Hi, I m 22 and have moderate to severe plaque psoriasis on my face, scalp and torso. I ve exhausted most topical creams and ointments, taken courses of steroids with no real results. Would phototherapy be my next course of action. Is thinking about biologics too radical?
Hello. Thank you for writing to topical treatment with ointments and lotions is usually combined with systemic treatment/ oral treatment for psoriasis involving > 20% body surface area. Phototherapy, though is a good choice for extensive body involvement with plaque psoriasis, however, certain body sites like scalp are resistant even to phototherapy. Apart from phototherapy Oral methotrexate is a well known treatment for plaque psoriasis and can be considered in a healthy young adult. Biologics like golimumab, ustekinumab are not first line options in a young patient with limited involvement with plaque psoriasis. Scalp involvement responds well to topical steroids lotions with or without salicylic acid. Vitamin D analogues e.g. calcitriol/ calcitriol lotions are also effective in scalp psoriasis. I suggest that you visit a dermatologist in your region. Your dermatologist will assess the severity of involvement and advice accordingly. Regards