As long as I’ve lived with psoriasis I’ve suffered from seasonal allergies. In fact I’ve been diagnosed with what’s called the “atopic triad” — eczema, seasonal allergies, and asthma. (“Atopy” means a genetic tendency to develop allergic diseases, according to the American Academy of Allergy, Asthma, and Immunology.)
To ease my allergy symptoms, my allergists have suggested I try allergy shots (immunotherapy). But I balked at the time commitment of going to the clinic every week for the shots, and I couldn’t find a lot of evidence that allergy shots would benefit my eczema.
Still, I figured that if the shots helped my allergies, which can trigger my asthma, then they might be worth a try.
I also wondered if allergy shots might help my psoriasis too.
Do Allergies Trigger Psoriasis Flares?
Allergists have told me unequivocally that allergies and psoriasis are not linked. But then I found a published case report detailing a patient with psoriasis who started immunotherapy for airborne allergic reactions. The authors reported that the patient experienced “rapid and impressive improvement of the psoriatic lesions.”
That was just one person’s experience, so I didn’t want to get my hopes up too high. Besides, I found differences in my case from theirs, such as which allergens were involved and how the immunotherapy would be administered.
But I do notice that when my eczema is triggered, my psoriasis tends to worsen. I’ve met others living with atopic diseases and psoriasis who also wonder if there is a connection.
Starting Allergy Shots
My curiosity met with opportunity this summer. My allergist returned from maternity leave and asked if I wanted to start allergy shots. A quick call to my insurance provider confirmed they would cover the costs of the weekly injections.
I expressed my interest in the shots, but also that I feared my eczema or psoriasis would become triggered. She explained how we would build up to the full dose slowly and cautiously. After six months I would then begin a maintenance period of over a year on that full dose.
My dermatologist, along with my wife, Lori, both agreed that allergy shots were worth a try. My dermatologist conveyed there was a fifty-fifty chance that my eczema would improve with them. Lori shared how allergy shots greatly improved her seasonal allergies when she was a teenager.
I harbored hope that my psoriasis might respond like with the patient in the case study.
A few weeks later I entered the allergy clinic ready to start a new adventure. I would receive three injections each visit, two in my right upper arm and one in my left. Then I would need to remain in a waiting room for thirty minutes for observation.
The Final Injection
I quickly fell into a weekly routine. I drove to the clinic on Mondays for allergy shots, then watched the rest of the week to see if my skin would react one way or the other. After a few weeks I began to feel less anxious about a skin flare as I tolerated the shots better than expected.
In early September I felt my eczema begin to break out. My allergist explained that some exacerbation of eczema could occur, so I didn’t think too much of it. But the eleventh allergy shot I took, two days after Labor Day, turned out to be my last.
The eczema flare that ensued lasted for weeks and covered most of my body. To my surprise, the allergist wanted to continue the shots after a brief break. She explained how we could back off the dose while starting a new medication to treat the eczema flare.
Unfortunately, it turned out I was not a good candidate for the eczema medication due to reports that it could worsen psoriasis. I decided to treat the eczema with wet wrap therapy and took antihistamines to help with the intense itch.
My dermatologist saw me a week later. She said that it was the worst flare I’ve had in several years and agreed I should stop the allergy shots. My wife, mortified by how much discomfort I was experiencing, told me no more shots.
A Failed Experiment
By mid-October my skin flare calmed down. I felt fortunate that my psoriasis biologic kept my condition managed well enough so I could focus on treating the eczema inflammation.
In the end, sadly, allergy shots turned out to be a failed experiment. While I did learn that they triggered my eczema, I won’t know if they would have helped my psoriasis. That disappointment still lingers today.
This doesn’t mean that I’ll give up on finding ways to better manage my psoriasis. I’ll just add allergy shots to the list of tried and failed attempts as I remain hopeful something else will work in the future.
Life moves forward through trial and error, and living with psoriasis is no different.
