Health Boards
Mon-27-07-2015, 03:50 AM
Hello All,
I am new to this site, but have read with interest your various trial and tribulations with psoriasis.
I thought I would share my experiences with Methotrexate and Acitretin
I was first diagnosed with Psoriasis when I was 5yo (thanks mum). In the 49 years since I have tried almost everything I think, tar, steroid creams, vitamin A & D, sulphur creams, anthralin, antibiotic ointment and just about everything topical.
But about 10 years ago the plaques got particularly bad and the steroid creams just weren't coping. Also, the psoriasis was on my face. I can almost live with it on my body, using moisturizer, steroid and covering up, but its hard to cover up on your face and all the Dermatologists recommend against strong steroid on the face (thins the skin too much).
So I started on Methotrexate (30mg per week in two 15mg doses). For me, the MTX was miraculous at clearing the plaques on the body, but it never worked on my face, and Oh the side effects! Nausea and vomiting. Of course it affects everyone differently. I know people who take much larger doses of MTX than me, (for Rheumatoid arthritis) and have no side effects at all. But I couldn't stand it long term. So I went off the MTX and of course the plaques came back. I would use MTX again for a flare but not long term.
Anyway, my dermatologist still felt I need something systemic rather than just topical. So I started on Acitretin. We started on a low dose (10mg/day) which I think was the dermatologists way to get me used to the side effects slowly. Response was slow or negligible after 3 months, so we went to 20 then 37.5mg/day. Side effects increased (of course) mainly dry lips and mucous membranes (I'm still looking for a way to effectively alleviate the dryness and blockage in my nose) but did start seeing results. Now after nearly a year on the drug my body is (mostly) clear, but importantly for me it has cleared my face. So for the first time in a long time I can go out without people looking at me strangely and asking me if I am sun-burned or something. The side-effects are there, but are manageable, certainly when compared with untreated psoriasis or MTX. So its been an excellent treatment for me and I would recommend to anyone to persevere with Acetretin for a while (ie months) to see if it will have an effect. Itis a slow acting drug.
So the question for me now is how long to stay on this treatment and how do you know if you still need to be on it. I might try to reduce the dose and see how it goes.
Anyway, hope this story is useful to others looking for a treatment that work for them.
I am new to this site, but have read with interest your various trial and tribulations with psoriasis.
I thought I would share my experiences with Methotrexate and Acitretin
I was first diagnosed with Psoriasis when I was 5yo (thanks mum). In the 49 years since I have tried almost everything I think, tar, steroid creams, vitamin A & D, sulphur creams, anthralin, antibiotic ointment and just about everything topical.
But about 10 years ago the plaques got particularly bad and the steroid creams just weren't coping. Also, the psoriasis was on my face. I can almost live with it on my body, using moisturizer, steroid and covering up, but its hard to cover up on your face and all the Dermatologists recommend against strong steroid on the face (thins the skin too much).
So I started on Methotrexate (30mg per week in two 15mg doses). For me, the MTX was miraculous at clearing the plaques on the body, but it never worked on my face, and Oh the side effects! Nausea and vomiting. Of course it affects everyone differently. I know people who take much larger doses of MTX than me, (for Rheumatoid arthritis) and have no side effects at all. But I couldn't stand it long term. So I went off the MTX and of course the plaques came back. I would use MTX again for a flare but not long term.
Anyway, my dermatologist still felt I need something systemic rather than just topical. So I started on Acitretin. We started on a low dose (10mg/day) which I think was the dermatologists way to get me used to the side effects slowly. Response was slow or negligible after 3 months, so we went to 20 then 37.5mg/day. Side effects increased (of course) mainly dry lips and mucous membranes (I'm still looking for a way to effectively alleviate the dryness and blockage in my nose) but did start seeing results. Now after nearly a year on the drug my body is (mostly) clear, but importantly for me it has cleared my face. So for the first time in a long time I can go out without people looking at me strangely and asking me if I am sun-burned or something. The side-effects are there, but are manageable, certainly when compared with untreated psoriasis or MTX. So its been an excellent treatment for me and I would recommend to anyone to persevere with Acetretin for a while (ie months) to see if it will have an effect. Itis a slow acting drug.
So the question for me now is how long to stay on this treatment and how do you know if you still need to be on it. I might try to reduce the dose and see how it goes.
Anyway, hope this story is useful to others looking for a treatment that work for them.