causing pain, swelling, and loss of function. Methotrexate can also slow the growth of cancer cells, and is used to treat certain types of cancer as well. 

How should I take methotrexate? 

Methotrexate is an oral medication that you take by mouth. While your doctor will tell you how often to take this medication, it is usually administered weekly as a single oral dose for psoriasis. However, your dosing schedule will depend on the condition you have and on how your body responds to the medication. Whatever your dosing schedule, make sure to follow your doctor’s prescribing directions carefully and ask your doctor or pharmacist if you do not know when to take your medication. 

If you’re taking methotrexate for psoriasis, your doctor may start you on a low dose of the medication before gradually increasing your dose. 

What precautions should I follow before taking methotrexate? 

Before taking methotrexate, make sure to tell your doctor if you are allergic to methotrexate, any other medications, or any of the ingredients in methotrexate tablets. You can always ask your doctor or pharmacists for the list of ingredients. You’ll also want to tell your doctor about prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take—may need to change the doses of your medications or monitor you carefully for side effects. 

It’s important not to breast-feed while taking methotrexate, and mention this medication if you are having surgery, including dental surgery. You’ll also want to avoid having any vaccinations during your treatment with methotrexate without first talking to your doctor.

Methotrexate can also make your skin sensitive to sunlight or ultraviolet light, so do your best to avoid unnecessary or prolonged exposure to sunlight or ultraviolet light, and to wear protective clothing, sunglasses, and sunscreen. 

What should I do if I miss a dose? 

If you miss a dose of methotrexate, take the missed dose as soon as you can. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What are the side effects of methotrexate? 

Common side effects of methotrexate include: 

  • dizziness
  • drowsiness
  • headache
  • swollen, tender gums
  • decreased appetite
  • reddened eyes
  • hair loss

If you experience any of the following side effects while taking methotrexate, contact your doctor immediately: 

  • blurred vision or sudden loss of vision
  • seizures
  • confusion
  • weakness or difficulty moving one or both sides of the body
  • loss of consciousness

If you are suffering from severe, long-term psoriasis, methotrexate may be an option for you. In addition to rest, physical therapy, and sometimes other medications, methotrexate may be able to help you with your psoriasis symptoms. If you feel this medication may be right for you, make an appointment with your healthcare provider to talk about the risks, benefits, and your overall health. 


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