Concierge dermatology · UK
psoriasis treatment - a consultant dermatologist and the full ladder - topicals to biologics.
A structured private psoriasis pathway - consultant dermatologist review, disease severity scoring, phototherapy, apremilast, methotrexate, ciclosporin and modern biologics through the full BAD-guided ladder. Skin, joints, mental health and cardiovascular risk all considered.
Why patients choose us
- 01
A consultant dermatologist, not a private GP
A UK consultant with a defined psoriasis practice, familiarity with the BAD biologics pathway, and rapid rheumatology referral for psoriatic arthritis.
- 02
The whole ladder, not a favourite drug
Topicals, phototherapy, methotrexate, ciclosporin, acitretin, apremilast, biologics - the right rung for your severity and your life, changed when it stops working.
- 03
Independent, and free
We hold no clinic contracts. If your care fits an NHS biologics pathway, we say so - starting is often faster on the NHS. It costs you nothing to ask.
Indicative pricing
What private psoriasis treatment costs in the UK.
Indicative ranges across our consultant dermatology partners. Firm quotes with drug, phototherapy and monitoring costs itemised.
In short
A structured psoriasis programme in our network: from £280 per visit, biologic-based years typically £8,000–£16,000.
| Option | Indicative range | Typical duration | Follow-up |
|---|---|---|---|
| Consultant dermatology consultation | £280–£450 | 30–45 min | Same visit |
| Topical therapy programme (year 1) | £400–£1,200 | 2–4 visits | Reviewed each visit |
| Narrow-band UVB phototherapy (course) | £1,200–£3,500 | 20–36 sessions | 3x/week for 8–12 weeks |
| Methotrexate or ciclosporin (year 1) | £900–£2,400 | Monthly bloods | 12-week review |
| Apremilast (year 1) | £3,500–£6,500 | 12-week review | Yearly monitoring |
| Biologic therapy (year 1, self-pay) | £8,000–£16,000 | 12-week review | Yearly monitoring |
| PsA rheumatology referral | £350–£650 | 45 min | Same visit |
Prices vary by clinic, by consultant seniority and by whether combined visits or extra work-up is needed. We come back with a firm quote within one working day.
The problem
Psoriasis is not just a skin problem.
Up to 30% of patients develop psoriatic arthritis, cardiovascular risk is raised, and the mental-health burden is significant. Good care addresses all four.
Screen for psoriatic arthritis every visit
A PEST questionnaire, a joint exam, and - where positive - a rheumatology referral. Early intervention preserves joints.
Cardiovascular risk deserves the same attention as skin
Blood pressure, lipids, HbA1c, weight and lifestyle. Psoriasis raises cardiovascular risk independent of severity.
Mental health matters
Depression, anxiety and impact on relationships and work are common. Screen for them; treat them; do not leave them for someone else.
The journey
From enquiry to recovery - what happens, in order.
One team from first message through the last follow-up.
Phase 1 · Before
Assessment and planning
Phase 2 · On the day
Treatment
Phase 3 · After
Follow-up
- 01
Before
You tell us about your skin
A short, confidential form. Duration, distribution, joint symptoms, mental health impact, current and previous treatments and any triggers.
- 02
Before
Consultant dermatology assessment
Skin exam with PASI/BSA scoring, DLQI questionnaire, joint screening (PEST), photographs, and baseline blood work.
- 03
Before
The recommended ladder step
Topicals, phototherapy, systemic therapy or biologic - chosen for severity, comorbidities and life practicalities. Pre-biologic screening (TB, hepatitis, immunisations) started early.
- 04
On the day
Start of treatment
Prescription with clear counselling on side effects and monitoring. Biologic training if a self-injected therapy is chosen.
- 05
On the day
Structured monitoring
Blood work, blood pressure and photography at defined intervals. Any new joint pain triggers immediate rheumatology review.
- 06
After
Response review at 12–16 weeks
PASI 75/90/100 targets discussed. Rescore skin and quality of life; escalate, swap or maintain.
- 07
After
Long-term care and comorbidity checks
Annual cardiovascular risk review, mental health check-in, and ongoing therapy monitoring as long as the drug is in use.
Typical end-to-end: 2–4 months to see meaningful benefit on the right rung of the ladder.
