Methotrexate vs acitretin

Posted Fri 17 Feb 2017 5.01pm by Linda


I've had psoriasis all my life and have been able to control it with creams . I've recently had severe psoriasis on my hands and feet to the point where I can't get shoes on. The doctor has now recommended I take methotrexate but did mention acitretin as an alternative. Having read up on the pros and cons of both I'm interested to hear your views on these tablets. Appreciate everyone is different but any comments and advice would be great. Thanks. Linda x

Posted Thu 24 Aug 2017 4.37pm by Billy boob

I was on acitretin for a while along with nbuvb I tolerated it well and had no side effects had to have regular blood tests

I was taken off it because it raised my Cholesteryl

Posted Wed 30 Aug 2017 10.21pm by Janw

I was on Acitren for a good few months can't say I really noticed a difference was took off it as side effects were out waying the good effect. Have now been put on methotrexate been on it 2 months now can't say I've seen a difference yet. My feet are still bright red,itching like mad and burning they are constantly red hot and still loads of blisters all over them.

Posted Fri 1 Sep 2017 12.41pm by EQ

I have been on Methotrexate and it worked brilliantly for me, within 3 months I was clear but unfortunately it caused problems with my Liver and shocked the deematologist due to my age. They mentioned Acitriten to me but it was not something I considered due to the pregnancy tests and how long you had to wait once stopping the treatment to have kids.

I would advise to try Methotrexate first!

Posted Wed 6 Sep 2017 8.04pm by andrea
have had p for too many years

hi I have been on methotrexate for two years and now up to highest dose I'm allowed 17.5 mg once a week. I get really bad pain around my eyes at the time of the month for a few days and occasional headaches inbetween. I have very low iron levels so have to take extra iron every day. The psoriasis is returning but not severely but still embarassing so it has been decided to keep me on this dose for a bit longer as any lower and it gets quite bad again. The derm is not sure which path to take next.

Posted Fri 8 Sep 2017 10.38pm by Sue P

Hi, I tried both, the side effects were horrendous & I didn't see any improvement. My psoriasis is on my hands & feet & the impact on my life these last 2 years has been overwhelming. My turning point was when I decided to stop all treatments & look into lifestyle changes. Not for everyone I know but it has given me back my control. I started by reading The Good Skin Solution by Shann Nix Jones. I can now get my shoes on, walk & sew ! My Dermatologist is following my progress with great interest & is now doing his own research.

Everyone is different & my thoughts are with you as I really do know how you feel.

Posted Tue 12 Sep 2017 8.15pm by Roofire

I've tried both.......

Methotrexate: Initially I responded really well, with nearly 100% clearance, the only side effect was feeling as though I'd been hit by a bus for the few days immediately after having taken my tablets. Over a period of 18 months or so, my dosage was regularly increased to combat a resurgence, it was almost as if my body was becoming used to it. Having reached the maximum dosage with the p still returning and with the ongoing side effect starting to effect my job, i agreed with the consultant that we should stop this treatment.

Acitretin: I suffered very severe side effects ranging from infected nails, major hair loss, cold sweats, insomnia......needless to say I wasn't on it for long

Posted Fri 15 Sep 2017 4.01pm by smondle

I've not tried Acitretin yet but I was on Methotrexate for 5 years. At first it seemed to be working well, though I was on 30 mg/week for 2 years before I was fully clear. This continued to work but the side effects got more unbearable, I became very lethargic (it was a struggle just to get out of bed in the morning), weight gain, and severe nausea for a day or two after taking my weekly dose of 12 tablets. Eventually a bout of stress caused my psoriasis to return again and I was taken off Methotrexate and put on Fumaderm. Methotrexate was good for me while it lasted, but as soon as I began to relapse it was far from worth tolerating the side effects.

If you're concerned at all with Acitretin, you should ask your dermatologist about Fumaderm, It is unlicenced in the UK but has been used in Germany since the 1980's and can be prescribed by consultant dermatologists in the UK ( I am seen at a London hospital). I've been on it for about a year now and it has changed my life. I am not yet clear but it is working steadily and gone are the days of lethargy and nausea. The only down side is serious diarrhoea when you first start on it, but if you can fight through that it is easily controlled with a reasonably healthy diet.

Posted Fri 9 Nov 2018 12.50pm by Stevie
Alright there! I'm Steve I'm 36 and have suffered with psoriasis since I was 18.

Hey all I'm currently sitting in a waiting room about to have bloods and pick up my first dose of acitretin. I have been on methotrexate for about 8 months I was on ciclosporin for about 6 months before that and both worked but only for a while in the end I was using 240 mg a month of dovabet at the same time. I have suffered since I was 18 and am now 36 I used to control it perfectly by having a sunbed then a baby oil bath then putting my dovabet on but unfortunately I ended up in prison and wasn't prescribed anything at all which led to me nearly having sepsis, I was over 90%coverd when I finally got put on ciclosporin and have been battling ever since but you can never let it beat you! I had a sunbed a couple of days ago and it calmed right down but boy I got a bollocking off the dermatologist today lol... I hope the acitretin works for me as I know sunbeds aren't really the best thing... But they work! What to do???

