Any advice welcome!!

[Emi1995]

Hi

I was diagnosed with guttate psoriasis in early childhood. I've been on loads of treatments over the last 20 years including topicals, light treatment and a short stint on cyclosporin. About 4 years ago I decided to stop all treatment for a while and see how my skin was, I changed my diet and lifestyle and worked on my stress levels which is a huge trigger for flare-ups. I've flared a couple of times a year since coming off treatment and always have a baseline level of active patches which I had just learnt to accept. I'm not particularly self-conscious about the appearance of my psoriasis so that helped me not worry so much about having a break from treatment. 

After catching covid in January I have been in a constant cycle of flaring up then my skin settles for a couple of days before flaring again. Over the last couple of weeks, I've had a HUGE flare-up, my skin is a mess and the patches are everywhere - on my face, in my ears on my scalp and everywhere else imaginable. I can't sleep and I'm struggling to concentrate on anything other than my skin, it really is horrid.

I am ready to try some treatment again but I want to start with topicals again rather than just being given a referral to dermatology straight away which has happened in the past.

I'm hoping someone has some advice on the best topicals to ask for so I can go to the GP armed with loads of information, I always found dovobet to be really effective, is this still an option? 

Any advice welcome on how to go back into treatment after such a long break. xx

[Kat]

First welcome to Psoriasis Club!

I'm in the US so treatment here sometimes vary from how it may be in your part of the world (or are called by another name).

For topicals I had my best luck with Talconex (Enstilar) which contains Betamethasone, which is a steroid. I hesitate to use steroids for too long as it can cause issues for some people. It is by prescription only here.

For non prescription topicals Virgin Coconut Oil can help. No, it won't clear you up but it can help with the itching. I found that I would put a little in a bowl and set that bowl in some warm water to "melt" the coconut oil and it felt wonderful for my ears as they are difficult to get topicals in folds and such. But any good moisturizer will help a little with itchiness.

Light treatment didn't really help me much honestly. I tried the laser light treatment as well. There are SO many treatments out there and after an exam I'm sure your doctor will have some recommendations. There is a lot of information here from natural treatments and diet to topicals, oral treatment and biologics. The one thing I personally have noticed from being here for awhile now is that something that has worked wonders for one person here may not work at all for another.

Feel free to ask questions, and others will be along to offer some advice.

Again, welcome!

Kat

[Emi1995]

Thank you Kat,

I used to use coconut oil in the past and it helped a lot, I'd forgot about it actually.

One of the main reasons i stopped treatment was because of how time consuming the constant appointments are, it was so hard to balance the appointments with work. Im hoping having a list of things that I want to try before going back down the light treatment/ biologics route will help me keep my appointments to a minimum.

I will add to my list Enstilar to my list of possibilities.

Thanks for being so welcoming! x

[Fred]

Hello Emi, I'm with Kat on the coconut oil and Enstilar but a topical isn't a long term fix and though you are not keen, a dermatologist is the way to go.

I'm a big fan of the Bio's and once you get going it doesn't take up much of your time, for example I take my injection once every three months and see my dermatologist twice per year. It may take a bit of time to get to that stage but once you find one that works for you, there isn't much need for loads of appointments.

I would suggest reading through these threads to see if it helps you in your decision.

Dovobet And Dovonex (What's the difference ?)

Enstilar foam

Synalar

Oral Treatments For Psoriasis

Biological Treatments For Psoriasis

And like Kat said don't hesitate to start other threads if you have a specific question about a treatment.

Welcome to Psoriasis Club by the way. 

Regards.

Fred.

[Caroline]

Hi Emi,

Welcome to psoriasisclub.

Very nasty the guttate version of psoriasis.

I agree with both Kat and Fred.
But I would like to add the option of Sorion cream. At least over here in the Netherlands it is available. It is a non-steroid, but I heard several people mentioning a good result.

Personally I am a fan of DMF. Maybe the dermatologist with whom you will perhaps end up, will want to try that.
The fumarates are a body owned substance and will bring a better balance in your body. It has also the advantage that it is basically harmless. And it is cheaper than the bio's
The disadvantage is that it doesn't work for everyone, as possible side effect can be intestinal cramps, these also are harmless but can be inconvenient.

What Fred forgot to tell is to stay away from MTX, which is kind of a poison and when trying finally almost everyone will quit it because of liver values that go off the scale or the nausea that it often gives.

Hope you will get some more hints on treating yourself.

Cheers,
Caroline

[Kat]

I totally understand about the time. When I was first diagnosed and did the light treatments, I had to go to the doctor's office 3 times per week.

I do think biologics were one of the easiest treatments and for most people they work wonders! Admittedly the treatment that worked best for me was an oral treatment, Acitretin. But the more I read up on it, the less I wanted to take it. I cleared up pretty well so was able to come off of it. Then I had a bad flare with scalp and ears. Biologics helped me get it under control but I haven't been clear since, but it's manageable for me right now.

Now I'll be honest and say that when covid hit, I was really glad that I wasn't on biologics. But with that said, members here have not had any more of an issue than those not taking biologics. Just thought I'd mention it.

[Fred]

But I would like to add the option of Sorion cream.

Be careful where you buy it: sorion ointment

What Fred forgot to tell is to stay away from MTX, which is kind of a poison and when trying finally almost everyone will quit it because of liver values that go off the scale or the nausea that it often gives.

As you know I agree with you, but I didn't mention my opinion as it may be all Emi gets offered at first as she has not seen a dermatologist for a while. They will probably want to start from the beginning and the UK are known for using it first.

[Sheila]

Hi Emi! 

Welcome aboard! This place has been an absolute Godsend for me and I hope it is just as wonderful for you!

First, I have to agree with the others and I will emphasize to stay away from MTX. It's an option, but not a good one. There is a steroid spray that was helpful for me in the early goings. Did well for me early on. Forgotten what the name was however. In the end, Skyrizi has been my saviour and rescued me from decades of shame and agony.

Wish you luck on your journey. This place is about as good as any to get advice from as we are all a pretty unbiased crew, so I am glad you found it. 

Cheers,

Sheila

[Forest Walker]

Welcome, Emi1995!  

[KatT]

Hi Emi 

 to the psoriasis club 

Tropicals are not meant to use long term and are harmful to your skin

Oral treatments are easy and will require routine blood tests.  The frequency will depend on your doctor/derm

Biologics are super easy as you auto inject.  Can't say about blood tests as I am on a combination of biologic and oral.

Hope you find a treatment that works well for you