Living with psoriasis can be challenging, especially when treatment doesn't deliver the expected results. Despite the array of effective treatments available, from topical creams to biologics, some patients struggle to find relief. If you're frustrated with your current treatment, it's time to explore the potential reasons behind its ineffectiveness.
Why Your Psoriasis Treatment May Be Failing
According to a 2014 study, psoriasis is a prevalent chronic inflammatory skin condition that presents various clinical forms. It arises from a combination of genetic, environmental, and immune-related factors.
As a dermatologist, I also prefer to inform my patients that it is not as easy as applying a cream to your skin or taking a pill to eradicate psoriasis, said Dr Vidushi Jain, Dermatologist and Medical Head, Dermalinks, Noida and Ghaziabad. Here are 10 key factors that might be hindering your psoriasis treatment, and what you can do about it.
1. Misdiagnosis
What appears to be psoriasis might be another condition, such as eczema, a fungal infection, or lichen planus. “A misdiagnosis can lead to ineffective treatment. A thorough evaluation and accurate diagnosis by a skilled dermatologist are essential for determining the correct diagnosis and developing an effective treatment plan,” said Dr Jain.
2. Poor Adherence to Treatment
Consistency is also necessary in the treatment of chronic skin disease. Missing doses, irregular use of topical therapy, or too early stopping of treatment will compromise the effectiveness of drugs.
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3. Unrealistic Expectations
Psoriasis is a chronic disease, and there can never be total clearance. Treatment objectives are typically to clear the lesions and reduce relapses. Patients will be dissatisfied with treatment if they anticipate permanent or complete clearance.
4. Uncontrolled Triggers
Some factors in life provoke or initiate psoriasis. Some of these are smoking, alcohol, infection, skin trauma (Koebner phenomenon), and some drugs. Avoidance of these is a part of disease control.
5. Obesity and Metabolic Health
“Obesity and metabolic syndrome have been noted to negatively influence the treatment of psoriasis. Obesity also disrupts the metabolism of systemic medications, decreasing their effectiveness,” added Dr Jain.
6. Inadequate Moisturising
Dry, irritable skin can trigger psoriasis lesions. Regular moisturising helps strengthen the skin's barrier function, reduces scaling, and improves the absorption of topical treatments.
Also Read: Dermatologist Shares Do's And Don'ts For Psoriasis Management
7. Inadequate Dosage or Formulation
At times, the strength of the dose, or drug delivery could be inappropriate to the severity of psoriasis, or the type of psoriasis. For instance, scalp psoriasis may be treated with specialised preparations, such as medicated shampoo or foams that allow penetration.
8. Treatment Resistance Development
Over time, some patients develop resistance to certain treatments, especially with prolonged use of a single agent. In such cases, a dermatologist may need to adjust the treatment regimen or explore alternative approaches, such as combination therapy. According to a 2013 study, biologic drugs can become less effective over time due to a phenomenon known as biologic fatigue.
9. Uncorrected Comorbidities
Psoriasis also coexists with other conditions like psoriatic arthritis, cardiovascular disease, and depression. These comorbidities, when uncorrected, can impact the treatment of psoriasis.
10. Therapies
Certain patients cannot afford newer treatments, such as phototherapy or biologics due to cost, geographic, or insurance limitations. New treatments have aided a large majority of patients with moderate to severe psoriasis.
Bottomline
Dr Jain concluded, “Psoriasis must be treated on an individual basis, considering not just the skin but the patient as a whole. If treatment fails, it's crucial to consult a dermatologist to revisit the diagnosis, identify potential causative factors, and develop a personalised treatment plan. Psoriasis can be effectively managed in most individuals with a tailored medical approach, lifestyle adjustments, and patient education.”
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your professional if you are dealing with any health issue to avoid complications.]