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Treatment

There's currently no cure for pemphigus vulgaris (PV), but treatment can help keep the symptoms under control.

The main aim of treatment is to heal the blisters and prevent new ones forming.

Steroid medication (corticosteroids) plus another immunosuppressant medication are usually recommended. These help stop the immune system damaging healthy tissue.

You may eventually be able to stop taking medication if your symptoms disappear and don't come back when treatment is stopped. However, many people will need to keep taking a low dose.

Steroid medication

Steroid medication can help reduce the harmful activity of the immune system in a short space of time. It's usually taken as a tablet, although creams and injections are also sometimes used.

You usually start on a high dose to get your symptoms under control. This can lead to a noticeable improvement within a few days, although it usually takes 2 to 3 weeks to stop new blisters forming and 6 to 8 weeks for existing blisters to heal.

Once your symptoms are under control, your steroid medication will gradually be reduced to the lowest possible dose that can still control your symptoms. This will help reduce the risk of side effects.

It can take a while to find the best dose for you. It may take a few months to reach a balance between controlling your symptoms and limiting unpleasant side effects.

Side effects

If taken for a long time at high doses, steroid medication can have a range of unpleasant side effects, such as:

Most of these side effects should improve if you're able to reduce your dose. However, osteoporosis can be a lasting problem. 

Read more about the side effects of steroids medication.

Other immunosuppressants

Once your symptoms are under control, other immunosuppressant medications may be taken alongside a low dose of steroids.

Medicines that may be used include azathioprine, mycophenolate mofetil, ciclosporin and cyclophosphamide. These are usually taken as tablets.

Side effects

Like steroids, these medicines can make you more vulnerable to infection, so you'll need to take precautions when taking them, such as:

Other possible side effects include:

Additional treatments

Several other treatments are sometimes used in combination with steroid medication and other immunosuppressants if these medications don't fully control your symptoms.

These include:

These treatments don't tend to be used very often and aren't always widely available. For example, rituximab is relatively expensive and some clinical commissioning groups (CCGs) may not fund it.

Self-help tips

To help cope with pemphigus vulgaris: