Driven mad with Psoriasis

[kman3555]

Hi. For ten years now I have been driven mad with Psoriasis. My skin is dry, with red blotches, cracking, plaques, itching, flakes of skin etc. my children get so annoyed with the flakes of skin lying around the house, my wife get annoyed with blood from itching on bed clothes etc and I just get so embarrassed and annoyed. I have tried so many different products as well as UV treatments, steriod creams etc but with no success. I have also tried medicated powder, again with no effect. What options do I have left?? My dermotologist just seems unable to help. Please help.

[Dr Anjali Mahto]

It sounds like you are going through a very difficult time with your psoriasis. I really am very sorry to hear this. Psoriasis is a chronic illness that can have profound effects on your self-confidence and self-esteem.

The cream treatment and ultraviolet light do not work for everybody. Has your dermatologist suggested any tablet treatment for your skin? We often use oral drugs that work by suppressing the immune system for psoriasis (methotrexate, acitretin, ciclosporin, fumaderm). These often provide good control. If these fail to work then there are also injection treatments (also suppress the immune system) that are available if your psoriasis is severe.

My advice to you would be to have an open, honest discussion with your dermatologist and let them know how much this is affecting your well-being and your relationships with your family. He or she will be able to discuss these other treatments with you in more detail as they will have access to your full medical history.

Lots of luck and best wishes getting this under control.

Dr Anjali Mahto

[ckbridgett]

Very sorry to hear about your life with psoriasis. The physical treatments for psoriasis can be very effective, but when this is not the case having a review of the psychological side of things may be important. There is now much research evidence that better results in treating psoriasis are achieved for at least some people if they are seen by a health psychologist as well as a dermatologist and if, for example, stress management techniques are added to the treatment.
For more on stress and psoriasis see https://www.psoriasis.org/life-with-psoriasis/stress

[kman3555]

Thank you both for your replies. I will ask my doctor to refer me again to a dermatologist.
I have also put my name down for a two day stress management course. I do realise that because I suffer from depression that this probably makes the psoriasis worse. I would be interested to know if you feel that drugs for depression could make psoriasis worse.
Also, does anyone know of any alternative solutions for psoriasis.

[kman3555]

You mentioned taking tablets for psoriasis, I just want to ask if these can be taken with Warfarin?

[Dr Anton Alexandroff]

Hello,
thank you for you questions. I have special interest in psoriasis management and I appreciate that psoriasis treatment can be challenging. I fully agree with my colleagues. The next logical step are systemic treatments (acitretin, methotrexate, ciclosporin, fumaderm). Your current medications, past medical problems and other factors have to be checked carefully by your dermatologist to see what treatment suits you best. If tablets are not suitable there are some injections (humira, stelara, secukinumab and there arre also new tablets otezla (apremilast)).

For example warfarin may interact with acitretin. There is not much evidence on alternative treatments as far as I know. To be correct we do not learn alternative medicine in medical school. However, my patient claims that recently yoga helped him a lot, and there is a small amount of evidence that raw cumin added to food may help psoriasis.

I hope this is helpful.
Dr Anton Alexandroff MRCP(UK) CCT(Dermatol) FAAD FRSM
Consultant Dermatologist
Member of the British Association of Dermatologists
Leicester Spire and Nuffield Health Hospitals, and Leicester Royal Infirmary
www.alexandroff.org.uk

[Psoriasis Association]

There's lots of great advice here. If you'd like any further information on any of the treatments mentioned here, you can find it on the Psoriasis Association website http://www.psoriasis-association.org.uk or by getting in touch with our free and confidential helpline on 01604 251620 / mail@psoriasis-association.org.uk.

You might find it useful to print out some of the information, or make notes, and take it along with you to your doctor appointment.

[ckbridgett]

Thank you both for your replies. I will ask my doctor to refer me again to a dermatologist.
I have also put my name down for a two day stress management course. I do realise that because I suffer from depression that this probably makes the psoriasis worse. I would be interested to know if you feel that drugs for depression could make psoriasis worse.
Also, does anyone know of any alternative solutions for psoriasis.

No, I do not think that antidepressants can worsen psoriasis. Did that seem to happen to you?
Here is a list of treatments that can flare up psoriasis - lithium is used in treating depression, and can certainly make psoriasis flare up. http://www.everydayhealth.com/psoriasis ... iasis.aspx