Got Worse Upon Diagnosis
from Michelle S.

Hello:  I'm a 24-year-old women from Chicago suffering from psoriasis since 13. The funny thing is, it was NEVER bad until the derm actually diagnosed me with it two years ago! I would get a tiny patch of it here and there, but with some jojoba moisturizer, it was gone and never came back. Then, when I was diagnosed, it just began to spread and didn't stop! It's like, once it was found out, it felt free to show it's ugly face!

Anyhow, I'm going to Florida this summer and even though I have put on a few extra pounds over the holidays, I'm more concerned and embarrassed about showing off my psoriasis, then my shape!

I have recently been using a combination of coal tar soap, Dovonex, and Psorialeve — a moisturizer made by Masada.

I wash with the coal tar soap in the morning, apply a regular moisturizer (Vaseline Intensive Care), and then apply the Dovonex to my lesions.

Sometimes in the evening, I soak in a tub of 1 1/2 cups of Epsom Salts, 1 cup of Apple Cider Vinegar, and 2 Tbsp of olive oil. When I get out, I put the Psorialeve on.

It seems to be working, as the lesions are a little smaller, but 100% smooth and not at all itchy, but the REDNESS never goes away. Any ideas of how to take that away?

By the way, if anyone wants to check out Masada, the website is http://www.masadaspa.com. There are many products made with Dead Sea Salts, such as their bath salts, but they're VERY EXPENSIVE and according to the study they sent me, you need to use a whole 2 lb. container in each bath!

Thanks for listening to my problems!  Michelle S.

*****

Ed’s Response:  Two pounds of salts added to a bath?  Wow!  I completely understand your reluctance to pay the price.  Furthermore, I’ve not received a single email suggesting bath additives do more than make a slight improvement.  (But I’ve not heard from anyone who spends, say, four or more hours a day soaking....  To do so in the bath you describe might preserve you for eons, like salt-cured meat, or olives....)

I think your story about your P blossoming only AFTER it was diagnosed may not be as unusual as you think.  (Though having it mildly for 10 years before it was diagnosed and blossomed into something major might be rare.)  My own milestone history looks like this:

1.     Severe flaky scalp (figured “bad dandruff”)

2.     Red sores on nose and at hairline on forehead

3.     Derm diagnoses P

4.     Lesions pop out all over

Why might it be that we get worse when we become fully informed?  Stress?  Maybe.  I was definitely stressed when the derm who finally made the diagnosis said, “We can’t cure this.”  Definitely stressed.  What the hell good are you?  (Thought, not said.)

Except for the Dovonex, you appear to be undergoing a very mild treatment. Even the Dovonex — compared to alternatives — is mild.  You might want to ask your derm about a combination topical therapy.  I hear from lots of people who are having very good results using Dovonex AND a topical corticosteroid (typically halobetasol [Ultravate], clobetasol propionate [Temovate or generic], or betamethasone dipropionate [Diprolene]).  If your derm doesn’t currently have you on a topical corticosteroid (you didn’t indicate any) s/he probably wants to spare you the potential bad side effects.  Unless you are allergic to these steroids, the side effects most common accompany long-term use.  Therefore, you might ask about using one of these in combination with your Dovonex starting 6-8 weeks before your Florida vacation, then use them through your beach time and, if your derm recommends it, stop using the steroids after you come home.  You’re likely to derive the greatest benefit from these topicals in that time frame; however, you may find that you rebound significantly when you stop using them.  Most people — including me — try to taper off using the high-potency topical corticosteroids because a sudden cessation virtually guarantees a flare-up. 

Keep us informed, Michelle, and thanks for sharing the Masada web address.  -Ed

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