[split] Acitretin

[mataribot]

Well bk from appointment nurse thinks I should go on methotrexate but need to change dermatologist as mine only likes to prescribe Acitretin but should be on it within six weeks

Really methotrexate!!    all I will say is some on here swear by it, but I couldn't get on with it myself but we are all different, ... You say the nurse suggested methotrexate, I hope it works well for you...... It is difficult to argue with the  proffesionals... I wish you success with it ...do make sure they monitor you liver and kidney function regularly and . Do keep us updated

I argue with any professional that is motivated by the $ sign. There is no recommend dose of Acitretin. It typically causes flares for a month or so before it starts to work, if it does. The drug has more efficacy with PP, rather than plaque. It also does a number on your cholesterol and can impact your liver. It shouldn't be given to women who plan to have kids.

[kh924]

Hi all,
Hard to believe it's a year later and I'm clear as a bell still with no adverse affects from the Acitretin. It turned my life around, gave me my confidence back.  I've missed chatting with you all and hope everyone is having a great summer.
Hugs
Kelly

[jiml]

Hi all,
Hard to believe it's a year later and I'm clear as a bell still with no adverse affects from the Acitretin. It turned my life around, gave me my confidence back.  I've missed chatting with you all and hope everyone is having a great summer.
Hugs
Kelly

Wow a year round ...... And still clear, that's great news Kelly I'm so pleased for you, that acetretin has worked so well for you. May you continue to stay spotless.....
I've missed you on here but enjoy your posts when you return
Thanks for updating it will give many others hope that there is a light at the end of the tunnel

Edit by the way loving the profile picture and the top

[csmith]

Hello All,

I am new to this site, but have read with interest your various trial and tribulations with psoriasis.

I thought I would share my experiences with Methotrexate and Acitretin

I was first diagnosed with Psoriasis when I was 5yo (thanks mum). In the 49 years since I have tried almost everything I think, tar, steroid creams, vitamin A & D, sulphur creams, anthralin, antibiotic ointment and just about everything topical.

But about 10 years ago the plaques got particularly bad and the steroid creams just weren't coping. Also, the psoriasis was on my face. I can almost live with it on my body, using moisturizer, steroid and covering up, but its hard to cover up on your face and all the Dermatologists recommend against strong steroid on the face (thins the skin too much).

So I started on Methotrexate (30mg per week in two 15mg doses). For me, the MTX was miraculous at clearing the plaques on the body, but it never worked on my face, and Oh the side effects! Nausea and vomiting. Of course it affects everyone differently. I know people who take much larger doses of MTX than me, (for Rheumatoid arthritis) and have no side effects at all. But I couldn't stand it long term.  So I went off the MTX and of course the plaques came back. I would use MTX again for a flare but not long term.

Anyway, my dermatologist still felt I need something systemic rather than just topical. So I started on Acitretin. We started on a low dose (10mg/day) which I think was the dermatologists way to get me used to the side effects slowly. Response was slow or negligible after 3 months, so we went to 20 then 37.5mg/day. Side effects increased (of course) mainly dry lips and mucous membranes (I'm still looking for a way to effectively alleviate the dryness and blockage in my nose) but did start seeing results.  Now after nearly a year on the drug my body is (mostly) clear, but importantly for me it has cleared my face. So for the first time in a long time I can go out without people looking at me strangely and asking me if I am sun-burned or something. The side-effects are there, but are manageable, certainly when compared with untreated psoriasis or MTX. So its been an excellent treatment for me and I would recommend to anyone to persevere with Acetretin for a while (ie months) to see if it will have an effect. Itis a slow acting drug.

So the question for me now is how long to stay on this treatment and how do you know if you still need to be on it. I might try to reduce the dose and see how it goes.

Anyway, hope this story is useful to others looking for a treatment that work for them.

[csmith]

Sorry, small errata to my previous post.

MTX dose was 15mg per week not 30mg (tablets are 2.5mg each not 5mg).

For me 15mg was effective, but not pleasant,
10mg less effective, less side effects
7.5mg  not effective, low side effects.
So minimum useful dose was 10mg (for 85kg body weight).

[jiml]

Hi csmith and a big   to the club here you will notice we are a small but worldwide community, all sharing our experiences and offering and receiving supprt and advice when required. Thank you for posting your experiences of life with psoriasis and it must have been tough going through your formative years .

I myself developed When I was  17 and was devastated.
I see you have been through loads of different treatments and like me had success with methotrexate but the side effects beat you, as they did me.
You have now found a place where you can share with fellow sufferers

With regards to how long you will need to stay on acetretin I don't know we have members on maintenance doses here and some that have stopped and stayed mostly clear ....I'm sure you will hear from others about that but it's a treatment I didn't get to as after methotrexate I found my current treatment fumaderm

Thank you for joining and posting it will give others hope reading your story
Jim

[kh924]

Hi folks,

Had a dermatology appointment today and figured I'd update everyone. While I am not 100% clear I'd say I am 90% clear with a few persistent spots. My cholesterol and triglycerides are only slightly elevated which is a side effect of the medication. My doctor does not feel that I need to be on medication to lower them or to stop taking the Acitretin. He knows I will not use steroid cream. he gave me a prescription for vitamin D cream. Here in the states prescription vitamin D cream is free so I'm looking forward to getting it and giving it a try. He also suggested I try something called DHS zinc shampoo. Has anyone here used it? I have color treated hair and I need to use shampoos that won't strip the color out of my hair too quickly. That's about it for now. Hope you're all doing well

[Caroline]

Hi Kelly,

I don't exactly get what the doctor said to you. Does he think you should go off the medication?
I have the impression that the medication is essential for you, am I correct?

Can't help you with the shampoo things, I don't colour my hair so have never searched for the specific shampoos that will save coloured hair.

Thanks for the update, always nice to hear how others are going.

Caroline

[jiml]

Hi Kelly,

I don't exactly get what the doctor said to you. Does he think you should go off the medication?
I have the impression that the medication is essential for you, am I correct?

Can't help you with the shampoo things, I don't colour my hair so have never searched for the specific shampoos that will save coloured hair.

Thanks for the update, always nice to hear how others are going.

Caroline

My understanding Caroline and I could be wrong is that the dermatologist is happy with the Acetretin, although elevated bloods there is no need for additional medication to control the blood ( it's not high enough to add more medication) so I read it as "continue as the current plan", but with a vitamin D cream to help with the few spots that are hanging on.

@kelly
Your psoriasis may well be erupting a bit if you have stress in your life at the moment , it is a known trigger and if that is the case, maybe as the stress gets less the psoriasis that has come back may well disappear, the vitamin D cream may be helpful it will be interesting to read if it works

[kh924]

@Caroline,
Jim interpreted my message perfectly ? Acitretin is working relatively well for me with no need to change at this point.
@jim, I had a bit of a flare when the weather turned dry a month or so ago but I'm actually doing OK, not much added stress.