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UVB Works but Lifestyle Change In Order
from Paul C.

Hello! I am P sufferer living in London. I am 28 and have had P since 15. It got really bad after 24, when I started working, reduced exercise, smoked heavier than normal and drank more. Oh yeah, I ate really badly as well. I have had the topical treatments which are frankly a waste of time. I tried Psorigon and experienced the comeback from hell. I tried a course of UVB for a month before going on holiday and this was the only time I have been (virtually) free from the P.

Now it is back with a vengeance and I am starting a course of Acitretin (Neotigason), a vitamin A derivative. I am unsure whether to continue this course because the pack talks about hair loss and liver damage. Sod that. My doctor told me there are no side effects. As an aside, I am almost 100% sure that UK doctors do not give a damn about Psoriasis and that virtually all Psoriatics suffer in silence over here.

I have been browsing the responses on your site and the one that has really taken my attention is the value of proper diet (important for all) and the eradication of Candida (yeast infection). If I think back in the last ten years my diet basically read like this (how many other psoriasis sufferers out there relate to this?) ... beer (quite a bit actually), chips (fries), fast food, smoking, hardly any vegetables, chocolate, curries, Chinese takeaways, hardly any fruit, etc. etc.

I am now changing my diet completely with specific diet changes to tackle the yeast problem. This I am combining with supplements of Zinc, Antioxidants, Fish Oils, Selenium, Milk Thistle, Echinacea and multivitamins and minerals. I am going to give it one month (off the beer and the fags as well) combined with UVB treatment. I think the realization has sunk in that this is not temporary—this is how I should LIVE my life—not for the sake of getting rid of the psoriasis.

Just out of interest, how about asking psoriatic sufferers to describe their diet over the last 5-10 years? I read that while taking MTX you had a spicy Cajun meal and suffered afterwards. Any link there? -Paul C.

*****

Ed's Response: You've covered lots of ground here, Paul, and I want to respond to most of it.

On your earlier success with UVB. It was great that you achieved this. Though light therapies come with dangers of their own, clearing this way is to be preferred over many other therapies, including systemic drugs. Will come back to your success with UVB in a moment.

On your current Neotigason therapy. I understand this is a retinoid often used to supplement light therapy. Also, according to Nicholas Lowe's book Psoriasis: A Patient's Guide, hair loss is a sometimes side effect. In fact, he lists a number of mild-sounding side effects which makes me wonder why your doctor insists there are none. Perhaps he is prescribing a super-low dose for you, at least to start.... Or, perhaps, he just doesn't give a damn, as you suggest. You're not the first to report dissatisfaction with P treatment in the UK, but I'm happy to report we've heard some success stories, too. If you haven't already, read After Hospital Stay I'm Flake Free in the archives.

On diet and P. We reflect on this issue often. Most recently, this month in Reverse Koebner? and "Zone" Diet. Check it out if you haven't already. You may be quite right to decide "this is how I should LIVE my life." We all know people who seem younger than their years and stay in remarkably good health, who attribute this to watching what they eat and drink and, in essence, how they live. That's pretty strong evidence. On the other hand, instituting all the changes you have listed, on top of reviving the UVB therapy, may not enable you to determine just what does or does not work. I promised I would get back to the UVB therapy. If your sole inclination is to subdue your flaking, wasn't the UVB enough last time? On the other hand, if you make the effort to accomplish all those other changes, are you sure you would NEED the UVB therapy?

Another caution against making too many changes all at once: Just as it's difficult to tell precisely what's working or doing good, it's equally difficult to identify culprits when something goes wrong. I was forced for medical reasons to undergo tremendous life-changing behaviors in the summer of 1986. During that "summer of recovery" I felt terrible—all the time. In retrospect, even doctors tell me I changed too much too quickly.

And one final comment: You wrote you were going to give all this "a month." I'm not sure, but I do not believe a month is sufficient time to judge the consequences of any routine directed at full-body metabolism. Three or six months to a year is what I hear or read most frequently.

Good luck, Paul and keep us apprized! -Ed

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