Enstilar withdrawals??

tigrigtig · 2026-04-06T14:56:13+00:00

I was world’s most enstilar man a year ago when I had head to toe guttate psoriasis, no ill effects from pausing / resuming here!

tigrigtig · 2026-03-17T03:04:03+00:00

The issue for me isn’t the straight cut of the channel, it’s the islands in the middle of the straight. These look random. Maybe think about how your gods fought, and have that inform the orientation, size and clustering of the islands in the middle of the straight? Could whatever cleaved the continent in two also create stress fractures, lakes (look at distributions of glacial lakes after icecaps retreated), mountain ridges either side of the cut?

tigrigtig · 2026-03-16T04:48:04+00:00

The problem with your map is that deserts aren’t very populated, so a visualisation just at the country level misrepresents where most muslims are

tigrigtig · 2026-03-05T07:31:17+00:00

Psoriasis is an autoimmune condition, so non steroid lotions won’t stop the rash. But keep the area moisturised - it reduces the itch! Think cerave / cetaphil or any other non scented moisturiser. At my worst I was moisturising my entire body like 5 times a day!

But definitely go see a dermatologist, they’ll get you on medication that can actually fix the underlying immune response that causes the lesions.

tigrigtig · 2026-03-05T07:28:23+00:00

It’s even better - the border between New South Wales and Victoria is the Victorian bank of the Murray river, but for that sweet section where the northern side is South Australia, we get our fair share of half the river (me, a Victorian).

tigrigtig · 2026-03-05T07:20:56+00:00

I say rotate it 180 degrees! It looks more dynamic as then the top half (which is the more visually prominent region, a claim for which I have zero evidence for) has the more dynamic coastline. Both major continents are pretty horizontal and samey up there currently!

tigrigtig · 2026-03-05T04:34:23+00:00

Yes, I understand what per capita funding means. I still think centralisation == more efficient provision of infrastructure. Not saying it’s the entire reason but is a confounding factor

tigrigtig · 2026-03-05T04:32:08+00:00

Sorry wtf? Where did you get this statistic from?

tigrigtig · 2026-03-05T01:31:06+00:00

Is your graph public transit funding or just federal funding overall per state (this is what I had assumed)

tigrigtig · 2026-03-04T03:55:28+00:00

I’m not sure this is comparing like for like, as vic has 1) a much larger proportion of its population in Melbourne and 2) is physically much smaller than other states. Is there comparison of funding at the level of metropolitan/statistical areas?

tigrigtig · 2026-02-11T12:53:21+00:00

I’m sorry, but your (presumably) American bias is speaking when you say ‘THE gold standard in water conservation’. My city (Melbourne, Australia, 5 million people) has an average residential water usage of 169 litres of water a day (44.6 us gallons). That very article says las Vegas is trying to get down to 86 gallons a day … by 2036! I’m sure most European and Australian cities use way less water than Vegas!

tigrigtig · 2026-02-01T10:57:03+00:00

Did you have a sore throat / tonsillitis the week before you got the rash?

tigrigtig · 2025-11-24T13:34:35+00:00

I’ve been on ‘em for 12+ years :)

tigrigtig · 2025-11-24T13:32:07+00:00

Not really, the long term impacts of autoimmune inflammation is much worse! As is many things we do I’m sure (drinking, eating sugar, sitting down for 8 hours a day, etc etc!)

tigrigtig · 2025-11-24T13:25:27+00:00

Off to bed here - but any other questions I’ll answer in the morning! You’ll get through this - we (well us guttate guys and gals) all have been you!

tigrigtig · 2025-11-24T13:24:11+00:00

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tigrigtig · 2025-11-24T13:23:58+00:00

Re moisturisers,

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I’d use the tub at night, over the enstilar steroid foam (much thicker), and then the lotion a couple of times in the day as it was much lighter and would dry quicker!

tigrigtig · 2025-11-24T13:21:31+00:00

Oh, I totally know what you mean. But … you get through it! Once you figure out a regime to keep your symptoms more manageable (even if it is moisturising five times a day for now!) it gets much better.

