Is there a permanent remedy to get rid of psoriasis?

Question

Hello doctor,

I would like to know a few details of the tablets which I have been taking for my scalp psoriasis.

Winolap 5mg once in a while when itching is too high (without doctor's prescription).

Isotretinoin drugs/other drugs (with doctor's prescription).

I have been taking these medicines on a regular basis and were very effective. But only till I take them. If I stop the medication, I have to visit my doctor again and start medications again to get some relief from itching in scalp. I want to know if these medicines will cause harm/side-effects in future? Can these be taken continuously?

Answer 1

Hello,

Welcome to icliniq.com.

Isotretinoin is a potentially dangerous drug and in many countries there are very strict guidelines over its use. It basically contains retinoids which in simple language is a derivative of vitamin A. It is primarily used to treat severe cystic acne and I fail to understand why your doctor has prescribed it to you for psoriasis.

Its side effects include:

Dry lips/dry and fragile skin/incresed risk of sun burns.

Inflammatory bowel disease like Crohn's disease and ulcerative colitis.

Decreased night vision and dry eyes.

Anemia and decreased platelets in blood.

Diabetes and increased uric acid level in blood.

Depression/anxiety/mood disturbances.

Nose bleeding/headaches.

Joint and body pains.

Loss of hair i.e, alopecia.

Increased cholesterol.

Well, I need some more information:

1) For how long have you been suffering from scalp psoriasis?

2) Exact name and exact dose of the medicines which you are taking?

3) For how long have you been taking each medicine (in detail)?

4) Any medicine which you had taken in the past but not taking now?

5) Do you feel any side effects which I have mentioned above?

6) How much relief have you got in your scalp psoriasis from these medicines or no effect at all yet?

7) Do you have psoriatic lesions anywhere else on the body or just on scalp?

Kindly provide these information, so that we can evaluate your case in detail and prescribe you with the best possible treatment.

Revert back to a dermatologist online for further follow up.

Answer 2

Thank you for reverting back with the details.

First of all I would like to tell you in simple language a bit about scalp psoriasis, so that you can get to know certain facts about your disease.Scalp psoriasis is a disease in which there occurs inflammation of the scalp skin. The inflammatory areas are called as papules and many such small papules join to form big lesions called as plaques. These plaques then slowly get covered by layers of dead skin cells and multiple layers cover these plaques and are called as scales. These scales are those which cause most of the problems like excess falling of dandruff and excessive itching etc.Cause:

Psoriasis is believed to be a genetic disorder. But the factors which play a very important role in initiating this disease are stress and environment.Symptoms:

Intense itching and scratching.

Scaly red patches on scalp.

Excessive dandruff.

Dryness of scalp.

Burning senastion or sores.

Loss of scalp hair.

Diagnosis: Diagnosis is usually made by just looking at your scalp lesions, but at times biopsy of scalp lesion is needed.Treatment: There are a lot of treatment options available. Some of them are:

Topical application - i.e, medicines which are applied locally on the scalp like corticosteroids/creams/ointments/lotions/oils/moisturisers etc.

Medicated shampoos - shampoos containing tar/salicylic acid.

Scales softeners and keratolytics.

Intra-lesional local injection of steroids in the affected region of scalp.

Phototherapy and laser treatment.

Oral drugs like Methotrexate, Cyclosporine and Acitretin.

Biological medicines - these are the latest and most advanced systemic agents used to treat psoriasis and are very effective drugs. Some of these agents are Infliximab, Etanercept, Adalimumab and Ustenkinumab.

Coming to your questions:1) It is generally beleived that there is no permanent cure for psoriasis, but my experience tells me that I have seen so many patients who are leading a disease free life. Actually problem is that it needs regular and detailed evaluation by a doctor to fight with the disease effectively.

One important point in the treatment of scalp psoriasis is that one should not keep taking the same treatment for a long time because, the psoriasis gets resistant to that treatment. So, the doctor should keep rotating the drugs to get the best results.

2) Yes, you should get these tests done from a good lab:

Complete hemogram.

Lipid profile.

RFT.

LFT.

3) Winolap is not the only drug to control itching. There are many other better options available to control itching.

I would suggest you to immediately stop Isotretinoin because, it has no role in the treatment of psoriasis. And even for acne there are other drugs which you can take.

Revert back to a dermatologist online for further follow up.