Tablets for P

If you read enough of the threads you will realise that reactions to Psoriasis treatments are very personal - what works for one person doesn't for another. What is likely to happen is that you will try a treatment for six months. If it works you will stay with it. If it doesn't you will move on to the next one. It is also common to rotate through treatments over the years as the body seems to build up tolerance to treatments if you stay on them for long periods of time. I suspect that the first treatment will be Methotrexate - which a lot of people find very effective. It worked very well on my Psoriasis, but I came off it because my PsA flared up badly while I was on it. https://www.psoriasis-association.org.uk/systemics

There are around ~200 prescription meds available today for psoriasis. There is plenty of choice. But almost none of them really work. For example, some studies show oral methotrexate (chemotherapy) has just a tiny 9% chance of achieving 90% clearance (PASI 90). UVB phototherapy is often the next step after creams. Then, pills. Then, injections. The derm will be able to advise, etc.

The track record of Methotrexate is somewhat better than this last post implies. Typically between 40 and 50% achieve PASI 75 or better. https://www.sciencedirect.com/science/article/abs/pii/S0151963818312821 https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0153740 https://pubmed.ncbi.nlm.nih.gov/25225524/

Two problems with that analysis. 1. PASI 75 is only 75% clearance. It still leaves big red marks and flakes on the skin. It is not clearance. 2. A 40% chance of PASI 75 means 4 in 10 are (mostly) left with some redness, while 6 in 10 are left with a lot of redness. In other words, a patient is taking powerful chemo... but few get clearance, some get partial clearance, and most get little or no clearance. The majority do not get clearance. PASI 90 and PASI 100 are the benchmark. It brings clear skin (or close enough). Lots of photos on the Web, showing the (huge) gulf between PASI 75 and PASI 90. Small gap in numbers, but a large gap in visual improvement. https://www.europeanpharmaceuticalreview.com/wp-content/uploads/novartishand3graph-1.jpg

There is plenty of choice. But almost none of them really work. Certainly I found that to be true for myself. But gosh. How depressing to read that. :(

It is a shame that you are being left with that impression Mary. Psoriasis and Psoriatic Arthritis are incurable diseases it is true, but there are treatments out there that can make a very significant difference to the lives of people with Psoriasis. There are good reasons to believe that you will find a treatment that makes it manageable for you. To downplay the prospects of substantial improvement from the medicines available serves two purposes, both of them negative. To suggest in advance that nothing is going to work so it is not worth even trying has a negative impact on the mental state of sufferers. It also pushes them towards quacks offering miracle cures.

Hello CBMan I am currently 100% clear of psoriasis Cleared with diet and supplements (about 13 years now), and I continue to manage the disease and maintain clearance that way. So yes, this treatment has (as you say) made a very significant difference to my life. But given all the advances in technology and medicines, it is still quite depressing to read a comment such as "There is plenty of choice - but almost none of them really work". That is certainly true for my attempts at clearing over the years. Lost count of everything I tired and how much money I spent, only to get half hearted or no results.

Hi Mary1968 What have you found helpful in terms of diet and supplements? That is wonderful that you have been so healed of psoriasis :0) Really happy for you.

Hello bargainlovingmum I don’t want to give you the wrong idea or raise your hopes. I have not healed (cured) of psoriasis, as it is always lurking in the background ready to flare up. But 99% of the time, I can keep it dormant and out of sight. So, whilst I have managed clearance and remission, it is not an actual permanent forever cure. Several steps were taken: The first step I took was figuring out what made the plaques worsen, spread, itch, flare, or bleed. It was initially tricky and confusing, because sometimes several days would pass and therefore it was hard to pinpoint and make a connection. But over several months of keeping mental notes, I identified that the plaques seemed redder or itchier after eating or doing certain things. Factors included everyday mundane things such as, partying too hard, wearing nylon clothing against the skin, sweating in summer, work related stress, winter, being rundown or unwell with flu or a sore throat, swimming in chlorinated pools, getting sunburnt. Also discovered that the hygiene products that I was using, were in fact making the psoriasis worse in the long run. Had to stop using anything scented or chemical based (washing powder, shampoo, conditioner, cleansers, toners, moisturizers, deodorant, makeup, soap, body gel, talc, bubble bath), basically anything that contained perfume, sodium lauryl sulfate, mineral oil, parabens, artificial colours, or alcohol. Once I removed all irritants and started using natural products, I stopped itching and picking so much. Diet wise the following seemed to impact negatively: processed meats, white potatoes, tomatoes and other nightshades, dairy products (particularly cheese), wheat, peanutbutter, greasy food, too much sugar, coke-cola, beer, and whiskey. Once identified, I removed them from my everyday diet at that time. I then set about improving my gut flora with probiotics. You can also try fermented foods for this, but I dislike the sour taste, so I used a powdered supplement instead. I then started flooding my body with additional nutrients via making juices and smoothies every day, whilst also eating an anti-inflammatory Mediterranean style diet. I stopped eating processed foods and started eating wholefoods. Ate organic when I could afford it. Plus taking supplements to assist the healing process – the two biggies were Vitamin D3, and Fish Oil. Since then, I would also include Zinc and Marine Collagen, as also being absolutely vital. Drank lots of dandelion root, red clover, burdock root and nettle tea, as these are all good for the liver, and also clearing psoriasis. Another biggie was managing stress. I had an incredibly stressful job, but was not in the position to leave it, so I started walking, meditation and yoga in the evenings to wind down, relax and de-stress. From start to clearance took about nine months, and then probably another six months afterwards of reintroducing some foods and watching for flares. Unfortunately my favourite foods of peanutbutter and cheese, seem to flare me the most, and I consume them minimally nowadays (use to be addicted to cheese - so a huge change for me) I didn't really do it at the time, but I think now that Intermittent Fasting would be a good route to take. This all seems a lot and possibly overwhelming when written down, but apart from identifying triggers, it was all pretty easy and enjoyable. Interesting learning process too. My doctor is still amazed at the clearing, especially since he told me not to bother trying, as it wouldn't work. :)

Thanks so much, Mary1968, for taking the time to share your experiences. Really interesting to hear. And helpful. Thanks again.