Hi everyone! I posted on Snapchat on Tuesday about going for a blood test to test my liver enzymes because I’m on some medication for my psoriasis and many of you emailed me asking me about my psoriasis and what I do to control it. I’m going to address all your questions and give you a break down here in the form of a post because it has played such a major part of my life and I know how it feels to have this terrible skin condition.
From as long as I can remember, I’ve had psoriasis. I think it started developing on my skin when I was 6 years old and has been part of my life on and off ever since. I’ve managed to get rid of it for a few years at a time and somehow managed to control it throughout my life but like anything, it certainly has its ups and downs. Growing up I’ve been to countless numbers of doctors, doctors in the form of general practitioners, dermatologists, homeopaths, Chinese traditional doctors and even doctors from various countries. The amount of money my parents have spent on going to doctor visits, medication and ointments is unthinkable and probably in the millions. Many people who don’t have it may disagree with me but those who do have it knows that it is the worst and most embarrassing skin condition to ever affect someone. Till this day, doctors still have not found an absolute cure for psoriasis (I guess I can speak for those with eczema too) but there are many ways one can control their psoriasis.
What is psoriasis and how do I know I have it?
Psoriasis is a skin condition which leaves patches of your skin inflamed, raised, red and scaly. Psoriasis affects people differently, some say that it burns or that it itches. Some have thick scales and some just appear dry and flakey. Some people get it in big patches but some are small red dots. Typically, most people get it by the elbows, the knees, behind the knees and the scalp but it may also spread to other places such as the stomach, the back and the bum. Many people get it on the arms and legs, like Kim Kardashian who mentioned in an episode of Keeping Up With The Kardashians that she has psoriasis and it’s always been an insecurity of hers. It can really happen to just about anyone.
Why does one get psoriasis?
There’s no explanation as to why some people have it, although many doctors believe that it is inherited. Apparently you’re very likely to get it if one or both your parents have it. This is not my case because neither of my parents have psoriasis or eczema for that matter so I’m not quite sure where I got mine from. The one thing doctors do know about psoriasis is that people who have psoriasis tend to have an over-reacting immune system in that my skin cells tend to grow at an abnormally faster rate than other people who don’t have it, hence the skin build-up causing scales. I must make one thing very clear, psoriasis is NOT contagious! You can’t catch it from someone just because you’re sitting close to them or because you’ve touched a patch of their psoriasis. I’ve also heard somewhere that many people who have psoriasis at a young age will grow out of it but then again, there are also those who live with it for life, like me.
So what does it mean if I have psoriasis?
It still surprises me how little doctors know about this skin condition considering that it affects about 10% of the people in this world. I guess the one major thing people who have psoriasis have to watch out for is psoriatic arthritis because about over 25% of people who have psoriasis end up with it. Psoriasis arthritis is basically damage to the joints which causes swelling, stiffness and pain.
How do I control it on my body?
I’ve tried many things in my life to control my psoriasis. I’ve pretty much had it all the way from mild to very severe in different phases of my life. The good thing is, I’ve also been completely clear before too for a good few years until it came back (I guess I do know what the good life is after all :))
The first thing I tend to do and have tried many many times is changing my diet. I’ve pretty much tried it all, avoiding sugar and preservatives, avoiding certain groups of fruits and vegetables because it is rumoured to inflame the skin and make the psoriasis worse, I’ve avoided certain types of meats because it is also rumoured to do the same. I’ve even gone as far as to avoid tomatoes for a good 4 months, by tomatoes I mean ketchup included! Of course none of it came through for me. One thing I’ve learnt from all this is that you should eat what makes you happy and importantly, what makes you feel good. I stopped eating sugars unnecessarily because it doesn’t make me feel good, I avoid fried foods because surely that can’t be healthy for you and when it comes to fresh fruits and vegetables, I eat as I please. I’ve also tried avoiding gluten because at one stage I believed that it caused my psoriasis, of course that wasn’t true for my case.
Over the last year or so my psoriasis has spread to every part of my body. I guess I can call myself lucky because I don’t get it in big, red patches with thick scales but I do have small 10c coin-sized patches that tend to spread everywhere and if I don’t keep my skin moisturised, it flakes. Naturally, I’ve also tried switching my detergents which I use to wash my clothes, I’ve changed my washing powder to those that are less fragrant and contains less chemicals. I’ve even stopped using fabric softener for a few months because I believed that the chemicals that washed my clothes were rubbing off on my skin which made my psoriasis even worse. Of course, that didn’t really change anything because my psoriasis continued to spread.
I was eventually put onto methotrexate a couple of years ago. For those who don’t know, methotrexate is used in the treatment of cancer, its medication taken by cancer patients to slow down the growth of cells. Since this type of drug is pretty potent, I was put onto a low dose, I used to take it about once or twice a week. The downside to this drug is that you cannot tell it to control the growth of certain cells only, which means it slows down the growth of all your cells, including liver enzymes and white blood cells etc. A side effect could be hair loss for example. I eventually came off it because it stopped working for me so I’ve been off it for about 3 years now. A lot of dermatologists seem to prefer this method of treatment, I’m not exactly sure why because it’s quite dangerous considering how potent it is and I had to always go for blood tests to check my liver enzymes etc so it’s definitely no joke.
