Tips to Make Biologic Self-Injections Easier

If topical medications haven’t been strong enough to control your psoriasis, your dermatologist may recommend a biologic — a type of drug that targets the part of the immune system responsible for triggering your symptoms.

Biologics are often available as self-injectables, either as a single-use, prefilled syringe or an auto-injector. One big difference between the two: The prefilled syringe has a plunger and a visible needle, whereas the auto-injector is like a pen with a hidden needle.

If you’re squeamish about giving yourself an injection, you’re not the only one. About 20 percent of people have some anxiety about giving themselves an injection, according to a review in Rheumatology and Therapy.

But the benefits of biologics usually outweigh the concerns. “Even if people dislike the injection, they often like the relief,” says Adelaide Hebert, MD, a dermatologist with University of Texas Health Houston. “They’re usually willing to put up with a bit of discomfort in order to have an outcome that is favorable.”

And, she adds, “Injectables are often more [effective] than topicals.”

Whether you are new to injections or have done them regularly, these tips can help ease your anxiety and lessen the pain.

8 Self-Injection Tips

There’s a lot you can control about the process of giving yourself a shot. Follow these steps to make it easier.

1. Let the Medication Warm Up

Injecting cold medication can be uncomfortable. Try taking your medication out of the refrigerator and letting it warm up to room temperature (at least 35 to 40 minutes), says Dr. Hebert. Check your medication’s instructions for specifics.

2. Make It Routine

If you’re feeling nervous, try giving yourself the injection at the same time each time, while sitting in the same spot. Turning the process into a ritual gives you more control over it, which can improve your confidence and lessen fears, according to the review in Rheumatology and Therapy.

3. Pick the Right Injection Site

Decide where you’re going to give yourself the shot — your arm, abdomen (two inches away from the belly button), or thigh. Many people have an easier time giving themselves an injection in the front of the thigh, partly because it’s easy to reach and you’re also able to sit down, according to a study in Dermatology and Therapy.

4. Numb the Skin

Applying an ice pack to the injection site will numb the area, which helps ease the pain. The Arthritis Foundation recommends keeping the ice pack in place for about 15 minutes before you give yourself the injection — any longer and you may “overfreeze” the skin, which can lead to frostbite.

5. Relax Your Muscles

Injections tend to hurt more if your muscles are tensed, according to the Arthritis Foundation. If you’re nervous about giving yourself an injection, try listening to some calming music, taking a few deep breaths, or distracting yourself by talking to someone else.

6. Pinch the Skin

When you’re ready to give yourself the injection, experts recommend pinching the skin with your fingers and then injecting the medication into the raised skin with your other hand. If you’re using a prefilled syringe, you’ll probably need to hold it at a 45-degree angle; if you’re using an auto-injector, you’ll hold it at a 90-degree angle. But always check the instructions for your specific medication first.

7. Give Yourself a Massage

After you’re finished, gently rub the injection site with your fingers. According to the Arthritis Foundation, this helps loosen the muscles and disperse the medication, which can help ease the ache.

8. Make a Note

Once you’ve properly disposed of the needle or auto-injector, jot down where you gave yourself the injection (left thigh or right side of stomach, for example). When it’s time for the next shot, pick a new spot. “There is some injury to the skin during the injection, so we like patients to rotate the site of the injection,” says Hebert.

The following day, you may notice that the area where the needle went in is red, itchy, or swollen. That’s normal and typically goes away within a few days. If you’re uncomfortable, though, talk to your doctor. They may prescribe an anti-inflammatory to use on the skin, such as a topical steroid, says Hebert.

Find the Right Biologic for You

More than a dozen biologics are available to treat psoriasis, according to the National Psoriasis Foundation. Some of these target specific proteins in the immune system, such as tumor necrosis factor alpha or interleukins, while others target certain cells, such as T cells. Some biologics need to be taken weekly; others need to be taken every three months.

Some people prefer to use an auto-injector, where you simply press a button and never have to see a needle. Others prefer to use a syringe: Unlike the auto-injector, a syringe makes no noise, and you’re able to control the speed of the injection better. Despite these differences, research shows that people tolerate both devices equally.

That’s a good thing. The medication your doctor prescribes — and whether you get the syringe or auto-injector — may depend on a combination of factors. These include whether you also have psoriatic arthritis, which medications you’ve tried in the past, and what your insurance will cover, says Hebert.

Besides, you may not be on the same biologic next year. Over time, some people with psoriasis may need to switch to a different medication, because either the biologic loses its efficacy or there are too many side effects. In fact, about 14 percent of people with psoriasis change biologics within a year, and 26 percent change biologics within two years, according to a study.

Even if one biologic doesn’t succeed, it’s likely that another one will. “Biologics are very effective,” says Hebert. And there are many to choose from.