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When Your Psoriasis Treatment Isn't Working

What to consider if you're not getting the results you wanted.

Be Patient

Depending on the treatment, you may need one to three months before the drug starts working, Van Voorhees says. Be sure to ask your doctor how soon you might notice improvement, and how you’ll be able to know if the treatment is helping, she says.

Remember That Control Is a Long-Term Process

“There’s not a treatment that allows you to take a pill once and make psoriasis go away, like treating an infection with an antibiotic,” Van Voorhees says. If your treatment is to rub steroid medicine onto your skin, you may do it several times a day until your lesions have dwindled away, then hold off on further treatment until they start to return, Blauvelt says. You’ll then continue this cycle indefinitely.

Be sure to stick with your treatment, even when your skin starts looking better, Van Voorhees says. “When their skin is looking good, sometimes patients get more casual, and they need to remain conscientious about continuing their treatments.”

Find an Expert

If your disease requires medicine that you put into your body, seek out a skin doctor who has a special focus on psoriasis, Blauvelt says. “The care of patients on systemic therapies can become complicated, and it’s probably best done by those with experience with newer medications,” he says.

Help Your Doctor Find a Treatment That Fits

In general, people with psoriasis are happy to use their medicines as directed, Green says. But if your doctor prescribes a treatment that’s hard for you to use, you’ll be more likely to drift away from it, and your disease can return.

Be sure your doctor gives you a treatment that suits your lifestyle. If you travel often, needing a UV light several times a week may not be a good choice, says Green, who has had psoriasis since he was a teen.

Be Ready to Deal with Insurance Issues

Your insurance company may want you to first try an older treatment that’s cheaper. For example, “Methotrexate is often a first-line systemic therapy for psoriasis, but it’s only 30% to 40% effective and has potential serious side effects," Blauvelt says. "Often it’s used first, because it costs about $500 a year, where newer, more effective treatments that go into the 80% effective range are around $20,000 a year."

Do What You Can to Help Yourself Heal

"I encourage my patients to work on managing their stress levels, getting enough sleep, and eating a balanced diet. Most people think that psoriasis is made worse by stress. So anything patients can do for themselves is certainly helpful,” Van Voorhees says.

And by reaching out to others with psoriasis through a group such as the National Psoriasis Foundation (NPF), you can pick up more ideas on how to deal with the effects of the disease, Green says.

Eisenberg, 63, relies on meditation and music to help him stay relaxed and to reduce his chance of flare-ups, and he stays active with the NPF. “Try to deal with it and ask your doctor questions,” he says. “You’ll learn that there are no silver bullets. If you luck out finding a treatment that works, you luck out. But if one thing fails, I myself have learned to not give up hope.”

Reviewed on May 13, 2011

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