When it helps
When treatment escalation is the right call.
The patterns of psoriasis where escalation is warranted - plus the red flag that means A&E rather than an outpatient booking.
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Plaque psoriasis (chronic plaque)
The commonest form - thick red plaques with silvery scale on scalp, elbows, knees and lower back.
-
Scalp psoriasis
Thick scale on the scalp, often extending to hairline and behind the ears - undertreated with generic shampoos.
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Nail psoriasis
Pitting, onycholysis and oil-drop signs - often signal higher risk of psoriatic arthritis and benefit from systemic treatment.
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Guttate psoriasis
Small drop-like lesions after a streptococcal throat infection - often responds well to phototherapy.
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Inverse (flexural) psoriasis
Smooth red plaques in armpits, groin and under breasts - needs mild topicals rather than potent steroids.
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Palmoplantar psoriasis
Thick scale, cracks and pustules on palms and soles - disabling for work, often needs systemic treatment.
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Psoriatic arthritis
Joint pain, stiffness and swelling - screen every psoriasis patient every visit and escalate to rheumatology promptly.
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Red flag: generalised pustular or erythrodermic psoriasis
Widespread pustules with fever, or the whole skin red and shedding, is a dermatological emergency - A&E, not an outpatient booking.
Treatment options
A therapy ladder, not a single pill.
Every rung of the modern psoriasis treatment ladder, and how the choice is made per patient.
Topicals - potent corticosteroids + vitamin D analogues
The first-line combination for mild-to-moderate plaque disease. Effective, cheap, needs proper counselling and rotation.
Tazarotene and coal tar
Older topicals still useful in selected patients; tar has a role in scalp and thick plaque disease.
Narrow-band UVB phototherapy
Two to three sessions a week for 8–12 weeks - clears many patients with moderate disease and buys a drug-free interval.
Methotrexate
Weekly oral or subcutaneous - the traditional systemic. Cheap, well understood, needs monthly blood monitoring.
Ciclosporin
Fast-acting oral systemic - used to break severe flares. Blood pressure and renal monitoring; usually a short course.
Apremilast (PDE4 inhibitor)
Oral, no bloods needed. Modest efficacy - a good bridge for patients not ready for injectables.
Biologics - TNF, IL-17, IL-23 inhibitors
Highly effective for moderate-to-severe disease and psoriatic arthritis. Self-injected. Screening and long-term monitoring needed.
JAK inhibitors and newer oral options
Deucravacitinib and others - a growing oral option for moderate-to-severe disease; specialist prescribing.
Our vetted UK network
A small panel of consultant dermatologists, we picked them.
Consultant dermatologists across London, Manchester, Birmingham, Leeds and Edinburgh with structured psoriasis clinics, phototherapy access and rapid rheumatology links.
Selection criteria
How we choose every clinician in our network.
Consultant dermatologists with a defined psoriasis practice, familiar with BAD biologics pathway
Phototherapy service on site or by direct referral
Rapid rheumatology referral for suspected psoriatic arthritis
Cardiovascular risk and mental health integrated into every visit
Safety and recovery
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Steroid rotation prevents skin atrophy
Potent topicals should not run continuously on the same area for months. Rotation and steroid-sparing agents are standard.
Phototherapy carries a small skin-cancer signal
Cumulative UVB exposure is tracked over a lifetime. Skin surveillance and dose ceilings are standard.
Methotrexate needs monthly bloods
Liver, kidney and marrow function; folic acid daily except on the dose day; alcohol restraint; and pregnancy avoidance for both partners.
Ciclosporin is short-course by design
Blood pressure and renal function monitored - usually 3–6 months at a time.
Biologics need pre-treatment screening
TB (IGRA), hepatitis B and C, HIV, immunisation review and - for some agents - pregnancy planning. Long-term infection surveillance continues.
Vaccination planning is essential
Live vaccines are avoided on many systemic and biologic therapies. Annual flu and pneumococcal are standard.
Cardiovascular and metabolic care
Blood pressure, lipids, HbA1c and weight annually. Psoriasis raises cardiovascular risk - treat it explicitly.
Mental health is part of psoriasis care
Depression, anxiety and impact on relationships and work - asked at every visit, treated, not deferred.
