Yup. Plaque psoriasis here. Started on my elbows when i was 18ish. Now it's pretty much everywhere, but hands and face are all that's visible in public.
The treatment ladder is pretty interesting. UVb is step one, i always felt a little silly about going in to the dermatologist for a tan. That had no noticable effect for me, but it does help some people.
The topical cremes are fairly effective for me, but it's tough to get pharmacies to give me enough. They show up with a little tube, and i have to explain that's like 3 days worth - covering the whole body 2x a day takes, like, a lot. I need nine more and i'll see you in a month buddy. And of course they thin the skin. I try not to overtreat, no creme if there's no redness. but i'm sure there are spots with consequences.
The generalized immune suppressants are pretty scary to me, 20 years of methotrexate seems untenable. I could see perhaps a short term 3 months ish run to get it under control, then touch up with the cremes.
I like the idea of the biologics. humera, stelara and enbril, are the big ones i think. narrowly targeting just the inflammation response part of my immune system seems a little less risky than the broad suppression of cancer drugs.
I dunno. it sucks. I try to use the lightest touch to get by in the hope that something better will come along, without doing too much damage right now.
Talk to your derm, of course, but for me just a really good moisturizing creme a few times a day will soften up those hard patches so they don't crack so easy. I try to keep up with the vanity treatments, hands and face, to banish the redness all the time. I tend to not worry about the rest until it gets pretty itchy - moisturizer helps keep the itching down quite a bit for me.
Anyway, i go through phases. I'm sure this summer i'll try to hit everything hard for two solid months. Maybe i can get back to a casual maintenance mode.
it sucks. you're not alone. I'm not exactly in your same boat, i'm just hoping it does not spread to my joints. At that point i think i'd have to go with a cancer drug or injectable. hopefully there will be better drugs, or the current drugs will be better understood, before that's an issue.
It sucks it can't be fixed. My least effort to make this tolerable probably isn't ideal, i'm probably over weighting the risk of side effects and under weighting the damage done to my skin by just letting things go. but you know, it's a thing. it's a thing i can't really do much about so i try not to let it dominate my life. There have been times when it really controlled my thoughts and fears. Those times suck, you'll get through them.