Different REPLY to Same Question: PSORIASIS, topical antimicrobial treatments for skin, oral, genital (etc) use

I replied to this question earlier (3 Sep 2022), but today I`m going to reply to it again because I think here I might be able to provide a shorter answer.

I replied to this question earlier (3 Sep 2022), but today I`m going to reply to it again without reviewing my previous answer because I think here I might be able to provide a shorter and perhaps clearer answer. I`ll include a link to the previously referenced question and answer here:

REPLY to Question: PSORIASIS, topical antimicrobial treatments for skin, oral, genital (etc) use

Additional information about the skin microbiome can also be found in the microbiome and dysbiosis course:

Microbiome and Dysbiosis Video #9: Dysbiosis by Location—Skin and Environmental Dysbiosis

I included psoriasis as one of the prototypes:

Microbiome and Dysbiosis Video #3: Prototypic Clinical Patterns of Dysbiosis-Induced Disease

Original question:

So, these are my questions for now about psoriasis: when you recommend the nostrils, nails, genitals cleanse with the povidone iodine, can you please tell me how many times per week or per month shall the patient do this?

And should the psoriatic skin patches be cleansed with the povidone iodine too?

Also, once we put the patient on an anti-staphylococcus aureus treatment let’s say with Berberine or other, do we continue this anti-microbial treatment for three months? Or for more if needed?

Today’s reply:

Basically people can use povidone iodine at least on a once daily basis as long as they’re not having any adverse effects or irritation from it. Surgeons commonly scrub with povidone iodine solution several times per day in the same location (their hands and under their nails) without having problems so I really don`t have any concern about the inherent “risk” of povidone iodine, which is probably the most widely used topical antiseptic in the world, either before or after alcohol, which is much weaker as an antimicrobial and much more likely to lead to local irritation.

Sure, the psoriatic lesions can be treated with topical povidone iodine as well. These commonly have secondary infections or colonization.

I think that three months is a very reasonable treatment duration for a generalized and multifaceted antimicrobial approach. As always, we have to monitor individual patient responses and sensitivities to individual antimicrobial agents, especially drug antibiotics taken internally.

As far as topical antimicrobials are concerned, I think the povidone iodine is clearly the best. The other one that has good research specifically with regard to eczema/atopic dermatitis is diluted bleach but obviously that comes with more risk of skin and mucosal irritation. Remember to also use povidone iodine in the nares/nostrils, where we typically use a 5% solution, the approved version of which is made by 3M for presurgical use.