Ds and skin problem

[Tevion10]

Posting here for traffic.
I am feeling really bad for 18 year old ds as he is covered in what looks like guttate psoriasis and despite creams from the doctor it doesn't seem to be responding.
He is very distressed about as he is due to go on holiday in July and he is fretting about them.
Please does anybody know of a treatment for this that acts fairly quickly.

Thank you for all your suggestions. I don't want anymore creams but would prefer to go the route of oral or injectables

Iight therapy sounds good but I don't know how he will manage the sessions with college.

@Tevion10 a dermatologist won’t start you off on oral or injectables, it’ll likely be dovobet which will probably clear it up in a week. Or light therapy. There is no way they’ll start directly on systemic treatments, especially for guttate which is one the easiest forms of psoriasis to clear.

I’ve had psoriasis (guttate, plaque, inverse, nail and psoriatic arthritis, all at once!) for 15 years and I’m still not on oral or injectable medication.

I'm looking for something rapid so it clears up or at least fades dramatically in time for his hols

My dh has psoriasis. In his experience UV light works (sun beds in tanning shops work well) childs farm moisturizers work well, drinking plenty of water and cutting down/out sugar and dairy products.

Yeah no way will they give him orals (highly toxic) or injectables (impaired immunity). Those are last resort treaments for when creams and UV treatment doesn't work.

Cetraben moisturiser as often as possible. Scrub the plaques off in the bath followed by lots more certraben. Some dovobet- creams always work best in well moisturised skin not on top of the plaques. Yes the scrubbing can be a bit sore. Sun beds as last resort but def can help and also gives a base for the holiday to stop burning which def can make it worse. Just a few mins each time. No quick fix but as youre time limited this should help somewhat or has for me at least

Also there is a long wait for biologics. It was a while ago but I was told 2 years wait and even then you had to have arthritis/joint involvement before it was really an option.

Orals / injections are not usually used to treat guttate psoriasis, certainly not without first trying ubv or decent strength topical steroids.

Dovobet will clear it up within a week tops if he is meticulous in applying and can be prescribed by the GP.

After much research and many failed attempts with Dovobet etc I asked my Dr to prescribe Enstilar foam last year and it completely got rid of the psoriasis on my elbows.

I have recommended it a few times on MN. It works very quickly too.

You've said the doctor says it 'looks like' guttate psoriasis. I had biopsies to confirm that I had the condition 18 years ago (and still have it to this day). My concern would be that psoriasis (as someone stated earlier) is not so much a skin condition as an autoimmune disorder. Skin creams may help the redness/itchiness, but (again as stated earlier) dovobet is probably the best topical skin treatment for this type of psoriasis. I have had light treatment (through the hospital), and also tried sunbeds with limited results.
As Mustard said, oral meds/injections, either Dmards or biologics are not prescribed as a first line of defence. I have psoriatic athritis too, and have been on methotrexate for 7 years - I am only able to obtain this drug through the hospital, as my GP cannot prescribe, and it is very closely monitored through regular blood tests.
I think first of all your son needs a definitive diagnosis, which should then dictate the way forward.

I have tonight managed to get a prescription for Enstillar foam from one of those extra gp evening appointments you can have when your struggling to get one with your own gp, trouble is that they can't do referrals but they will send over the recommendation to my own gp. I also went and bought mothers farm lotion from Boots.

Enstillar foam has been recommended to me before but God I had to persist to get it.

I suffer really badly on and off from guttate psoriasis. I originally got it after having a strep infection. UVB treatment is the best for it.
Clears it in nearly 90% of cases according to my consultant. Have had it done and it has worked for me.

Can I just add uvb treatment is not like a regular sun bed in a tanning shop. I am shocked at people here suggesting that.

Well done! It's expensive so they don't like prescribing it (£40 my Dr said) but it works.
Good luck with it

Antibiotics and roaccutane don’t treat psoriasis, they are used for acne. Pushing for a dermatology referral is not going to help by July in our area- time from referral to clinic review is several months and then you have to give time for treatment to take effect. In addition, in many areas dermatology will not accept a referral unless all appropriate measures have already been taken in primary care (GP) and been unsuccessful or not tolerated by patient (e.g. significant side-effects), or in cases where there is diagnostic uncertainty.

Have you tried potent/very potent topical steroid ointment (better than cream), possibly in conjunction with topical . Regular emollients are also important, sometimes coal tar can be helpful (if tolerated). In cases not responding to topical treatment, or very severe cases, phototherapy can be helpful.

Sorry- should read potent/very potent topical steroid ointment, possibly in conjunction with calciptriol ointment.

I've had guttate psoriasis since I was 4 (I'm now 35) and the only thing that I've seen major improvement with is Zorac gel (tarazotene) from the doctors and cutting nightshades and caffeine from my diet.

I've had a lot of treatments from the doctor and dermatologist over the years - creams, biologics, uvb treatment but nothing that's worked long term if at all and the more serious drugs aren't worth the side effects.

I never used to buy into the diet ideas but I started it last year and it's really helped calm it down better than just the Zorac on its own.

I've went from a severe outbreak last year to 90% clear now for the last 4 months.

Hope he finds something that works for him.

OP I would also say you would be mad to want DMARDs or biologics at this stage (which is what oral or injectable medications are)- they are quite serious drugs with significant side-effects and potentially very serious complications. They also require monitoring (bloods mainly- weekly to begin with). Simply not worth the risk so he’s clear for a holiday when there are other, far safer, methods available. The dermatologist would be highly unlikely to prescribe them so early on in the disease course/when other treatments not been trialled in all but very serious cases +/- with other complications (e.g. psoriatic arthritis).

I’ve had psoriasis (guttate, plaque, inverse, nail and psoriatic arthritis, all at once!) for 15 years and I’m still not on oral or injectable medication

I've had psoriasis all of my life (I'm 58). Growing up I had guttate, plaque, inverse and nail psoriasis. Now to add to the mix I have psoriatic arthritis, rheumatoid arthritis, osteoporosis and scoliosis and i was only given injectable methotrexate 2 yrs ago.

Sadly there are very few quick fixes for it but there are some good suggestions here. Definitely get a referral to a dermatologist though even if it's not in time for his holiday. I had to get a new referral last year as I hadn't seen him for a while and the wait time was 16 weeks.

Well shall keep going with this Enstillar and get the referral moving anyway.

The doctor suggested going privately.
If only I had the money.

It took me 3 months between referral and appointment and then longer for treatment. There's no quick fix for these things I'm afraid.
Private appt is faster obviously.

@Pigsinduvets really? My sisters a doctor and she told me the subbed is pretty much the same thing as Light therapy...