From skin creams to coal tar to sun lamps, Karen Martino tried most of the traditional remedies for psoriasis — with little luck.

The young schoolteacher went to one doctor after another.

"They ran out of ideas," she said. "Then they started talking about this new drug, and it was an eye-opener."

Martino's experience is typical, says Gail Zimmerman, president of the National Psoriasis Foundation. Her group has started reaching out to patients with the tag line "Now is the time to try again."

Which is just what Martino, 24, is doing. Recently, she started one of the most popular new options, Enbrel, a "biologic drug" that quiets the immune system. It's too soon to know if it will work.

"I have a friend in remission," she says, noting that studies indicate the medicine works in at least 50 percent of cases.

What is psoriasis? Psoriasis is a noncontagious, chronic skin disease with varying levels of severity. Some people also get a form of arthritis, psoriatic arthritis. Appearance: Patches of raised red skin covered by a flaky white buildup; can have a pimple-ish (pustular psoriasis) or burned (erythrodermic) look. Can cause intense itching and burning. May be in patches or cover entire limbs. Triggers: Emotional stress, injury to the skin, some types of infection, certain drugs. Treatments: "Biologic drugs" alter faulty immune response blamed for the disease. Medicated skin creams and light therapy can control excess skin production, inflammation. Source: National Psoriasis Foundation

Several similar products also work well, such as the drug Raptiva, says Eric Treiber, a Rye, N.Y., dermatologist. Still, he prescribes the new drugs with caution.

"They are miraculous drugs," he says, "but the side effects aren't yet fully understood, and the cost is enormous."

The drugs, which can cost about $15,000 a year, are given by self-injection only, which may put off some patients. And they increase risk of infection, since they weaken the immune system.

Doctors often recommend newer and less-invasive options first, such as narrow-band ultraviolet light B treatments, during which a patient stands for just a few minutes in a machine that looks like a tanning bed but has specialized bulbs. The UVB light slows the production of skin.

For people with just a few patches of psoriasis, doctors can also use special lasers.

These options usually work, but not all dermatologists have the "light box" machines or new lasers, and not all patients can make the required weekly visits, Treiber says.

Each person with psoriasis faces different struggles, says Marc Grossman, a clinical dermatologist and a professor at Columbia University College of Physicians and Surgeons in New York.

For example, a patient who can't afford Enbrel can take Methotrexate, which treats psoriasis but can cause liver damage.

But that doesn't mean Grossman won't prescribe it. "If we rotate treatments for a period of time, the patient gets the maximum benefits with a minimum of side effects."

Martino is learning new ways of coping with the disease, which looks like a sunburn on her cheeks. Stress is a big trigger.

"I'm a worrier," says Martino, who sees a therapist. "But I'm learning breathing techniques and other ways to calm the body down and lower the heart rate. That part has really helped."