Ummm if he is taking methotrexate for his p, then he is being really irresponsible by not having his appointments. Other meds for it aren't as bad, but you can't assume that meds will take care of it. I have just gotten myself to 97% clear after over a year of hard work with applying topicals and the buck stops with you. If you want to be clear, then you need to use the creams.