Hi, Kathleen. There are many causes of weakened urethra and bladder problems, including childbirth and menopause, but I have not seen this due to topical steroids. I think that it is important for you to consult with a urologist.
A great question, Kermit. It is true that the patents on some of the early biologic medications (like Enbrel and Humira) are coming to an end soon. Unfortunately, that does not mean their costs are going to come down much. The factories required to produce these drugs are very expensive and complex and it is unlikely that the usual generic manufacturers will be able to afford to build them. I expect prices on these drugs will come down about 10-20% percent but they may drop further in time. Unfortunately, that may not make a big difference on a medication that costs around $30,000 per year to treat one patient.
The OTC shampoos available for psoriasis contain one or more of the following ingredients-coal tar, zinc pyrithione, selenium sulfide, and salicylic acid. I recommend that my patients get several shampoos to keep in the shower, and rotate them. Different shampoos work well for different people, and you may find that the scalp becomes temporarily resistant to one shampoo.
Thanks, Christopher. A lot of people ask about triggers for their psoriasis and it can be different for every person. Common triggers include emotional stress, physical stress (like surgery or having a baby), certain medications (listed in a previous answer), and winter weather. The sun often makes psoriasis better, so many people are worse when they travel to less sunny places or during the winter.
Hi, Rachel Lee. Psoriasis undergoes something called the Koebner phenomenon, which is the appearance of new psoriasis in areas that are traumatized, like in a scratch. A tattoo is major trauma to the skin, so she risks developing new areas of psoriasis in the tattoo.
Hi, Kim. Statistics show that 30% of people with psoriasis have or will develop psoriatic arthritis, so they don’t inevitably go together.
Thanks, Pete. No, methotrexate does not commonly lose effectiveness over time. I saw some patients when I practiced in England who had been on it for over 30 years! Of course, any treatment can lose effectiveness and so it is important to see you dermatologist if that is happening. We are fortunate to have many new treatments available in the last decade, so you don’t have to suffer in silence.
Hi, Kristin. Keep your son’s skin moisturized at all times! During the summer, a little bit of sun exposure is helpful. Start with 15 minutes without sun block and increase by 5 minutes a day. You can also try some OTC hydrocortisone 1% on the areas that are flaring. If this doesn’t work, take him to a dermatologist for some prescription medication.
Katie, I am sorry that your daughter is suffering. There are definitely more aggressive treatments that your daughter can try. With children, we often start with gentle treatments like creams or UV light treatment since they are the safest options we have. Unfortunately, for some children that it not enough and they need stronger treatments. You can consider seeing a specialized pediatric dermatologist or a dermatologist who specializes in psoriasis, if one is available in your area.