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 medications such as steroids, emollients, and antihistamines can also work; however, their effectiveness will be temporary only. Methotrexate is considered an effective drug to deal with serious lesions and those that cannot be treated with topical medications. Usually, this drug is taken orally in pills once a week.

Usually, patients feel much better after taking Methotrexate. Although new biological drugs are now being used, this drug can still be considered an affordable and effective treatment. Methotrexate is rather safe; however, it cannot be used by pregnant women since it might cause congenital abnormalities in children.

Liver and kidney functions should be controlled in case of the use of Methotrexate for a long period of time. It is known that in the case of any autoimmune disease, a healthy lifestyle helps to decrease the number of attacks. One should exercise, get enough sleep, drink water, have enough vitamins, especially vitamin D, and reduce stress levels since hormonal imbalance and lack of sleep may lead to a flare-up.

Please feel free to follow up with any further questions.

Thank you.