Posted Sun 2 Dec 2018 11.17am by jk76

After being prescribed all the lotions and potions, my consultant started me on 10mg acitretin daily. Side effects were peeling lips, low mood and the psoriasis actually got worse. I broke down at my last appointment so was presumed my low mood is due to the medication. She now wants to start me on methotrexate although been told these can also cause low mood. My problem with these meds is the constant weekly hospital appointments for blood tests. Not good when working full time. I feel like just throwing the towel in now and just get on with the psoriasis. Think it’s here to stay

Posted Sun 2 Dec 2018 6.41pm by ChrisB

Hi, my name is Chris, I am 49 and have had psoriasis for the past 30 years.

I have tried various creams etc, light treatments etc, however nothing has worked. I cannot have the light treatments for longer than 30seconds to a minute as I also have Vitaligo. I have had this since I was 18 months old.

I have been the consultant and he has given me the information on methotrexate and acitretin but quite frankly the side effects scare me so I think I will refuse to take them.

I will look for alternative treatments.

If anyone has any suggestions or advice please feel free to make suggestions.

Thank you

All the best


Posted Mon 3 Dec 2018 10.58pm by angela r
4 years

Chris I was on acitretin for 6 years and it was great until about three months ago. I started to feel quite unwell as in muscle pain which turned to severe bone pain. I stopped immediately just prior to light treatment which had now finished. They think I may now have psoriatic arthritis. The lesions are starting to appear again. I will not be going on methotrexate as my mum was on it for 10 years and her system is totally shot at. I am attempting to deal with it through diet but it's hard. It's all about your insides I think. Good luck with whatever you decide x

Posted Wed 26 Dec 2018 10.46pm by ChrisB

Thanks Angela.

I will be advising the consultant that I will not be partaking. I have been trying CBD oil orally and will keep on with that for a while.

All the best


Posted Wed 26 Dec 2018 11.16pm by Stevie
Alright there! I'm Steve I'm 36 and have suffered with psoriasis since I was 18.

Hey all I've been taking acitretin for about 7 weeks now and my feet are peeling very badly and the palms of my hands am constantly putting lip balm on due to dry lips and the edges of my finger nails are swollen and sore but is it making my psoriasis better... Well it got worse at first but I think it is dying down now im quite pink all over but I have it from head to tow so am use to that... I use 500g of e45 a week and 120mg of dovabet a month as well... Im gonna give it the 3 months untill my check up but honestly the only thing that worked for me was a sunbed then baby oil bath then dovabet one after the other...

Posted Thu 27 Dec 2018 7.04pm by angela r
4 years


I have just started Cbd oil today orally. Are you doing the same or are you applying it to your lesions?

Posted Wed 2 Jan 2019 10.10am by ChrisB

Hi Angela. I have been taking CBD orally since the beginning of December. I am waiting to see if it has any effect and will let you know.

Happy New year

All the best


Posted Wed 2 Jan 2019 12.19pm by angela r
4 years

Chris I have had a five day trial and just ordered some more as I feel it has helped my joints so I will continue and see how I do. Good luck to you and happy new year. Let me know how you get on


Posted Wed 2 Jan 2019 12.21pm by angela r
4 years


I have also just been prescribed Ciclosporin but not going to start it just yet as I have been following the blueberries thread of comments and just about to start them today to see if they help before going on any strong medication.

Posted Mon 4 Feb 2019 8.10am by mjrbk1 (edited Mon 4 Feb 2019 8.11am by mjrbk1)

I have been taking acitretin for the last 10 years with overall very good results, throughout my 20s. It allowed me to function normally and only required occasional dovobet (now enstillar foam) for occasional flare ups, which tended to be during winter.

40mg daily worked best for me, either clearing my P or reducing it to a much less aggressive shadow on the skin.

My only side effects were the obvious skin peeling and cracked lips. This was easily managed though by exfoliating most days, moisturising after washing and always carrying a lip balm. (Vaseline like lip balms offered short term relief, but someone recommended 8 hour miracle cream which was a life saver!)

I hope you find a treatment which works for you.

Posted Sat 9 Feb 2019 11.47am by Moule

I have agreed to start taking acitretin but after reading all this, I'm not sure I want to. I already suffer low moods. The dermatologist never mentioned any of this. Is there anything positive about this drug?

Posted Fri 12 Apr 2019 0.30am by Cmmoor

Methotrexate didn’t work for me and I came off it to try acetretin as it supposedly had less side effects. After around 8 weeks the acetretin worked and my Psorasis started to clear but unfortunately the side effects aren’t very nice . Peeling skin on feet and hands, finger nails splitting and painful, headaches, severe dry skin , dry lips and feeling low ... all of this I can just about cope with but then at around 3 months I started to notice the hair loss , quite severe thinning of my hair which I couldn’t cope with . I came off the drug and the Psorasis came back almost immediately and severely and having not been on the drug for 5 weeks I am still losing hair but all other side effects have subsided. This got me down also so I have decided to go back on acetretin but a lower dose as I have limited options left having tried most other treatments available to me but I am wondering if anyone has had advice on how to reduce the side effects especially the hair loss whilst on this medication???? Pls help

Posted Fri 7 Jun 2019 7.34pm by JIMBO

I have been on Acetretin for about 6 or 7 years. The dermatologist kept increasing the dose until I was taking 40mg per day. I found the side effects became intolerable, dry eyes very dry lining of my nose and severely cracked lips. The dermatologist agreed to reduce the dosage to 20mg per day. I get a few plaques but nothing major and the side effects have been reduced to an acceptable level.

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