moving to new treatments

[jimmyfenn]

i have psoriasis for 15 years, its been quite managable with creams, and it goes away in the summer, if im on holiday its like i dont have it, but the last few years it got so bad i had 2 light treatments and was recommended to go on oral medication like ciclsporin. since my last light treatment it disappeared for 6 months, amazing, but its coming back now. my main problem is that it comes back mostly and quickly on my face, making me look quite ill. creams knock it back but it comes back straight away when i stop using them.

i think i will have to consider one of two oral drugs, ciclosporin or the other one i cant remember right now, which is a weekly oral drug.

i really dont want to use them becuase i understand there are issues with them and they can only betaken for max a couple of years becuase of side effects.

i also think its a shame becuase if i lived in the sunnier climate i wouldnt even be effected by psoriasis as the sun works so well to keep it at bay, also why would i take a potent drug during the summer if m psoriasis clears up, and my psoriasis may clear up on its own and i might not know?

but my main concern is the speed and verocity it appears on my face and scalp as it makes work and socialising impossible to enjoy.

are these transplant rejection drugs like ciclosporin suitable for me? or a long term option at all? im quite wary of them. the last time i was recommended them i opted for light treatment instead and my psoriasis cleared for 6 months? but obviously i cant keep doing light treatments for ever, i feel very confused anout what i should do!

[Psoriasis Association]

Hi Jimmyfenn,

Sorry to hear that your psoriasis is now coming back after a couple of courses of light treatment. Unfortunately, although light treatment is effective for a lot of people, it isn't a long term solution and most people do find that their psoriasis comes back and they have to try something else.

It is not uncommon to feel wary of the 'systemic' tablet treatments that are on offer, many people do find them to be daunting. It is, however, important to remember that every medication (even paracetamol!) has a list of possible side effects and not every person will get every side effect listed. The main systemic treatments that are used in psoriasis have been used for many years and, although some people do have issues with side effects or other complications, there are also many people who find them to be useful and beneficial treatments.

As you mentioned, it is usually advised that ciclosporin is not used for more than two years at a time (although it may be stopped and started again at a later date), however, there are other systemic treatments that can be taken more long-term.

Please do visit our website for more information on systemic treatments: https://psoriasis-association.org.uk/pa ... medication
You can also get in touch with our free confidential helpline (01604 251620 / mail@psoriasis-association.org.uk) if you have specific questions. If you use Facebook, you might like to check out our Facebook Group (https://www.facebook.com/groups/18615883609/) where there are lots of people who use different treatments, who will be able to relay their own experiences.

Finally, please do speak to your doctor about any questions or concerns you have about any treatment. It is important that they know your feelings so that they can formulate a treatment plan that is right for you.

Hope this helps!

[Dr Anton Alexandroff]

Dear Jimmyfenn,

Thank you for your question. You are right - ciclosporin should be used intermittently but there are other medications which can be used long term continuously if required (providing monitoring tests are satisfactory) including weekly methotrexate. Also the general opinion is that up to 500 treatments of UVB phototherapy lifetime has a reasonable risk/benefit ration for patients in the UK who do not have sun-damaged skin. There are also new oral and injectable treatments available (e.g. humira, stelara, secukinumab). you may want to discuss treatment options with your dermatologist.

I hope this is helpful. If you would like to read more about psoriasis management you can go to: www.alexandroff.org.uk

With best wishes,

Dr Anton Alexandroff MCP(UK) CCT(Dermatology) FAAD FRSM
Consultant Dermatologist in Leicester Spire and Nuffield Health Hospitals and University Hospitals of Leicester
Member of the British Association of Dermatologists
www.alexandroff.org.uk

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