Jennifer Goldwasser, M.D.

I believe in a tiered approach to psoriasis. First we need to consider what might need to be subtracted to improve the skin: tobacco, alcohol, and a proinflammatory diet, for instance. We need to correct the correctable exacerbating factors, such as low vitamin D, overweight, gluten sensitivity, infection, medications, microtrauma, and stress. Then we can consider addition of topical therapies, energy-based therapies (like phototherapy and laser), oral therapies, and injectable therapies.