Saw Dermatologist today

[Cowsaregreat]

Saw a lovely Dermatologist today. Managed to see him privately though he told he I need to get into the NHS system for dermatology at my local hospital. Anyway he was talking about different ways of trying to manage my psoriasis - topical, injections and oral. He said injections wouldn’t help and then said oral would but comes with a lot of side affects. To be honest, I’m not bothered about the side affects at the moment. Just wondering what oral medication anyone is taking and if it’s been successful or if the side affects have been awful - I’m happy to have good and/or bad stories!  My psoriasis gets so sore due to friction from my clothes plus I have them in all the crevices in the body! I’ve got to wait for a letter from him, then I need to go and see my GP to get referred into the system and I go back and see the chap I saw today on 27/1/20 with my research done and ideas of how I want to move on. After 15 years of suffering today has been the first day where I’ve felt someone may be able to give me help and hope!

[Fred]

I would start here:

Oral Treatments For Psoriasis

Biological Treatments For Psoriasis

And get an idea of what you would like to try. My personal opinion would be if you have the choice then go for a Bio (injections)

Good luck on your choice.

[jiml]

Hi Cowsaregreat I'm glad that you have seen a specialist about your psoriasis and he is right you do need to get on the NHS system then you can move forward and begin to find something that works

I would like to contradict him and say injections of biological treatments would almost certainly help control the psoriasis

But I will also say that you are unlikely to get a biological drug on the NHS until you have been through cheaper options and failed with them
They will start you on topical steroid based creams and ointments or the vitamin d derivative ointments
These may well work but they are something you shouldn't use long term

After the creams come the oral treatments methotrexate, cyclosporine, acetretin and skilarence

I myself am on skilarence and have been clear on it and have been taking it in the form of fumaderm then skilarence for the last 7 years and now have just a couple of small stubborn spots in my scalp that won't clear up but the rest is clear and I lead a life with Barely a thought about psoriasis
At the start there were side effects that were unpleasant and the worst for me was the abdominal cramps that did on occasions double me up with pain and also you tend to get flushes the side effects for me only lasted about half an hour a day but I stuck with it after having 50 years with the problem and short term fixes with cream and uv treatment and after a few months the side effects got less and less and now I get the occasional flush and sometimeschave to drop everything and do a toilet dash

I'm not saying to start it's easy and it's not a fast acting drug, but if it works for you you can look forward hopefully to a lengthy time clear of plaques

I can't speak about other orals like acetretin or cyclosporine but will say I had a spell on methotrexate which worked well but I gave it up in the end as I would rather be covered in psoriasis than feel as wretched as I did taking it

Now the NHS will be unlikely to advance you to biological injections until you have failed on at least 2 of the above treatments

Unfortunately we all react to drugs differently and what works for me may not work for you it is a matter of trial and error but try to get appointments with the hospital at no more than three monthly intervals when you start in case the treatments don't work and it should be apparent at 3 months if it's working or not

That's my two penneth I hope it's not made it more confusing for you

Jim

[Caroline]

MTX ..
DMF ..

Bios mostly work, but you never know how long.

[Cowsaregreat]

Hi Cowsaregreat I'm glad that you have seen a specialist about your psoriasis and he is right you do need to get on the NHS system then you can move forward and begin to find something that works

I would like to contradict him and say injections of biological treatments would almost certainly help control the psoriasis

But I will also say that you are unlikely to get a biological drug on the NHS until you have been through cheaper options and failed with them
They will start you on topical steroid based creams and ointments or the vitamin d derivative ointments
These may well work but they are something you shouldn't use long term

After the creams come the oral treatments methotrexate, cyclosporine, acetretin and skilarence

I myself am on skilarence and have been clear on it and have been taking it in the form of fumaderm then skilarence for the last 7 years and now have just a couple of small stubborn spots in my scalp that won't clear up but the rest is clear and I lead a life with Barely a thought about psoriasis
At the start there were side effects that were unpleasant and the worst for me was the abdominal cramps that did on occasions double me up with pain and also you tend to get flushes the side effects for me only lasted about half an hour a day but I stuck with it after having 50 years with the problem and short term fixes with cream and uv treatment and after a few months the side effects got less and less and now I get the occasional flush and sometimeschave to drop everything and do a toilet dash

I'm not saying to start it's easy and it's not a fast acting drug, but if it works for you you can look forward hopefully to a lengthy time clear of plaques

I can't speak about other orals like acetretin or cyclosporine but will say I had a spell on methotrexate which worked well but I gave it up in the end as I would rather be covered in psoriasis than feel as wretched as I did taking it

Now the NHS will be unlikely to advance you to biological injections until you have failed on at least 2 of the above treatments

Unfortunately we all react to drugs differently and what works for me may not work for you it is a matter of trial and error but try to get appointments with the hospital at no more than three monthly intervals when you start in case the treatments don't work and it should be apparent at 3 months if it's working or not

That's my two penneth I hope it's not made it more confusing for you

Jim

Thank you. Great help. I feel like I’ve ‘done’ the majority of the topicals through my GP. I’ll continue reading up on the different orals. I’m willing to try anything, so fingers crossed 2020 could become less about psoriasis for me!!

[jiml]

You're welcome ask as many questions as you like and we will try to help with answers

[KatT]

Hi Cowsaregreat!

I've taken MTX and leflunomide.  Both cleared my psoriasis and didn't have any side effects.  That being said, I rarely experience side effects for any medication.  Everyone reacts differently.

I was on MTX for a year but my dermatologist wanted to send me for a liver biopsy so I stopped.  Went back on after a year break, then leflunomide but they were however not working for my psoriatic arthritis.

Good luck!  There are lots of options and if it doesn't work, move to the next!

[Grizzly Bear]

Good luck Cowsaregreat

[Bill]

Hi Cowsaregreat,

If you have psoriasis all over you are probably beyond being managed solely with a topical. Light treatments may help, and if your disease is really bad you may be put on a short course of cyclosporin as it can bring a disease under control pretty quickly. Other than that I cannot add to the good advice already provided. I have had excellent control of my psoriasis with dimethyl fumarate for over seven years.

Cheers

[Kat]

I'd have to agree with the DMF crew that it seems to work very well! (I'm in the US and it's not prescribed here for psoriasis)

After topicals, my first treatment was Acitretin (Soriatane). It definitely helped. However, the cost in the US with my insurance at the time made it run a bit expensive. Other members have had success with it, however some did have issues with the side effects.

I've never been on Methotrexate and it isn't something I care to try, but I have a distant relative who swears by it and a few members here have mentioned it helped them as well.

Otezla is an oral medication, it also comes with a list of side effects.

As suggested by Fred, I'd read up on them here and that gives you lots of info to take back to the doctor on what treatments you are interested in. Also questions to ask for any concerns you might have.



Good luck!