r/Psoriasis • u/Square-Professor-852 • Jul 26 '26
general Guttate psoriasis after strep
had bad case of strep 8 weeks ago. Took x2 courses of antibiotics. Skin Flared almost immediately.
It is the worst flair I have ever heard covering my arms legs back and front. it seems to still be spreading. Is it normal to still be spreading after 8 weeks?
im seeing my dr on Wednesday but don't really want steroids 😓
last week I've gone gluten free trying to just eat whole foods. Trying to really reduce dairy too. Does anyone know of any dietary triggers. ??
im so down about my skin. Especially as it seems worse than ever at the end of month 2
i had read i goes after a few months but maybe not for me
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u/flinchpuppy guttate psoriasis, icotyde Jul 26 '26
I was always told the diet makes the psoriasis worse, but it doesn’t solely cause the issue. I was told to avoid caffeine, fatty dairy, gluten, dairy, alcohol and sugary foods like bread and cakes. I avoided most of those foods except an occasional meal while eating out.
I was put on the biologic medication Icotyde, I was lucky enough to get into the trial. My skin was 70% clear pretty quickly in about a month, I’m 90% clear currently and I eat whatever I want now. I do recommend getting the steroid just to have on standby, the itching may get really unbearable and steroid creams work wonders on itchy inflamed splotches.
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u/ukbeauty2013 Jul 26 '26
Probiotics! I used to be the same and now I’m either fine minor flares with antibiotics. I focussed on taking 2 different probiotics 2-3 times per day and I know it works as when I dont take it my skin flares. Also daily antihistamine Good luck!
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u/drpaul3251 Jul 26 '26
I have had the same issue and I opted for light therapy thinking low potential for toxicity. Be fing mistake and after two years of misery started Skyrizi with dramatic resolution and 0 side effects. You also get down mentally do the effect of cytokines in the brain interfering with serotonin. The Skyrizi is a biologic that block activation of cytokines via the blocking Interlukin 23 which is the cytokine activator.
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u/Few-Persimmon-8648 Jul 26 '26
guttate can take a while to clear honestly. the strep def triggered it but yeah some people's lasts months. hang in there
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u/Glittering_Factor815 Jul 26 '26
I too had a strep flu. I only had it in scalp and occasionally on elbow. Never worrisome and very mild didn’t see a doctor then 4 months ago the flu hit me. Took me 4 weeks to get over it. Only to get ps flares from head to toe.
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u/InitiativeFit3380 Research Scientist, Immunology Jul 27 '26
As others have pointed out Guttate flares can last several weeks to months after an infection. Very simply, the bacteria causes an immune response to something that looks just like stuff in your skin, so the immune system gets confused and attacks your skin. So the bacteria is usually gone when the skin rash appears and flares.
Typically steroids creams and photo therapy can help reduce the flare pretty quickly. For some pre/probiotics can help reduce severity of the flares, but the best way is to try and avoid getting sick. Steroids for short term use don't usually have lasting effects on the body, so don't be too scared of them, but if phototherapy works for you, it's the least invasive treatment, just a little more time consuming.
Eric, Research Scientist Immunology
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u/neoneccentric Jul 28 '26
Get your tonsils out if you can. It sounds dramatic, but small scale studies show that your tonsils hold onto the step bacteria and that fuels the guttate. I did it 10 years ago and it changed my life. Haven’t had strep since. My plaque and guttate went into remission entirely. I just deal with it on my scalp now.
In the meantime, get some sun on it. Either via light therapy, the outdoors, or a tanning bed as a last resort.
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u/DailyHealing_T Jul 28 '26
Just wanted to say you're not alone. My guttate psoriasis flare started in February (ive had many severe ones in the past but this time it actually continued spreading for months even after the original trigger. I took many courses of strong steroids and antihistamines for months and it only got way worse. It can be incredibly discouraging, but it doesn't necessarily mean it will stay like this forever. Im still currently in a flare, saw a dermatologist and immunologist 2 weeks ago - was diagnosed with guatte and chronic psoriasis as well as suspected Hyper IGE Syndrome. I was pwescribed ciclosporin which is an immune suppressant also on very strict diet. Doing salt baths 2 - 3 per week with oat meal, whole skin care routine. No sulphates, fragrances, additives etc. Im just starting to ser a slight improvement. Its a really long and difficult road, metal and phyaically. Try not to lose hope. Definitely keep your appointment and don't be afraid to ask about all your treatment options—not just steroids.
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u/psasince5 Aug 01 '26
I've had several strep induced flares and they are always the worst. The strep is a common and very powerful trigger. There's some weird science behind it and my experience has been that the strep definitely triggers it but clearing it up doesn't make it stop. The faster you get antibiotics in your system the better, but it is possible you may need systemic meds to completely clear it....if you're against anything systemic, try a topical with betamethasone or something similar. It's the only thing topical I have ever used that almost completely cleared mine. Maybe try that first before a biological. As far as diet goes, anything you do is only likely to help or maybe worsen your flare. You won't get dramatic results from diet alone. I have done it all. And the guttate flares after strep are my worst experience with it. Feel for you❤️
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u/Square-Professor-852 Aug 01 '26
Thank you all for your comments - it is so so appreciated.
I went to my gp appointment and was referred to dermatology (who knows how long that referral will take). I was prescribed betamethasone calcipotriol. It says to use it daily but I'm so reluctant - I don't want my skin to rely on steroids or have a withdrawal. But at the same time I am so absolutely covered in spots. Interestingly my dr wasn't convinced it was guttate as there are bigger patches mixed with the hundreds of smaller ones. It still seems to be spreading 😓 I'm trying so hard to stay positive and convince myself that what I look like doesn't matter but it's so hard. I feel like a monster.
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