Anyone have a teen on Methotrexate for psoriasis?

[Solly554]

Please help. My teenage DD has awful psoriasis - spots all over her back and torso, and now it’s spreading down her arms. She’s so miserable as this has been going on for 8 months - she’s had scalp psoriasis and a few spots since she was 10 but nothing like this. She wants to try medication and although I’m desperate for her not to go on them, I can’t bear to see her suffer.

We’ve tried diet, supplements, every lotion and potion. She currently uses Enstilar steroid/ vit D foam which I worry is actually making things worse as her skin flares when she stops.

Is Methotrexate a terrible idea for a girl of her age? She’s so desperate for relief and I wonder if it would help her skin recover from the steroids? But I’m scared of the immunosuppressant element - it feels like such a horrible choice for her!

Does anyone have any experience of this?

I’m on biologic injections for severe psoriasis, and use Enstilar for spot flare-ups, and can answer questions about that, but can you first say how she is using the Enstilar?

I have two close friends-from-clinic (one F) on long-term methotrexate, so can check with them around any specifics if it would help.

And does your DD have access to a consultant dermatologist/clinic?

My sister has been on and off it for 15 years. In between trying diet and homeopathic remedies. There are two things that totally cleared it - pregnancy (not suggesting that!) and a nurosym… look it up. It’s worked for both her and my cousins psoriatic arthritis xx

My daughter is on a different but similar immune suppressant (azathioprine) for Crohn's disease, and has been for 5 years.

They get blood monitoring quarterly to pick up any issues. My daughter has been no more ill than anyone else in the family despite the immune suppression - but then her immune system was overactive so it needed dampening down a bit. I think it's different from taking immune suppressants when you don't have an autoimmune condition - they aren't knocking out an ordinary immune system, just reducing an overzealous one!

I would try. If they don't suit her, she can easily stop taking them.

Oh thank you for responding! She has almost certainly overused Enstilar - in the past I used to take it away from her and let her have it twice a week. But this became such a battle ground, I gave in and now she has the can in her room. She probably uses it at least three times a week, but it always flares back up if she goes without for a few days. She has phototherapy scheduled to start soon and I’m hoping this might get her off the steroids. And, yes, we are under a derm. But she’s told us 3 months relief is all she is likely to get from phototherapy and I can’t bear the disappointment for her. Hence the question about Methotrexate

I don't have a teen but I take methotrexate. It's a mixed bag for me with side effects but very, very good at it's job.
I don't find I pick up more infection but they take longer to shake off, plus you have to pause it while you are ill.
You don't say how old she is but DS has a friend who developed rheumatoid arthritis in her teens but refuses to take methotrexate because you have to limit alcohol.

She’s 18 so the alcohol thing is likely to become a problem - is it no alcohol at all?

I’ve been on methotrexate for about a year. I can’t say I’ve been blown away by its effectiveness. However, it does make me really queasy for a few days. I started on oral methotrexate once a week and I was really quite poorly for a couple of days each week. They’ve since moved me on to injectables which has helped slightly, but has only reduced the psoriasis by about 60 percent.

However, as I am also now being investigated for possible psoriatic arthritis, the rheumatologist is recommending that I stick with the methotrexate for the time being, as hopefully it will dampen some of those symptoms.

before methatrexate I was on cyclosporine for a few months. That was amazing, but had to discontinue as my blood pressure started going haywire. So there are other options that maybe available to your DD

I’ve had psoriasis for almost 30 years and can sympathise with your DD. I tried everything before turning to medication in my very early 20’s. I started with cyclosporine which worked amazingly well however caused me to get serious chest infections. I then used Methotrexate for around 2 years, starting with tablets and then injections, it wasn’t a miracle cure type medication for me but it kept it a bay for a considerable period of time. I had some side effects to the point I almost had to write off at least part of the day after taking it. I’ve also taken lots of other medications. Apremilist was great for me, I took it for a number of years with very little issues. I think it’s a rarer one as I was the only patient my dermatologist had ever prescribed it for.

I think with her age some medications maybe a no due issues around pregnancy even years later, but for me the risks out way the constant that is psoriasis, it effects so much of your life.

No it's not that bad. Consultants vary but in general it's stick well below recommended levels. I know alcohol is heavily disapproved of in some quarters but teenagers often go through a period of trying it out and I thought it worth a mention.. My own DC overdid it a few times in their teens but like many 20 something's they now barely touch it.

I found the methotrexate tablets very hard on my stomach but they swiftly swapped me to injections. The injections are a pen so very easy to use even for the squeamish.

https://nurosym.com/en-gb?tw_source=google&tw_adid=666203712467&tw_campaign=20375870610&tw_kwdid=kwd-1635576075283&gad_source=1&gad_campaignid=20375870610&gbraid=0AAAAACMaNB6XdZr_uHH9RRveCNE58pCUZ&gclid=EAIaIQobChMInoTt-LPhkwMVy6NQBh0R5AqeEAAYASAAEgJpJ_D_BwE

in case helpful for anyone - as I said it’s completely rid my sisters symptom of psoriatic arthritis.