Together with the methotrexate, I was also prescribed some topical ointment which generally contains steroid ointment. My previous dermatologist always prescribed me with ointment that had to be mixed by the pharmacist because it only contained a very very low dose of topical steroids since it is not actually good for your skin to be used in the long term. Many dermatologists also prefer these ointments because it’s effective and suppresses the psoriasis almost immediately when you start using it. However, it doesn’t completely get rid of it because it’s very likely that the moment you stop using it, the psoriasis will come back again.
As previously said, my psoriasis came back pretty badly in the last 2 years or so and it has spread everywhere. I’m currently seeing a new dermatologist in Sandton, Johannesburg. The first time I went to see him, it was before my Hong Kong/ Philippines trip. He put me on a course of antibiotics just to make sure the psoriasis is not caused by an underlying infection, then he gave me an anti-inflammatory jab, he also put me on vitamin D (which you can get anywhere) and I was prescribed 2 tubes of Dovabet, which is a topical ointment. My psoriasis did appear to be a bit better at first because of the ointment that I was applying to my skin but this did not prevent it from spreading. I went back to my dermatologist after I came back to South Africa and when my ointment was about to finish. This time, he put me on Ciclosporin but on a very low dosage because it works similarly to methotrexate. It’s an immune suppressing drug which means that it lowers the activity and growth of your immune system (yes more blood tests are involved here). The problem with this medication is that the dose you should take depends on how much you weigh, if I remember correctly, one should take about 2mg per kilogram that one weighs (phew seems so complicated). Currently I’m on a very low dosage, actually much lower than what I’m supposed to be taking based on the formula I just stated above but I just want to see if there’s any progress for my psoriasis before I go onto a higher dosage.
What can I take for scalp psoriasis?
Consider yourself lucky if you only have it on your scalp because as irritating as that may be where it seems like you have tons of dandruff but it seems to be easier to control than when it is on the body. There are many shampoos and ointments you can use for scalp psoriasis, some are over the counter and doesn’t need a prescription.
One shampoo I’ve been using for a while is the Neutrogena T-Gel Shampoo which contains coal tar so it may smell a bit funky but it really works. I use it lather it up, paying more attention to my scalp and then leave it for 15min before rinsing it off. The only problem with shampoo that contains coal tar as the active ingredient is that your body may become immune to it and it will stop working as effectively as when you used it for the first few treatments. Unfortunately, you cannot buy this shampoo in South Africa, I used to get mine overseas or I order them off Ebay but there are lots of other alternatives that are sold here locally with the same active ingredient (there are tons at Dischem).
Currently, I’m using a shampoo prescribed by my dermatologist called Clobex Shampoo by Galderma. The active ingredient is corticosteroids and again, you shouldn’t use this for longer than 4 weeks. I’ve used it twice so far and it has been pretty effective because my scalp psoriasis is almost clear now. Together with this shampoo, my dermatologist also prescribed me with a liquid to be applied to my scalp at night called Xamiol Gel and it is a topical treatment which also cannot be used for more than 4 consecutive weeks. Clearly these products are all pretty effective because of how potent it is, hence you cannot use it in the long term. If you’re desperate to get rid of your scalp psoriasis, I definitely recommend giving these two products a try.
What I use to moisturise my skin?
Until recently, I’ve used normal products to moisturise my skin such as body butter from the body shop, Johnson & Johnson baby lotion, Nivea products, I’ve pretty much tried them all. To me, it didn’t really make a ton of difference but I did get really paranoid about the fragrance of certain products at one stage caused made me stop using them. My dermatologist told me that aqueous creams are actually terrible for the skin especially if you have dry skin because it actually dries them out even more and doesn’t do a good job at moisturising the skin deep down. He said that creams that contain Urea is more effective so currently I’m using a cream called Ureadin Rx 20 from the dermatologist. I really like the scent and a little of it goes a long way because it’s very moisturising, however it is quite pricey so you might want to try some other brands that also contain urea that are available at Clicks or Dischem.
I’ve lived with psoriasis for so long that I’ve gradually come to accept them. I guess I can even call myself lucky because I don’t have bad skin overall, I don’t get pimples or blemishes easily (maybe a pimple a month), I don’t get freckles and I have very very small pores that are rarely noticeable. In fact, I feel so guilty every time someone compliments on how great my skin is because I’m actually laughing inside and thinking “only if you knew”. 🙂
I really hope this post is informative and it has managed to answer most, if not all of your questions. Also it has given you an insight to this skin condition that affects so many people worldwide but so little is actually known about it. If you don’t have psoriasis and you managed to have read my post till now, big ups on you, I love you too 🙂
Remember, if one method of treatment doesn’t work, then change, nothing is worse than banking all your hope and wasting all your time on something that doesn’t work for you! Good luck!