Hi everyone. I went with my son Jon for his scheduled derm appt. I have researched a new doctor from this website and have an appointment but I thought we would go just to see what he had to offer. Let me share. These are the creams he prescribed, Topicort x 4 weeks, then dovonex. For his head he prescribed Locoid 1% solution and then said to use T-gel shampoo, which we already do. I wanted to run this by all of you and see what you think.
Thanks everyone!

Hi Alicia,
I'm sorry that Jon's appointment with the derm didn't go as well as you had hoped. Unfrotunately, it sometimes takes several tries before you find the derm that's right for you. Hang in there!
Here's my thoughts on the medications that he suggested:
Topicort: I have no experience with it, but I did some research and discovered that it's listed as a Class 2 -- Potent Steroid. (Steroids are classified by strenghts, the lower the number the stronger the steroid. So that means that there's only one class of steroids that's stronger the group that Topicort is part of. Here's a link to a thread that includes a copy of the NPF's steroid classification chart:. Class 1 steroids and Class 2 steroids (like Topicort) can only be used for brief periods of time in order to prevent certain side effects like skin thinning. That's why your derm wants you to use it on Jon for only a couple of weeks. You can probably switch to the Dovonex at the end of two weeks, if you're concerned. (F.Y.I., my derm limits the use of the stronger steroids to two weeks max.) Here's a link to a previous post from someone who uses Topicort: .)
Dovonex: isn't a steroid. It's a synthetic (man-made) form of vitamin D3 that is used to treat mild to moderate psoriasis. I use it and so do a lot of people who post here. Everyone and their psoriasis is different and what works for one person may not work for another. Some people have gotten great results from it and some people report that it they've been disappointed with it. It find that it keeps the psoriasis on my ankles under control. I have to use it in combination with Protopic (another non-steroid) and Ultravate (a Class 1 or Superpotient Steroid) to keep the psoriasis on my hands under control. I used to use it on the psoriasis in my ears. Unfortunately, it stopped working there. (That actually happens sometimes, a medication that has been working great will suddenly stop working. It will work again the next time (or the time after that) that you try it.) It can very very frustrating. Here's a link to the NPF's discussion of Dovonex: .
Locoid 1% solution: is a CLASS 5 or Lower Mid-Strength steroid. It's safer then the Topicort because it's not as strong. Jon's derm problably wan't to limit it's use because it is a steroid. That's actually a good idea. I haven't used the solultion, but I sometimes use Locoid ointment on my hands. Here's a link to thread where it's mentioned: .)
I'm sorry that this turned into such a novel. You're probaly suffering from information overload. :rolleyes: I hope it helps. Keep us posted and please don't be a stranger.
Mike

I'm not impressed with that Rx. For an 8 year old I would think that Topicort is too strong. If it were to be used I would say twice a day for one week, then once a day for one week and Dovonex the other part of the day, then from there on use Dovonex twice a day. I'm a firm believer that steroids are a last resort (this based on personal experience). Dovonex, Elidel, Protopic....heck I would even do UV before steroids knowing what I know now.
Hopefully your new derm will be the derm on your dreams!

Hi Chaim and Mike!!!!
Thanks so much for the info. I was waiting to hear some info before I filled those scripts. I wasnt so thrilled about him useing steroids either and thanks to you Mike knowing how strong the one he prescribed is I think I'm going to pass until the new derm appt. He has been using dovonex for quite a while now. I was kind of wondering something. When he got out of the shower yesterday I gave him a good once over (for him it was tragic, I saw him naked :o) but anyway, the p that is on his elbows, knees and legs is red and almost resembles abrasions. It was was white, thick and scaley at one time. Now he is getting like little dots of P everywhere. Its all over his hands, behind, genital area and it is almost like speckeled on him and white. I was curious if he may have 2 different types. Also I wanted to tell you that I did buy the paul mitchall tee tree shampoo and we are useing the aveeno bath wash and oatmeal bath too. Thanks for your world of information as always!!!! Take care and talk to you soon!!!
Alicia

