What to do next

A little bit of history so I apologise for the length of this post. Psoriasis seems to be a term I’ve heard a lot over the last 2 years, when I’ve visited my GP. I must have spent £100s of pounds on different shampoos, Lotions and potions to try and get anything to work. It started with my scalp and then I noticed lumps on my neck (confirmed reactive nodes) reduced vision at times (Blepharitis) and then the scaling moved to my ears and eyebrows. I used Betnovate to begin with and then dovobet, I hated using it on my scalp as it’s a nightmare to wash out but I persisted until last October when I so fed up with being the woman constantly itchy her scalp and trying to remove the huge number of flakes left behind in my wake. I also started developing more dry spots and having really bad reactions to taking a shower. I visited a dermatologist who was good and suggested I used sebco to loosen the scales that were now heavily covering the back of my scalp in the hopes of removing the itching. Voila it worked like a charm, I’ve never seen anything so disgusting combing through the sheer amount of flakes from my scalp but in my mind at least I was doing it in the privacy of my own home and I wasn’t flaking as bad through the day. I got to a point of being able to cope even though I was having to do at least every other day as the build up was so quick. The dermatologist couldn’t give me a firm diagnosis of Psoriasis or eczema or a combination of both. Fast forward a few months and my reactions to water were becoming extreme, really bad hives and rashes and the number of spots up my arms was increasing ten fold. The itching as night was extreme, I itched till I bled and then itched some more. The odd thing was by the morning I would be left with a few scratch marks but my skin was back to being scaly just on a larger ringed scale! A visit to the walk in after a night of despair and I was given some antihistamines and the advice to use baby oil to loosen the scales rather than sebco which was costing me a small fortune every month. It kind of did work in the same way, just a bit harder to wash out. I was told stress was likely the cause for the flare up even though I couldn’t pin point actually feeling stressed! While the itching did decrease my patches were still multiplying, strangely my legs are ok apart from a couple of patches and my torso is completely clear. I went back to see a different dermatologist who confirmed it is in fact Psoriasis and to try Enstillar as a last ditch attempt at steroids as others haven’t worked. I was asked to consider immunosuppressants if this doesn’t work within a 4 week period. I’ve now been using it for 4 weeks, my arms are looking healthier, most spots are now just pink with some crocodile looking scales but nothing major. My scalp has improved a tiny bit but the build up hasn’t reduced but thankfully I don’t itch as much as I did. The patches on my face haven’t changed, still angry and red as before but my ears have somewhat cleared. I feel like while this has had a huge impact particularly over the last 6 months, I’m really worried about the side effects of immunosuppressants. I spend so much time moisturising and clearing scales on my scalp every day but I feel that if I’m not totally convinced it can’t be bad enough yet for me to try them. I work with so many people who are constantly sick and while I would try anything to get this to go away, I’m scared of the alternative! I questioned the first dermatologist on the pain I have in my joints and he said it was unlikely it was linked due to my age and how long I’ve had symptoms but to me having 2 really bad flares up in 6 months has coincided with some serious pain. Do I trust in his judgement or see a rheumatologist? I didn’t bring this up at the second dermatology appointment as I felt a little bit like I was undermining the first seeing a second one. Silly I know as she was in fact fantastic, but I don’t think I expected such a dramatic treatment plan as no one has really taken me very seriously before. I find Psoriasis hard to deal with as it’s something that affects so many people but to people who don’t experience it it’s just an inconvenience and not really something to be bothered about. I try to just deal it with and tell myself I’m ok with the routine but I’m starting to get fed up with everything it affects. I’m about to change my GP so I’m hoping to find one who can help manage my symptoms better as I stopped visiting my last one as I felt more of a nuisance than anything else. She offered me antidepressants when I discussed my pain level! I definitely wasn’t depressed at the time and was pretty unhappy she was suggested it was my mood making me feel pain. If only it was all in mind it would at least have an end! Thankfully I have medical insurance who have a private GP but long term I need someone I can visit rather than call. But I can’t fault their service for getting me to see the right specialists quickly, I just wish I haven’t waited so long. Can anyone tell me of their experiences with Methotrexate or Ciclosporin please? Or if you suffer from joint pain, how you were diagnosed with PA. For me, the stiffness is mainly in a morning or if I’ve been sat down. I have persistent pain in my neck (but I’ve been told it’s actually from the joints in the my shoulder) and pain in my wrist, hand and randomally one finger (all on the same side) Thank you for taking the time to read and I wish you all the best x