Why is my psoriasis spreading despite treatment?

Question

Hi doctor,

My psoriasis has been flaring up again, mainly on my elbows and scalp, but this time it is also spreading down my back. It is so itchy and painful that it keeps me up at night.

I have been using the steroid cream as my doctor prescribed early, but the relief does not last long. I am trying to keep my skin moisturized and avoid triggers, but stress seems to make everything worse.

Honestly, it has started to affect my confidence again. I used to wear sleeveless tops all the time, but now I only wear long sleeves because I do not want people staring or asking questions. I know it is not contagious, but the looks still hurt.

I read a little about those newer biologic injections and was wondering if they are safe. I would love to find something that provides more consistent control. I want to stop feeling like my skin is constantly fighting against me.

Please guide.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

I would like you to understand that psoriasis is an autoimmune condition that affects the layers of the epidermis. In this condition, skin regeneration occurs faster than normal, which leads to scaling on the top layer of the skin and ultimately to shedding.

Topical treatments such as steroids, emollients, and antihistamines can be effective but typically only provide temporary relief. Methotrexate is the standard medication prescribed for severe lesions or those that do not respond well to topical treatments. This medication is usually taken orally as a pill once a week.

Patients often experience significant improvement after using Methotrexate. While new biological agents are available, Methotrexate remains a cost-effective and efficient option. It is generally safe, but it should not be used during pregnancy, as it may cause congenital disabilities in a developing fetus.

Regular liver and kidney function tests are necessary for patients undergoing long-term methotrexate therapy.

As with all autoimmune diseases, maintaining a healthy lifestyle can help improve symptoms. It is essential to exercise regularly, establish a consistent sleep schedule, stay hydrated, ensure adequate vitamin D intake, and manage stress. Hormonal imbalances and poor sleep can trigger flare-ups.

Please feel free to follow up with any further questions.

Thank you.