Question about Psoriasis treatment/Relapse!

Question:

The first time I used valisone, I got a rebound effect and ended up using a light booth to get over it. It was the only flare I have ever had. However, it worked to clear my scalp, before the rebound. Then the scalp P came back in spades., plus other spots all over. Mind you I still only went to about 4% to 5% coverage during the flare. Still, the doctor would never prescribe steroids for me again. However, 10 years later, after he forgot, I convinced him to prescribe valisone again. I have been using it for several years. For me, it is only effective on the scalp and genitals, and newly forming plaques elsewhere that are just starting. I use if for a couple weeks on a spot, until it clears, and then for about a week afterwards to make sure. Then I stop using it. It has not lost it’s effectiveness for me. Unfortunately, it does not work on well established plaques not on the genitals or scalp, and it does not work under nails. I have never developed a resistance to coal tar. I have been using this for over thirty years. However, it does me no good on its own. I have to use it in conjunction with UVB to get any benefit. Anthralin was a disaster. It stained everything and didn’t do a darn thing for me. I hated it. I was prescribed it when the light booth had cleared up everything but a small spot on my elbow and a couple nails. The doctor said it should clear up the last bit. It didn’t. The P just came back to where it was before the flare. Tacrolimus, I have never used. Every time I have come close to being clear, or been the most clear, it has involved UVB, either from a booth, or the actual sun. The best treatment, that I have found, is Caribbean Sun and salt water. It is also the most fun. If you can also get into a sauna and/or a steam bath, followed by a shower, at the end of each day, this is good too. It not only seems to help with P, it also gets all the sun tan lotion and sweat off of you. A week in the Caribbean has done wonders for me on a couple of occasions. Two weeks would have been better. One week gets me almost clear. I think two weeks could do the whole job. (Sigh! One day) You have to swim in the ocean (do some snorkeling) and roast in the sun on the beach, every day, or you won’t benefit. Just being there is not going to help. So, if you do go, save the shopping, partying, and casino for the evening. Spend the midday on the beach and in the ocean. I don’t use sun block, until I begin to feel like I will start to burn if I wait any longer. Drink lots of green tea to help prevent skin cancer from the UVB. Eat plenty of seafood. I don’t know if it helps, but it is very enjoyable. I can taste the red snapper now! Cheers, Cruiser Hmmm…. I wonder if drinks with little umbrellas are good to treat psoriasis. Say waitress! I’ll have "sex on the beach", please. Ahhh! That’s better. Stress? What stress?

– Hide quoted text — Show quoted text ->   I know there are only a few treatments for Psoriasis that work temporarily > (such as Anthralin, Coal Tar, Tacrolimus, Corticosteroids, etc)   but Im scared > to start anymore treatments for my Psoriasis because I fear I will build up an > immunity to the medications and then nothing will help get rid of a Psoriasis > outbreak anymore! >   In other words,  I’ve heard that Corticosteroids usually work for a few weeks > but the Psoriasis always comes back even worse!   And that corticosteroids can > only be used a few times (in genital areas) and they will no longer work + the > skin gets thin! >   So If If I used some other topical treatments (such as > Anthralin,Tacrolimus,Coal Tar, etc)  will my Psoriasis come back even worse > with these treatments also?   People say this happens with

Corticosteroids, but – Hide quoted text — Show quoted text -> what about these other topical treatments? >   My question is " Do all these treatments listed above, only work temporarily > and  they will no longer work for me in the future when I need them?   Im > scared  that if I use Anthralin now, that I will build up a tolerance to it in > the future, then what will I do when it no longer works?

Response:

Ah the ’sun and sea’ treatment! wonder if I can get that on medical aid/health/insurance.