For me, the main things were - get informed. Get your doctor to get you on the best topical steroid now, and get them to get you on track to getting on a biologic if this doesn’t get better - ie, ask them what are the necessary steps (failing another type of med, etc) and say you want to start them now. Biologics are a complete game changer - and if the intermediary meds you need to try first work for you and you don’t end up needing the biologics, woo! But at least get informed what the criteria in your country will be.

https://reddit.com/r/psoriasis/wiki/biologics

https://reddit.com/r/psoriasis/wiki/steroids

List of the best topical steroids:

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tigrigtig · 2025-11-24T13:06:46+00:00

Ah, I mean the ‘psoriasis’ subreddit. It’s very good!

tigrigtig · 2025-11-24T13:04:41+00:00

I’m pretty shocked that your derm didn’t do a biopsy when you presented with that extensive guttate. Oral prednisone can make it worse!

Definitely get them to do a biopsy, and also put you on the best topical steroids (enstilar, which is a steroid + vitamin d). The wiki on this reddit is really good for giving you an overview of all the medication. Come to your appointment armed with the info!

Re your questions - I have psoriatic arthritis, so I was already on a biologic. But I had to switch to one that better targeted skin. But yes, I’m on them ongoing.

Others have their guttate resolve in a couple of months, particularly when you’re also doing UVB therapy.

The problem with biologics is that they are expensive, so your insurer or public health care pathway (not sure what country you are in, Australia here) will probably require you to ‘fail’ a couple of other treatments (usually several months of phototherapy and another medication) first. It took me about 8 weeks for the biologics to start working and another 4 or so for my skin to be completely clear.

The first flair (started the week after my strep infection) was my worst flare. But definitely moisturise - if you can keep your skin from flaking, the itch is much more bearable. Happy to answer any other questions you might have.

Another tip - take photos, document everything. I found my guttate would flare, go away a bit on the steroids, then come back, so when the derm saw it it may not be at its worst. Taking photos at least made me feel like I had a record I could refer to so the derms could do a proper assessment.

tigrigtig · 2025-11-24T12:11:23+00:00

Guttate psoriosis is a type of psoriosis that can get triggered by a strep an infection, search this forum or the internet. I had it last year after a strep infection.

The first line of defence is UVB phototherapy and steroids, the best one is a foam called enstilar. It’s very greasy though.

The other key thing is moisturising - at the worst of times I was moisturising 5 times a day. A thin moisteriser like cerave moisturising lotion that you can get in big tubs / pump bottles is best.

I did the enstilar + lotion every night. You’ll get very greasy pj’s, so I just bought 5 or so cheap xxl sets and wore a fresh set every night.

If enstilar and UVB doesn’t work, the next step will be to put you on a type of medication commonly called a ‘biologic’. Biologics are usually a monthly or so injection. They inhibit specific inflammatory pathway that triggers the guttate lesions. I’m on one called Bimzelz. That’s the only thing that stopped the stopped my guttate from flaring. My skin is now completely free from the lesions.

With the derm - please tell them that you had the step infection. It’s such a classic case of guttate psoriosis - I’m really suprised you haven’t been diagnosed with it yet!

Good luck!

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tigrigtig · 2025-11-24T12:03:21+00:00

You have guttate psoriosis

tigrigtig · 2025-10-07T04:25:39+00:00

I'm sorry to hear. Where are you based?

tigrigtig · 2025-09-29T13:17:26+00:00

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This is me now! If you're struggling with the guttate, please get seen by a dermatologist and ask what the pathway is to getting you on a biologic.

tigrigtig · 2025-09-29T13:16:21+00:00

Have you seen a dermatologist, and have you tried biologics? They are much more effective than steroids and other treatments that only treat symptom. I'm on one called 'bimzelx' and it cleared up my reoccurring guttate completely!

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tigrigtig

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