<human>: Hi, I m 22 and have moderate to severe plaque psoriasis on my face, scalp and torso. I ve exhausted most topical creams and ointments, taken courses of steroids with no real results. Would phototherapy be my next course of action. Is thinking about biologics too radical?
<bot>: Hello. Thank you for writing to topical treatment with ointments and lotions is usually combined with systemic treatment/ oral treatment for psoriasis involving > 20% body surface area. Phototherapy, though is a good choice for extensive body involvement with plaque psoriasis, however, certain body sites like scalp are resistant even to phototherapy. Apart from phototherapy Oral methotrexate is a well known treatment for plaque psoriasis and can be considered in a healthy young adult. Biologics like golimumab, ustekinumab are not first line options in a young patient with limited involvement with plaque psoriasis. Scalp involvement responds well to topical steroids lotions with or without salicylic acid. Vitamin D analogues e.g. calcitriol/ calcitriol lotions are also effective in scalp psoriasis. I suggest that you visit a dermatologist in your region. Your dermatologist will assess the severity of involvement and advice accordingly. Regards