“This isn’t working…” That's what I was thinking as I stood in the UVB light box for at least the 500th time in my life. I was around the age of 16 and had been doing phototherapy on and off for nine years, at least four days a week. It wasn’t working and it never had. But I held on to the hope that eventually something would change, that maybe my body would give in to the laser rays and my psoriasis would finally be defeated, never to resurface again. But after almost a decade of phototherapy with no improvement, the narrative I had hoped for proved not to be a reality.
Unfortunately, my struggle to find an effective treatment is not a unique one. I’ve talked to a variety of people living with psoriasis who complain about the challenges of finding a treatment that is right for them. Here are three major mistakes you could be making which could be hindering you from achieving clear, healthy, psoriasis-free skin.
Waiting too long to question your treatment
I’ve been guilty of using a treatment for much longer than I should have. This is a mistake I made for the first 10 years of living with psoriasis, but since I didn’t have a huge voice in my treatment options as an adolescence, I didn’t have much control. I exposed myself to a lot of unnecessary ultraviolet light, increasing my risk for skin cancer, when the risk didn’t prove to have a reward. The National Psoriasis Foundation suggests trying a treatment for three months and then evaluating your amount of improvement. If there is no improvement at all, your doctor may want to increase your dosage; if that doesn’t work, it’s time to try something else.
The more a treatment requires my attention, the less likely I am to comply with what it requires. Topical treatments, for example, typically need to be used 2 to 3 times a day to be effective. I dislike having to use something that many times in a 24-hour period. Topical treatments usually take longer to work, although the side effects are less severe than with biologics. If you aren’t using your treatment as directed, it will not work. Evaluate all factors with your doctor before starting a treatment. You must be consistent and diligent with any treatment.
Taking a biologic that isn’t hitting the proper target
There are four parts of your immune system which can possibly send a “faulty” signal, causing psoriasis, including TNF-alpha, interleukin-17A, interleukin-12, and interleukin-23; each has a different purpose in the fight against diseases and each biologic targets a different part. Unfortunately, there is no test to determine which area of one’s immune system is causing the problem; therefore, a lot of trial and error must be done with treatments. If you are using a biologic and do not begin to see significant changes within three months, it could mean it’s not hitting the right target. Talk to your doctor to see if there’s a more suitable biologic.