Psoriasis Treatment Dissatisfaction: What's Next

Patient Expert
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One of the hardest things for me to accept when I was first diagnosed was that there was no cure and that psoriasis would always be a part of my life...

I couldn’t believe it when the doctor started going through a treatment plan that included phrases such as, “we’ll start with…” and “if this doesn’t work, then we’ll try this.” I had expected to walk in, get a prescription for a pill or a cream, take it for a week or two, and then I’d be on with my fabulous, teenage life. It was early March at the time, and I figured I'd just wear long sleeves and pants to lacrosse practice and nobody would ever know about the crazy red spots hiding underneath.

Being a teenager, the my parents and doctors preferred to avoid steroids and the more intensive treatments at first. So we tried topical after topical for 4-6 weeks each to see if any would make a difference.  When they didn’t, I was prescribed light therapy 2-3 times a week - and that finally worked. Waiting to see what would work was the most frustrating part and once I stopped the light therapy, something would happen and I’d flare up again.

Obviously as I got older, I relied less and less on my parents to make those decisions and started working with my doctor directly on how I wanted to treat my disease. Being educated about psoriasis and available treatments will allow you to have a two-way conversation with your doctor about how you’d like to be treated and what lifestyle changes you can make to help complement any medications.

Having patience is essential to treating psoriasis. There are an overwhelming amount of ways to treat psoriasis – Topicals that come as creams, gels, or sprays. There's also light therapy, homeopathic, biologic, systemic and oral medication, and even chemotherapy for very aggressive cases. And once you’ve chosen the treatment type, there are multiple brands within the chosen category to choose from and ensuring that it is covered by insurance or fits within your treatment budget.

And finally, once you’ve gone through and determined all those puzzle pieces, your preferred treatment may not work for you. You may want to establish a Plan B, C, D, etc. upfront that plots your next moves if Plan A doesn’t work. This will help you feel in control, because it’s an incredibly tiresome and frustrating process to go through with each doctor’s visit and ensures the research is fresh in your mind and you can always adjust your treatment plan.

When strategizing your treatment plan, talk with your doctor from the start about the length of time that you’ll try each treatment for and what results will constitute success or failure. Having set guidelines will help you understand if the treatment is working and if not, what the next step will be.

In addition to prescriptions, talk to your doctor about establishing a nutrition and exercise plan to help minimize food or stress related flares. Studying and understanding what makes your psoriasis flare can help your doctor to figure out the best course of treatment for you. If you have an appointment coming up, start keeping track of what you did and ate each day, to see if you can pinpoint factors that made you flare or made a current flare worse.

Finding a doctor that you trust and who will work with you is another crucial step in creating your treatment plan. You are your own health advocate and you have the right to be a partner in the creation of your treatment plan.  Thanks to social media and the Internet, finding a dermatologist who specializes in psoriasis and is open to working with a patient is easier to find than ever. The National Psoriasis Foundation has a directory on their website and online psoriasis support groups are also a great resource for finding a personal recommendation.

If seeing a doctor isn’t possible, you can follow the same advice and put together your own plan of attack. Start with understanding your triggers and making your lifestyle as healthy and natural as possible, and only use one or two treatments at a time to understand if they’re working and the impact they’re having.

I know. At times this process may be frustrating and overwhelming, but having patience and a plan will go a long way in treating your psoriasis.