Doctors can give instructions in a few minutes during a clinic appointment, write out a prescription or print out an article, and go on their way. Patients are left with the task of carrying out their doctors’ directives, no matter how time-consuming, energy-depleting, or uncomfortable they may be. What follows are some of the most inconvenient and uncomfortable psoriasis treatments I’ve tried in my 40-plus years of living with this disease, plus my takeaway on whether they were worth it.
Coal Tar Treatments: The Smell of My Childhood
As a child I performed a nightly ritual involving liquid coal tar in Aquaphor ointment — a formulation compounded by the pharmacist — that I would apply all over my skin before bed. I can report that sleeping in greasy pajamas is quite unpleasant. I’ve also used bath solutions, soaps, and shampoos made with tar, staining my sheets, clothes, and even bathtub with brownish-black tar residue. When I visited the La Brea Tar Pits in Los Angeles I told my kids, “That’s what my tar treatment used to smell like.” They wrinkled their noses at me. Whenever the asphalt on the street is coated with tar, I am transported back to those childhood days.
Phototherapy Kept Me on the Go
Over the years I’ve undergone various treatments with light. When I was in fourth grade my mom took me out of school three days a week and drove me thirty-five minutes each way to the hospital. Since those early days I’ve traveled up to forty-five minutes each way to clinics for ultraviolet B (UVB) and Psoralen with ultraviolet A (PUVA) treatments. One memorable time I drove through snow and ice to get to the clinic, only to find out that weather had prevented the phototherapy unit nurse from making it in. RELATED: Smart Health: I Tried the Daavlin 7 Series Home Phototherapy Unit for My Psoriasis and Eczema — and Got My Skin Under Better Control
Anthralin Paste Treatment Dominated My Life for Weeks
After high school graduation, while my friends departed for exciting vacations, I drove to a relative’s house close to Stanford University. For six weeks, five days a week, I took a bus to a nearby daycare clinic for psoriasis treatment sessions lasting five to six hours each. The schedule kicked off with scalp treatments, then progressed to the application of an anthralin paste on every psoriasis lesion on my body. (Anthralin is a man-made version of a natural substance found in goa powder, the dried sap of the Brazilian araroba tree.) I wore pajamas over the paste and waited for hours, enduring a burning feeling as the paste did its work. Then I washed myself off, took a dose of ultraviolet light, and rode the bus back to the house where I was staying. None of this was fun, but to make matters even worse, the nurse became impatient with me when my skin did not respond as quickly as expected.
Injections Required More Trips to the Hospital
A couple of treatments required me to go to the hospital for injections. Methotrexate pills upset my stomach for days after each dose, so my doctor thought I could inject it in my hip, as some cancer patients do. The injection hurt more than any other I had before, and, unfortunately, did not help my stomach or my psoriasis as much as hoped. In the early 2000s, biologic treatments arrived on the scene. When one of the first, Amevive, came out, it needed to be administered intravenously in an oncology clinic. The treatment itself did not require a lot of time, but everything else took hours, including the travel, prep, and wait time afterward. The worst part? My skin got worse, not better, over time. RELATED: The Consumer’s Guide to Biologics for Psoriasis
Wet Wrap Therapy Helped but Took Up Time and Energy
A few years ago, my dermatologist prescribed an at-home treatment I had never heard of before, wet wrap therapy. It’s primarily used for eczema but it helped my psoriasis too, by moisturizing skin, allowing medicine to penetrate, and calming inflammation. Wet wrap therapy involves bathing, slathering (my doctor’s word, not mine) a medium-strength topical corticosteroid ointment on the skin, then covering the area with wet clothes. Over the wet clothes goes a layer of dry clothes to keep the wet clothes damp. Some instructions say to leave the wet clothes on overnight, but I usually did the therapy for about three hours in the evening after work. After about an hour I had to rewet the damp layer. I did feel better afterward, but the treatment took so much time and energy that I came to dread my wet-wrap nights. RELATED: ‘I Tried Wet Wrap Therapy for Eczema, and It Helped Reset My Skin’
Diluted Bleach Baths Made Me Nervous at First
Once my dermatologist suggested I try taking a bath with diluted bleach as a therapy for the skin infections proliferating all over my body. Apparently, the immune-suppressing effects of the medications I was taking at the time left me vulnerable to staph skin infections. The unchecked bacteria were causing infections in my hair follicles (folliculitis) and exacerbating my eczema. Since psoriasis medications had become my lifeline, I didn’t want to stop them just yet. But I felt reluctant to try the dilute bleach bath. Would it work? Would my skin dry out? What if I put too much bleach in? When I finally tried a bath, I found it refreshing, and it did help with minimizing skin infections. Over time, though, preparing the bath and moisturizing afterwards began to feel like a lot of work. Eventually the treatment began to irritate my skin to the point where I needed to stop altogether.
Worth the Trouble?
For all the inconvenience and discomfort, some psoriasis treatments worked quite well for me for a time. I’m glad I tried others even if they ultimately weren’t effective, because then I knew I could rule them out as potential therapies and didn’t have to wonder “What if?” Fortunately, treatments have come a long way since those days of using coal tar or anthralin paste. Now I can self-inject my biologic at home every eight weeks, and I have a home phototherapy unit that saves me hours of travel. As imperfect as certain psoriasis treatments may be, I have no doubt I’ll keep trying them. They’re worth the trouble as long as they offer at least one thing: hope for relief.