Flare triggers
Streptococcal infection, alcohol, smoking, stress and some medications (beta-blockers, lithium, hydroxychloroquine, sudden steroid withdrawal) - we identify and address them.
Reading your dermatology record
Your psoriasis record in four parts. Read the last one first.
Severity scoring, treatment record, monitoring results and forward plan - the parts a good dermatology clinic should send after every visit.
A quiet reminder
Skin, joints, heart and mind - a psoriasis review that misses any of these is incomplete. We insist on all four.
If you would like us to talk you through the record before your review, just ask.
- 01Severity
PASI, BSA and DLQI
Objective disease measures - Psoriasis Area and Severity Index, Body Surface Area, Dermatology Life Quality Index - recorded at every visit.
- 02Treatment
Current therapy and response
What you are on, how you are taking it and how you have responded - PASI 75, 90, 100 targets discussed against your baseline.
- 03Monitoring
Blood work and comorbidity checks
Bloods, blood pressure, joint screen (PEST), cardiovascular risk and mental health screen - all recorded and actioned.
- 04Impression
Next step and safety net
Read this first: whether to continue, escalate or swap; when to review; and what to do if you flare or develop joint symptoms.
Recognised by major UK insurers
Consultations and standard systemics are usually covered when medically indicated. Biologics are frequently limited by policy exclusion clauses - we check policy wording, and where NHS biologics access is faster we say so.
Frequently asked
Everything we get asked about psoriasis treatment.
Quick answers on cost, safety, recovery and how we compare with the NHS pathway.
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What causes psoriasis?
Psoriasis is a chronic immune-mediated skin disease with strong genetic and environmental drivers. Streptococcal infection, stress, alcohol, smoking and some medications can trigger flares. It is not infectious and not caused by hygiene.
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What is the best treatment for psoriasis?
There is no single best treatment - the right choice depends on severity, distribution, comorbidities and your life. Mild disease usually starts with topicals; moderate disease with phototherapy or apremilast; moderate-to-severe with methotrexate, ciclosporin or a biologic. Biologics are now first-line for many patients with moderate-to-severe disease or psoriatic arthritis.
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Are biologics safe long-term?
Modern biologics - anti-TNF, anti-IL-17, anti-IL-23 - have a good long-term safety profile with proper screening and monitoring. TB, hepatitis, HIV and vaccination review before starting; annual monitoring after. The commonest issues are injection-site reactions and infections; specific agents have specific cautions.
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What is psoriatic arthritis and how would I know?
Up to 30% of psoriasis patients develop inflammatory arthritis, sometimes years before the skin. Symptoms include morning joint stiffness, painful swollen fingers or toes, low back pain that improves with movement, and heel or Achilles pain. Any of these means a rheumatology review.
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Is phototherapy safe?
Narrow-band UVB is safe and effective for many moderate psoriasis patients - a 20–36 session course. Skin cancer risk is small and dose-tracked over a lifetime. It is often the right rung of the ladder for patients who prefer to avoid systemic therapy.
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How much does private psoriasis treatment cost in the UK?
Consultations from £280. Topical programmes £400–£1,200 a year. Phototherapy courses £1,200–£3,500. Methotrexate or ciclosporin £900–£2,400 in year one. Apremilast £3,500–£6,500. Biologics £8,000–£16,000 a year at private prices. Firm quote within one working day.
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Should I use the NHS instead?
For biologic-eligible patients, the NHS is often the faster and more affordable route - dedicated biologics pathways exist. Private care makes sense for speed of specialist review, flexibility of appointments and choice of consultant. We say so honestly at the first call.
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What lifestyle changes actually help?
Stop smoking, moderate alcohol, treat any streptococcal throat infection promptly, and address weight, blood pressure and lipids. There is no evidence for elimination diets. Emollients daily, whether or not you are flaring, is a low-effort win.
Related treatments
Looking for something else?
Eczema treatment
The other main inflammatory skin disease pathway.
Learn morePhototherapy
Narrow-band UVB courses in detail.
Learn morePhotodynamic therapy
PDT for actinic keratosis and selected skin cancers.
Learn moreInjection therapy
Intralesional injections for stubborn plaques.
Learn moreCortisone shots
Steroid injections for localised joint symptoms.
Learn moreAll tests & procedures
Every test and procedure we arrange.
Learn more