Solutions for skin thinning?

[kritty2009]

I have moderate psoriasis and have been applying topical clobetasol for a few months.
It seems to be helping the psoriatic spots, but has caused bruising and thinning of the skin in the surrounding, healthy areas.  
How do i reverse this?  
Sunlight helps the psoriasis, but is it dangerous to expose thinning skin to the rays?

THANK YOU

[Bhupinder Kaur, MD]

Hello,
Clobetasol is a high potency steroid and steroids are notorious for causing skin thinning and increased fragility. Taper off the steroids to low potency ones after consulting your dermatologist. The drugs that have been approved by FDA are adalimumab and Xtrac Velocity excimer laser system. Apart from that, topical medications like emollients, creams containing coal tar, dithranol (anthralin), corticosteroids like desoximetasone (Topicort), fluocinonide, vitamin D3 analogues (for example, calcipotriol), and retinoids have been routinely used. Phototherapy containing UV A has also been employed. But it is usually seen that psoriasis can become resistant to a specific therapy. Treatments may be periodically changed to prevent resistance developing. My advice would be to consult a dermatologist and discuss these treatment options so that treatment best suiting you can be decided.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[kritty2009]

Thank you for your response.

I have had a few dermatologists and they have been switching treatments on me to prevent resistance.
I have been on betamethasone, desonide, dovonex (for a year) and, now, clobetasol (once a day).  I will be undergoing phototherapy in a month.

My question is whether or not it is safe to have phototherapy on thinning skin.  
Also, should I treat thinning skin with moisturizers or is there another solution?  I have terrible bruising; but the cream seems to be working.

[Bhupinder Kaur, MD]

Hello,
Phototherapy is one of the commonest and effective treatment for psoriasis. UVB phototherapy continues to be an effective treatment. It works by exposing the skin to a type of ultraviolet (UV) light called UVB.

To be effective, 2 to 5 treatments per week are given for several weeks. The exact number of treatments varies with the patient’s response, type of UVB phototherapy prescribed, and the severity of the psoriasis. It can cause redness, irritation, burning and itching of skin and since your skin is already thinned , so it is best to discuss it with your dermatologist who had the advantage of examining you.
I hope it helps. Take care and regards.