Wide Variety of Treatment Options, Quest to Find What Works For You

Quest for the Best Psoriasis Treatment

From time to time I’m asked what treatments I’ve tried for psoriasis. At first I’m speechless. Then I respond, “I’ve tried them all.” Of course I haven’t used every psoriasis treatment that’s ever been offered. One person I met recently mentioned how he was subject to radiation treatment back in the 1960s. Radiation is not on my previously tried treatments list. It just feels like I’ve tried just about everything.

I’m sure many others with psoriatic conditions can relate to changing and switching treatments. Psoriasis is a fickle beast that’s difficult to beat. A treatment’s effectiveness can change over time. One systemic pill I used in college didn’t work at all in my thirties.

Some treatments lose effectiveness if used for too long, such as topical steroids for me in the past. Others might work well, but the toxicity or side effects preclude their use for long-term. One of my current medications fit in the latter category. It’s time to switch treatments to lessen the chance for serious side effects to vital organs.

Dissatisfaction with Psoriasis Treatments

A recent survey highlights the fact that those with psoriasis are not satisfied with their current treatment. The Psoriasis in America 2016 survey (sponsored by Health Union, conducted between April 26 and June 18, 2016) found that only a third of respondents like their treatment. For example, some forty percent used phototherapy in the past, but only four percent currently.

I’d want to ask those people why they stopped phototherapy or any other treatment. Short of those answers, what the survey does tell me is a large majority of people have reasons to not continue treatments. I would hope that some stopped because their psoriasis remitted because they worked so well.

On the other hand, I can think of many reasons I’ve been dissatisfied with treatments and stopped them: cost, insurance issues, safety, convenience, ease of use, how it feels on my skin, irritation, availability, effectiveness, etc. The list is as long as the treatments I’ve tried.

Finding a psoriasis treatment that works for you can feel like a never-ending quest with seemingly no happy ending in sight.

Some do give up. It can be a trying, tiring, and depressing process. I can’t think of another area of my life where I have so many unappealing options. Topical treatments can be messy, feel greasy, and can irritate or atrophy the skin. Systemic treatments can negatively impact internal organs. Biologics need to be injected and are expensive. Phototherapy can burn and incurs some risk for skin cancer. I’m open to alternatives such as herbal treatments, but I’m not sure what I can really trust.

Trying a New Treatment

I’m overjoyed for those who found what works and keeps psoriasis manageable. And of course the choice of what treatments to use, when, and for how long certainly need to be discussed with a doctor. It’s just that I haven’t found that perfect treatment yet. And when I see my doctor, I’m out of ideas of what to try next.

Despite these real concerns, I’m continuing my quest. My dermatologist would like me to try Goeckerman therapy. It’s a combination of coal tar and light therapy named after a dermatologist at the Mayo Clinic in 1925. I don’t have the exact plan yet from him, but from what I’ve read I’ll need to apply tar and wrap it in plastic wrap for some hours each day. The light therapy along with the tar can produce greater results than with either treatment alone with relatively few side effects.

Unfortunately, it’s not possible for me to go to a daycare psoriasis treatment center to undergo the treatment. I still need to work and be present with my family. But I’m open to trying it despite my fear of how messy, smelly, and time consuming it might be. I’ve burned in phototherapy before, too, but that was at least a decade ago.

So it looks like I’m switching psoriasis treatments again as the quest continues. A chronic condition like psoriasis demands an arsenal of treatments that can last as long as it stubbornly persists. Hopefully, this switch helps me find something I can use for some years to come.

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