When do I apply what creams?!

Posted Sat 15 Dec 2018 19.14 by micknug

Hi all. I'm 25 and about 12 weeks ago I broke out in Guttate psoriasis. I left it until today to get a GP appointment as I hoped it would go away. I was trying to manage it with E45 cream but it's now spreading down my arms as well and I'm getting really self-conscious about how I look. I don't wear t-shirts currently. My GP prescribed me with moisturiser, which I'm happy with how & when to apply. But she also has me using Betnovate cream and Calcipotiol ointment. They're both to be used twice a day for 2 weeks to see if there's any improvement. My question is, what's the difference between the last two creams (I know one's a steroid), and does it matter what order I apply them? Do I need to let one soak in before applying the other? Does either impact on the effectiveness of the other? My GP probably did tell me all this but it was a bit information overload at the time. Any suggestions would be most welcome. Thanks

Posted Sat 15 Dec 2018 21.17 by OhNo_NotAgain? (edited Sat 15 Dec 2018 21.19 by OhNo_NotAgain?)

Often GPs will prescribe a combined treatment (eg Dovobet) that contains each of these two ingredients. So I would assume that you can simply apply these together, no need to wait and order of application not important - but if in any doubt I suggest to phone your GP to ask, or ask the pharmacist who filled the prescription. ALSO, read the patient leaflets that came with each of them. Some years ago, steroids such as betnovate were prescribed for psoriasis. One problem many people have with steroids is that although they might clear the problem, when you stop the treatment it returns very quickly - this is referred to often as steroid rebound (you can google it). Then a few years ago another treatment was found: calcipotriol, a synthetic vitamin D derivative, sometimes prescribed as Dovonex. This did not have the rebound effect of the steroid, but was also not as effective a treatment. More recently, they have found that a combination of the two will often deliver an effective treatment, with a reduced rebound effect. I suggest you also read the Psoriasis and Treatments section of this website (not the forum), which contains a lot of information about various treatments. https://www.psoriasis-association.org.uk/psoriasis-and-treatments/treatments/from-a-gp https://www.psoriasis-association.org.uk/psoriasis-and-treatments/default.aspx

Posted Sat 15 Dec 2018 21.19 by victoria

Micknug hi ya Best ring surgery no good googling you will get different information, steroid cream go easy on it if I were you apply one wait an hour to soak in before applying the other, ring the surgery get them to ask g.p. then ring back Victoria

Posted Sat 15 Dec 2018 21.40 by micknug

Thanks guys, you've been. Really helpful. Especially pointing me to the treatment sections, I'm new to this so that's been a huge help! From what I've read the Vitamin D gel is one that I can be a little more liberal with, spreading over the skin including the unaffected areas... But the steroid cream I must be careful to only apply to the sores? So I'll put the Vitamin D on first before the steroid cream! As an aside, my GP prescribed me a course of antibiotics... I explained my symptoms started a good 12 weeks ago so is it really likely I'm still suffering a throat infection, which could be 15 weeks back?! Cheers again

Posted Sun 16 Dec 2018 09.18 by OhNo_NotAgain?

Low-level infections can hang around. My GP gave me a course of antibiotics for my outbreak of guttate psoriasis even though I presented no symptoms of a sore throat or similar. He said that I could have an infection that was not obvious. I would take the course as instructed, and acknowledge that you have a better informed GP than some. I have had plaque psoriasis to a geater or lesser extent for 40 years, and in the past 15 years or so I was prescribed Dovonex and then Dovobet. Even the treatment without steroid I still only applied to the affected skin, not to good skin. earlier this year, having been largely clear of psoriasis (apart from elbows and ears) for several years, I suddenly came out in guttate psoriasis all over my trunk and scalp. After discussion with my GP I decided not to use the Dovobet, as to apply it to each individual lesion and not the good skin was largely impractical in the case of guttate psoriasis. So I switched to using Psoriderm and Exorex on my trunk. I also started taking a vitamin D supplement daily (25ug). My GP thought that my guttate might have been triggered by a recent hip-replacement operation, and the guttate was a reaction to the trauma experienced by the body. He suggested that it might clear up after around 6 months. I found thet the non steroid col-tar treatments helped redice the vividness of the lesions and reduce the itching. I live alone and could not reach my back to apply any treatment, but i found that a nightly bath with Oilatum bath oil in the water helped to suppress the itching enough that I could get to sleep. Around the 6-7 month mark, the guttate lesions faded and largely disappeared. My scalp is no longer flaking, but does itch after 2-3 days without washing my hair. My favourite emollient/moisturiser ( I tried so many) was Doublebase Dayleve Gel - the Dayleve version has an added ingredient compared to the standard Doublebase Gel, that leaves a slight barrier on the skin.

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