Moisture may cure problem with skin

I have psoriasis, but only on my face. After eight years of seeing two dermatologists, I'm getting nowhere. I've been told it can't be cured, just controlled. I've been prescribed a lot of creams and pills over the years. Would you have any advice as to what I could try or discuss with my GP or dermatologist?
Psoriasis is a tough one. We don't clearly understand what causes it. We know it involves the chronic overgrowth of the top skin layer, caused when immune cells inappropriately release growth stimulants called cytokines. The result is usually silvery, itchy, thickened skin patches on the outsides of the elbows and knees, and often resistant to treatment. Some patients also develop arthritis, while an unlucky few get skin breakdown and serious infections. Even with minor cases, depression and embarrassment are extremely common.
Desperate patients have tried everything over the years, from rubs made with cat faeces and sulphur baths in ancient times, to UV light therapy and human antibody therapy today. There's even a trial to see if Botox injections might cause psoriasis remissions.
Every effective modern treatment has its associated risks, such as increased rates of skin cancer with UV light or increased susceptibility to infections with antibody treatments.
My basic recommendation for all psoriatics is to never let your skin dry out. Use mineral oil to hold in the skin's moisture and wash as infrequently and gently as possible to maintain your skin's natural oils and healthy bacteria. For moderate or severe cases, work through treatments in a staged manner, using topicals, light therapies, and finally immunomodulating pills under the strict supervision of your dermatologist. And keep checking in with your doctors, as there are many new therapies in the pipeline which may prove effective.
Gary Payinda MD is an emergency medicine consultant in Whangarei.
Have a science, health topic or question you'd like addressed? Email: drpayinda@gmail.com
(This column provides general information and is not a substitute for the medical advice of your personal doctor.)