Finding the Best Psoriasis Treatment: How I Got Psoriasis Relief

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Meet the Author

Zimlich is a critical care nurse who has been writing about healthcare and clinical developments for over ten years.

My first psoriasis plaques (raised, inflamed, and scaly skin patches that can itch and be painful) appeared in my early 20s. The itching and dryness occurred in an area where I had a deep wound from a bicycle accident in my teens, and the ones that followed usually appeared in places where I repeatedly had cuts or injuries, like nicks on my ankles or knees from shaving my legs.

My psoriasis was manageable with topical creams and home remedies when it was limited to this single spot. But as I moved through my 20s, life became more stressful. I went to college and changed jobs and relationships.

The added stress triggered psoriasis flare-ups, and the plaques spread from one small area to my elbows, forearms, hands, and legs. That’s when I knew it was time to see a doctor and get help.

Learn More: What Is Psoriasis?

My Early Psoriasis Treatments

My grandmother has had psoriasis for as long as I can remember, so given my family history and symptoms, I assumed that I had psoriasis, too. When I went to the doctor to discuss my concerns, my doctor didn’t do any skin testing; we just discussed my family history, and they visually inspected the plaques.

They referred me to a dermatologist, who officially diagnosed me, but we spoke very little about my prognosis, treatment options, or quality of life at that appointment. After I was formally diagnosed with psoriasis, the only treatment options available to me were topical creams and systemic medications (those that work throughout the body) with toxic side effects, such as:

• Topical creams were ineffective or so potent that I had to be careful not to apply them to healthy skin. Some could even cause congenital disorders (inherited medical conditions that develop before or after birth), so since I was planning to become pregnant, topical creams weren’t an option for me.

• Systemic medications that work similarly to chemotherapy, such as methotrexate, suppress the autoimmune response that triggers psoriasis, but they also take a toll on other parts of your body and overall health.

• Phototherapy (light therapy given under medical supervision) was new and not often covered by insurance.

Ultimately, my dermatologist gave me their blessing to use sun exposure and tanning beds to control my plaques during the summer months. Tanning was not an ideal treatment due to the cancer risk, but my only other option at the time was systemic medications that fell into the same category as chemotherapy.

Tanning beds offered me a more convenient—albeit more dangerous—version of phototherapy. A few sessions of ultraviolet light exposure cleared my skin enough for me to wear shorts and T-shirts with more confidence, but as soon as I stopped tanning, the plaques returned.

I used tanning beds on and off from around 1998 until 2009, when the World Health Organization’s (WHO) International Agency for Research on Cancer deemed indoor tanning a carcinogen (cancer-causing agent). The risks of tanning outweighed the benefits of psoriasis treatment.

Read Next: Psoriasis Treatment

Finding a Treatment That Works for Me

I had given up on topical treatments and tanning by my late 20s. I was getting used to the idea that psoriasis was just something I would live with, and doctors assured me that I should be thankful it was “just” a skin condition.

But after two pregnancies and the emergence of two new autoimmune conditions, my psoriasis became unbearable to the point where playing on the floor with my children would cause the plaques on my knees to open and bleed.

My arms were cherry red due to extreme exfoliation (removing dead skin cells from the top layer of skin) and the moisturizer I used to keep flaking at bay. While the exfoliation and moisturizing reduced the flaking, the resulting redness garnered unwanted stares and was even more painful than the dried plaques.

This all changed when biologics were introduced.

The Introduction of Biologics

I had just started hearing about Humira (adalimumab) and the promises of biologics when I had my first child in 2010, but knowing I wanted more babies deterred me from seeking treatment that I would probably have to stop during pregnancy.

Takeaway

Humira was one of the first biologic medications approved for psoriatic arthritis in 2005 and for moderate to severe psoriasis in 2008.

Late in the summer of 2012, after the birth of my second child, my body was in a severe state of inflammation. I was battling psoriasis alongside other health issues, including:

• Hashimoto’s thyroiditis (autoimmune disease that can cause an underactive thyroid)

• Myasthenia gravis (a breakdown in communication between nerves and muscles, which would not to be diagnosed for a few more years)

• Postural orthostatic tachycardia syndrome (POTS, an increase in heart rate when getting up to stand).

With two kids under 2, I needed some relief.

I had been through enough psoriasis treatment and had widespread enough plaques that I was a candidate for biologic therapy. The price tag was hefty—around $6,000 per dose, with a dose due every two weeks—but a good insurance plan and a manufacturer’s savings program made the treatment more affordable for me.

I was nervous because this was an entirely new kind of medication that worked differently than any before it. On top of that, I would have to give myself injections. I had just started the process of transitioning to a career in nursing and was certainly not an experienced shot-giver at that time.

I took my first dose in my dermatologist’s office, and it was surprisingly easy to administer with the preloaded injector pen. Miraculously to me, within four days of the injection, my plaques had nearly disappeared.

Living Life With Psoriasis

As with many chronic illnesses, psoriasis cannot be cured, but it can be managed. I continued on Humira for many years, later switching to Stelara (ustekinumab), which required only one shot every three months with the same effect.

After a decade on these two medications, insurance approval issues forced me to find another option, but thankfully, there are now various options for the biological treatment of psoriasis and similar diseases.

Today, I hardly think about the fact that I have psoriasis, outside of the reminder I get from my pharmacy app to approve the order for my next dose of Tremfya (guselkumab) and the yearly battle for insurance coverage.

Sometimes, I think I take the treatment for granted, but I’ve now enjoyed just about as many years without plaques as I had to struggle with them. The years that have passed almost make it easy to forget the pain, discomfort, and embarrassment psoriasis caused.

Read the original article on Verywell Health.