– Hide quoted text — Show quoted text -> The first time I used valisone, I got a rebound effect and ended up using a > light booth to get over it. It was the only flare I have ever had. However, > it worked to clear my scalp, before the rebound. Then the scalp P came back > in spades., plus other spots all over. Mind you I still only went to about > 4% to 5% coverage during the flare. > Still, the doctor would never prescribe steroids for me again. However, 10 > years later, after he forgot, I convinced him to prescribe valisone again. I > have been using it for several years. For me, it is only effective on the > scalp and genitals, and newly forming plaques elsewhere that are just > starting. I use if for a couple weeks on a spot, until it clears, and then > for about a week afterwards to make sure. Then I stop using it. It has not > lost it’s effectiveness for me. > Unfortunately, it does not work on well established plaques not on the > genitals or scalp, and it does not work under nails. > I have never developed a resistance to coal tar. I have been using this for > over thirty years. However, it does me no good on its own. I have to use it > in conjunction with UVB to get any benefit. > Anthralin was a disaster. It stained everything and didn’t do a darn thing > for me. I hated it. I was prescribed it when the light booth had cleared up > everything but a small spot on my elbow and a couple nails. The doctor said > it should clear up the last bit. It didn’t. The P just came back to where it > was before the flare. > Tacrolimus, I have never used. > Every time I have come close to being clear, or been the most clear, it has > involved UVB, either from a booth, or the actual sun. > The best treatment, that I have found, is Caribbean Sun and salt water. It > is also the most fun. If you can also get into a sauna and/or a steam bath, > followed by a shower, at the end of each day, this is good too. It not only > seems to help with P, it also gets all the sun tan lotion and sweat off of > you. A week in the Caribbean has done wonders for me on a couple of > occasions. Two weeks would have been better. One week gets me almost clear. > I think two weeks could do the whole job. (Sigh! One day) > You have to swim in the ocean (do some snorkeling) and roast in the sun on > the beach, every day, or you won’t benefit. Just being there is not going to > help. So, if you do go, save the shopping, partying, and casino for the > evening. Spend the midday on the beach and in the ocean. > I don’t use sun block, until I begin to feel like I will start to burn if I > wait any longer. > Drink lots of green tea to help prevent skin cancer from the UVB. Eat plenty > of seafood. I don’t know if it helps, but it is very enjoyable. I can taste > the red snapper now! > Cheers, Cruiser > Hmmm…. I wonder if drinks with little umbrellas are good to treat > psoriasis. Say waitress! I’ll have "sex on the beach", please. Ahhh! That’s > better. Stress? What stress? >   I know there are only a few treatments for Psoriasis that work > temporarily > (such as Anthralin, Coal Tar, Tacrolimus, Corticosteroids, etc)   but Im > scared > to start anymore treatments for my Psoriasis because I fear I will build > up an > immunity to the medications and then nothing will help get rid of a > Psoriasis > outbreak anymore! >   In other words,  I’ve heard that Corticosteroids usually work for a few > weeks > but the Psoriasis always comes back even worse!   And that corticosteroids > can > only be used a few times (in genital areas) and they will no longer work + > the > skin gets thin! >   So If If I used some other topical treatments (such as > Anthralin,Tacrolimus,Coal Tar, etc)  will my Psoriasis come back even > worse > with these treatments also?   People say this happens with > Corticosteroids, but > what about these other topical treatments? >   My question is " Do all these treatments listed above, only work > temporarily > and  they will no longer work for me in the future when I need them? Im > scared  that if I use Anthralin now, that I will build up a tolerance to > it in > the future, then what will I do when it no longer works?

Response:

  I know there are only a few treatments for Psoriasis that work temporarily (such as Anthralin, Coal Tar, Tacrolimus, Corticosteroids, etc)   but Im scared to start anymore treatments for my Psoriasis because I fear I will build up an immunity to the medications and then nothing will help get rid of a Psoriasis outbreak anymore!     In other words,  I’ve heard that Corticosteroids usually work for a few weeks but the Psoriasis always comes back even worse!   And that corticosteroids can only be used a few times (in genital areas) and they will no longer work + the skin gets thin!     So If If I used some other topical treatments (such as Anthralin,Tacrolimus,Coal Tar, etc)  will my Psoriasis come back even worse with these treatments also?   People say this happens with Corticosteroids, but what about these other topical treatments?     My question is " Do all these treatments listed above, only work temporarily and  they will no longer work for me in the future when I need them?   Im scared  that if I use Anthralin now, that I will build up a tolerance to it in the future, then what will I do when it no longer works?  

Response:

I’ve been using Cutar coal tar treatment since July 2001.  I now dillute it with 50% distilled water so that (in theory) I don’t build up a resistence to the 100% solution and can use it at 100% if need be.  I am using it once a day at present.  From July to Septemeber, I used it 2-3 times a day in order to obtain clearing. So far I am maintaining about 95% clear with a few small spots on my lower legs. An occasional spot shows up in various locations which I treat locally twice a day with a 50-50 mix. I figure I can begin to add light treatment to my regime if the coal tar starts to become ineffective.  If I can make it to May at 95% clear, I think I will dillute it even futher. Hope this helps, Ed

Response:

>  In other words,  I’ve heard that Corticosteroids usually work for a few weeks >but the Psoriasis always comes back even worse!   And that corticosteroids can >only be used a few times (in genital areas) and they will no longer work + the >skin gets thin!  

The steroids are the worst about this, it’s called "rebound" when it not only comes back, but comes back worse.  If you taper off the steroids, with any luck the rebound is small — the p may come back, but not worse.  I dislike the steroids because of other side-effects they have on me, but only a few others seem to have these kinds of effects. Most other treatments do not cause rebound.  They may lose effectiveness over time, but generally, if you stay off them for a few months, they return to whatever effectiveness they ever had.  So, don’t worry about "using up" treatments in any permanent fashion. Oh yeah, some stuff, like methotrexate, has a recommended "lifetime" does, but recently I’ve read that with small doses and a "vacation" of a few months, even that may not be a limitation. Good luck! J.

Response:

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