Successfully treating psoriasis

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For a treatment to have the best chance of success, you need to follow your doctor’s instructions as exactly as possible. How well you do this is often called compliance. Although, you should feel that you are part of the decision making process and a term, which is more appropriate is concordance in which you as the patient make decisions together with your clinician about treatments. This active participation will give you control and take ownership of your symptoms, therefore helping you to understand what works best in your own circumstances. With some medical conditions such as high blood pressure, good compliance is vital to help stop complications. With psoriasis, good compliance is important to help:

  • reduce the rate at which you produce new skin cells
  • stop the side-effects of some treatments such as burning or irritation
  • control your symptoms
  • keep your skin looking and feeling at its best.

When to stop treatment
Different types of treatment take different times to show a good effect. For example:

  • Treatment applied directly to the skin (called a "topical treatment") will usually show a good effect within three to six weeks but may be tried for up to 3 months to see if it works. Feel the treated area with your fingers and continue topical treatment until the skin feels entirely smooth and normal. Any staining (such as from using dithranol) will clear within 2 weeks of stopping treatment.
  • A disease-modifying drug such as methotrexate should start to make a difference within 2 or 3 months. Ciclosporin will show an effect within one month. If you do not think your treatment is helping, don’t just stop using or taking it. Go back to your doctor for advice. You may need to use the treatment more often, take a higher dose, change to a stronger product or see a specialist. Never stop taking an oral corticosteroid drug, other than on medical advice, as this may be dangerous.

Tell your doctor straight away if:

  • a product burns or irritates your skin or makes your symptoms worse
  • you think you have developed an unwanted effect of treatment
  • you think you may be pregnant.

Tips to help improve compliance

  • Try to take or use your treatment regularly, at the same time every day, so you get into a routine
  • Keep your tablets or creams somewhere you can remember them easily, such as with your toothpaste (but make sure they are out of the reach of children). If you have an alarm watch, set it for the time your next treatment is due
  • Make sure you get your next prescription in plenty of time so you don’t run out
  • If you are going away, take enough tablets or creams with you to last the whole time
  • Read and keep the information leaflet that comes with your medication
  • If in doubt about any part of your treatment, ask your pharmacist, practice nurse or doctor for advice
  • Keep a record of treatments you have tried in the past and let your doctor know if they caused you any problems
  • Remember to store your medications correctly according to the instructions given -this will usually be in a cool, dry place away from the sight of children
  • If the cost of your treatment is stopping you from using some or all of the medications advised, talk to your pharmacist about ways of reducing your prescription charges.

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