Acitretin or Methotrexate??

Posted Thu 12 Oct 2017 19.00 by Mary

I have been diagnosed with an unusual type of pustular psoriasis on my scalp and after trying many different treatments for the last few years, my dermatologist wants me to try Acitretin. A couple of years ago when my scalp was in a terrible state, I lost a lot of hair and I know that hair loss is a side effect of Acitretin. I am very concerned about this and as a result my dermatologist has suggested perhaps trying Methotrexate instead. He feels this may lead to less hair loss but it is of course a more drastic treatment. The thought of losing hair and showing my red, sore, inflamed scalp is making it very hard for me to consider taking medication. However my dermatologist says that whilst I have scalp psoriasis, my hair will fall out anyway and the only way to improve hair growth/condition is to improve the condition of my scalp. I understand this but am nervous and would appreciate any responses from people who have taken Acitretin or Methotrexate, particularly with regard to hair loss. Please help!

Posted Thu 12 Oct 2017 19.22 by Peterb

I had psoriasis all over and very bad on my head and after many different treatments my dematologist suggested that I should try Methotrexate. He explained the possible side affects and also told me that around every 5 years or so, I would have to have a liver biopsy to check for any damage to the liver. I accepted the risks and within 3 months of treatment I was completely clear on my body and head. I was treated for a period of over 15 years and it completely stayed away. My problem was with the liver biopsies. I dreaded the day when I was to have the biopsy and they were very hit and miss and just couldn't cope with them any more and although my biopsies came back clear I just had to cease taking methotrexate. Unfortunately the psoriasis returned with a vengeance and have been on various other treatments over the last 20 years or so which have just managed the condition. If I was to have that chance again I think I would definitely go for it as it was a fantastic drug and did what it said on the tin.

Posted Fri 13 Oct 2017 06.40 by Mary

Thanks for letting me know about your experience with methotrexate Peter. I'm so sorry to hear your psoriasis came back, it's a terrible condition. Hope you're coping with it ok.

Posted Fri 13 Oct 2017 12.46 by Camey2210

I have nail and scalp psoriasis, I was prescribed methotrexate and at first it was working and I had no side effects, after a couple of months it stopped working so they upped the dose, this was repeated several times when it showed my psoriasis was coming back. I ended up taking 10 tablets once a week which made me very poorly and ended up in hospital! I wouldn’t recommend at all. Also when I was on the higher dose the day I took the tablets I would be sick and feel very poorly.

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