Hey Alicia
How are you doing? I just thought I would write to tell you Hello and Thank You for keeping us updated. About your question if he can have more than one P? Jessie has Inverse and Guttate P. She also was showing some signs of having Eczema also but I don't think that was not the case. (Her Inverse can sometimes look like Eczema). I would say it is either another type of P or it is changing because of the meds. Jessie's Inverse started out really white and bumpy and is now red and sometimes with a little white. I agree totally with Mike about too many steriod creams for kids. Jessie was on 4 of them before we found Dovenex. Well back to work. Please keep us updated on the new derm.
Talk to you soon
M

Hi Alicia,
You're very welcome. I'm glad that I was able to help. I'm also glad you decided to wait until you see the new derm. Keep using the Dovonex in the meaning. However, you CAN'T use the Dovonex on Jon's face or other sensitive areas like his genital area. If you feel that you have to treat it with something you can use vaseline or even Desitin. (The diaper rash cream. Several people have posted here that the one with aloe in it is very helpful.) (Here's a link to the second page of a previous thread, where it's discussed: .)
Unfortunately, as Marielle mentioned, it's possible to have more than one type of psoriasis. Based on your description, I'm guessing that Jon has on his elbows and legs, etc. and everywhere else. Guttate psoriasis is often described as looking like someone took a paint brush and spattered pain all over your body. The so-called paint spatter presentation is sometimes a sign of strep. The paint spatter presentation can be very difficult to treat with topicals (i.e., lotions, creams and ointments), because large parts of the body are sometimes involved. If that's the case, Jon's new dermatologist may suggest that he undergo UVB light treatments. (Marille's daughter, Jessie, was helped by going for UVB light treatments.) Light treatments are very time consuming because you have to go three times a week at the very beginning. You may also run into insurance issues. (The NPF has an insurance advocacy service that will try to help with any insurance issues that may arise.) Not everyone responds to light treatments, and some people have also been burned by them, but they can be a very effective weapon in the war against psoriasis. (Depending on the doctor and the extent of their coverage (i.e., how much of their body is covered with psoriasis) some patients have to continue using topicals in addition to going for UVB treatments.) Home units are available and those are usually covered by insurance. (Again, the NPF has an insurance advocacy service.) A prescription is required. Since not everyone reponds the the treatments, most doctors and insurance companies generally require that UVB patients undergo their initial treatments at a doctors office or clinic or day treatment center, before they start talking about a home unit. Here's a link to the NPF's discussion of light treatments: .
Hang in there! I hope this helps. Good luck with the new derm. Keep us posted and please don't be a stranger.
Mike

Hi Marielle
Hope all is well with you and yours too! I am definatly going to stay away from the steroid creams until the derm appt on Feb.19th. Although the dovonex doesn't seem to be working on him and he just looks awful. His legs look like he's been through a war. His itching doesn't help. Monday we have an appointment with his ped for a strep test. Maybe that will be the beginning to some anwsers. Thanks again! Tell Jessie that Jon says hello!
Alicia

Hi Alicia,
You've gotten some really excelletnt advice so far from the gang, and they are dead on accurate. Mike's links are always so helpful.
I would like to point out that I agree with Chaim about conservative use of steroids with children. I am a psor myself, with almost 30 years of experience dealing with this disease. I am also the Mom of children who experience situational bouts of p.
One thing that my friends forgot to mention is that you should watch your child for any signs of psychological changes while using topical steroids. I am sure Mike will come along and post a link at the beginning of next week for you to read more on this topic.
In a nutshell, use of the stronger topical steroids over any large portion of the body introduces the potential of systemic absorbtion. In some rare cases, more frequently seen in men than in women, this can lead to pshychological disfunction. Namely, excessive aggression is of the most concern. There can also be changes in general additude and appetite. In some very rare cases psychosis may be induced.
I do not want to frighten you. Generally, judicious use of steroids for a short period of time, even the more potent ones, will not cause these side effects. However, in the past I have seen a few folks who post on the boards here who have experienced some of these side effects from prolonged use of potent steroids.
A good derm will monitor your son's progress on a regular basis and ask questions to make sure that these ae not issues you will need to worry about.
It is important to adhere strictly to the schedule that your dr outlined for the medications and the duration of use.
Unfortunately, this is a disease that requires daily treatment to control, and discipline with the regimine is the only way to gain the best sucess.
I often find that keeping a daily log of treatment and results/observations is very helpful when determining a course of ongoing treatment. The Dr will love you for it, and your child will benefit.
If we can help any further, please let us know.