Help for more severe psoriasis.

hello! I have severe psoriasis. I have it on my back, my underarms, my scalp and in other private places:( I'm desperate for something that works. I've had this since I was 18 im now 35(male). Its very difficult for me as I work out in the sun all day long and I know that makes it worse. I have seen so many doctors and I have been prescribed many creams but nothing that really clears my skin. Im hoping you would know of something you could recommend. Thank you very much for your time.

Psoriasis is especially frustrating because our understanding of the cause is limited and because therapy is often just partially effective.   I tell my patients that there is good or even great control, but no true cure.   And…… truly is a partnership between the dermatologist and you…….it requires teamwork.

There are two things that work best for more widespread psoriasis are narrow band UVB light done at a center that specializes in light therapy.   Look for a dermatology practice that specializes in light therapy or sometimes it will say PUVA (a different kind of light therapy).  It requires several visits a week for several months but then minimal maintenance after clearing.  

The second thing is “biologics.”  These are often effective, but unfortunately sometime toxic medications that need to be administered with an IV infusion.   A specialized center is needed for this also.  About 10% of patients with psoriasis also have arthritis.  Biologics may be the best choice, if someone also has arthritis.

You will still need to use your various topicals as prescribed by your doctor.

There is very definately much improvement to be gained with good treatment, so I’m hoping you will make the effort.  I truly wish there was a “magic wand” for this but there just isn’t at this point in time.

Hope this helps, Dr. I

Dr. Brandith Irwin, MD

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