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    Skip to main content

    Severe Psoriasis


    Out in the Open

    Severe Psoriasis

    Inside the Visit: Psoriasis

    Reviewed by Poonam Sachdev on February 18, 2022

    Video Transcript

    [MUSIC PLAYING]
    DR. HOLMES: Hi, great seeing you again. How have you been over these last couple of weeks?

    ANDREW: Right now I'm kind of having regular flare ups, patchy red spots that are popping up all over my scalp and getting really flaky.

    DR. HOLMES: So tell me, what type of work do you do?

    ANDREW: So I'm a research analyst in the DC area.

    DR. HOLMES: Is it a very stressful position?

    ANDREW: I think that's something I notice. When we have a quick turnaround time or it's really busy in the office, you know, the stress levels definitely go up. And I think that does affect my psoriasis.

    DR. HOLMES: Do you find any times if flares more than others?

    ANDREW: Sometimes it'll be in the middle of a workday. Other days I'll come in and see plaques and some of the flaking on my suit. And so before our treatment, I would never imagine wearing some dark colored shirt like this. Because if I go into a meeting, have that ash everywhere.

    So are my symptoms going to change over time, like as I get older? Or is it just a question of whether or not I'm having flare ups or not?

    DR. HOLMES: Well, we really don't know. Sometimes it will disappear and you may not have a flare again. But we can't predict that. It could flare at any time during your life. And unfortunately, we can't tell you when it will flare again. But it tends to clear, and it will go away for years. But it may always resurface. And that's why we tell you it's not really a cure. It's a treatment for the condition.

    ANDREW: Gotcha, that make sense. So is there something that I can do in my daily life to kind of help manage my flare ups in addition to the medication we're trying?

    DR. HOLMES: Well, try to not be so reactive to stress. Maybe find a stress outlet. Maybe exercising will help or taking a walk. So tell me, last time you were here we gave you a lotion to use for your psoriasis. How is that working for you?

    ANDREW: It's going pretty well. The fact that it's an ointment makes it a lot easier to apply, which is really great. Unfortunately a bit of the drawback is it's not working as efficiently as the cream that we started out with. So I'm just curious what other treatment options do we have, since my flare ups are being pretty stubborn?

    DR. HOLMES: Well, you do have some other options. We use topical steroids. We use other medicines, as well, topical medicines. We also have some pills that are geared toward treating psoriasis. In this day and time, we have a new group of meds called biologics, which are really meds that are designed for people who have widespread disease.

    So keep that in mind. There are lots of treatments available to you. So if what we're doing doesn't work, we can always try something different. One of the easiest things we can do is to add a medicated shampoo that will help with the flaking and the itchiness associated with it.

    ANDREW: Thank you. That sounds like a wonderful idea. Let's try that.

    DR. HOLMES: So I look forward to seeing you again in about six weeks.

    ANDREW: All right, sounds good. I'll see you then.

    EXPLORE MORE

    Caring for Patches of Itchy, Scaly Skin

    Treatments That Work

    A Whole-Body Approach

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