9 Questions Everyone with Psoriasis Should Ask Their Doctor
In managing psoriasis, it’s important to attend regular checkups with your dermatologist. Taking an active role in your care means educating yourself about your condition and preparing for each appointment. This can help you and your doctor figure out how to reach and maintain the best possible control of your condition.
While your doctor is likely leading each of your appointments, you don’t want to walk away feeling confused or as if you didn’t address everything on your mind. Asking questions can help steer the conversation to address your concerns. “You should feel extremely comfortable being as open and honest as you possibly can to form a good relationship with your physician,” says Anthony Fernandez, M.D., Ph.D., a dermatologist at the Cleveland Clinic in Ohio.
Here are some questions you may want to ask at your next checkup to help you cover all the bases.
1. Is My Psoriasis Affecting More Than My Skin?
Some people may think that psoriasis is just a rash—but that’s not the case. “One of the initial conversations with your healthcare provider should be to help you understand that psoriasis is a systemic, inflammatory disease—it’s not just a skin rash,” says Fernandez. “It has implications when you start thinking about the rest of the body—including how aggressive your treatment will be.”
For example, up to 30 percent of people who have psoriasis may also develop psoriatic arthritis, an inflammatory condition of the joints. “If you have both skin and joint symptoms, that can impact your treatment plan, so be sure to tell your doctor,” says Laura Ferris, M.D., Ph.D., associate professor of dermatology at the University of Pittsburgh, as prompt treatment of psoriatic arthritis can help prevent long-term joint damage.
2. How Severe Is My Psoriasis?
“Your dermatologist should tell you how your psoriasis would be classified on a severity scale,” explains Fernandez. Psoriasis severity can range from mild to moderate to severe, depending on how much of your body is typically affected and how much the condition impacts your day-to-day life.
Generally, psoriasis is classified as mild if it covers less than three percent of your body; moderate if it covers three to 10 percent of your body; and, severe if it covers more than 10 percent of your body. Though, if your psoriasis only covers a small area of your body—like your hands or feet—but makes it difficult for you to carry out daily tasks, it may be classified higher on the severity scale.
“It’s important to know where you stand,” adds Ferris. “Have an honest conversation with your doctor and talk about how psoriasis impacts your life.”
Left untreated, psoriasis can worsen over time—which is why it’s important to find the right treatment plan to control your psoriasis at its current severity level.
3. What Types of Treatments Are Available to Me?
There’s a large variety of available treatment options for psoriasis—from topicals to phototherapy to oral or injectable medications. Finding the right treatment, or combination of treatments, that work best for you should be a decision that you and your doctor make together, based on the severity of your psoriasis, any other health conditions you may have, and your personal preferences.
“It’s important to choose a therapy that fits in with your lifestyle,” says Ferris. “Be honest about important aspects if your life—including your reproductive status, how much alcohol you drink, and how realistic it is for you to lose weight.”
4. Are There Psoriasis Treatments You’re Not Comfortable Prescribing?
“Most dermatologists are comfortable with a wide breadth of psoriasis treatments,” says Ferris. “But some dermatologists may specialize in other skin issues outside of psoriasis and may be more comfortable with topicals over other treatments, so it’s important to know that early on.” If you’re interested in trying systemic treatment, a doctor who doesn’t typically prescribe that type of medication might not be the right provider for you.
You can always get a second opinion from a provider who has psoriasis expertise, adds Fernandez. “You may be in better hands with someone other than the provider you saw initially.”
5. What Are the Signs That I May Benefit from a Change in Treatment?
Finding the right treatment regimen can take some trial and error. It can also take patience, as certain medications may take up to six months to demonstrate whether they’re working. And even if you’ve found one that works for you, over time, some medications may lose effectiveness.
“Each visit should be a discussion of how you’re doing—your skin, your joints, how your therapy is working for you, whether or not you’re experiencing any side effects,” says Ferris. These discussions can help you and your provider decide if you’d benefit from a change in treatment.
6. How Long Will I Have to Take This Medication?
Certain medications, like corticosteroids, are not meant for long-term use due to potentially dangerous side effects, and are only used briefly to clear up a flare. Meanwhile, other medications, like systemics and biologics, are meant to be taken on an ongoing basis to help maintain control of your psoriasis.
“If you have severe disease at first, you may be prescribed two or three medications to help control things quickly,” explains Ferris. “Once things clear up, you can talk to your doctor about which medications can be taken away or tapered down while maintaining skin clearance.”
Regardless of the treatment plan you are on, it’s important to never stop taking a prescribed medication without talking to your doctor first.
7. What If I Want More from My Psoriasis Treatment?
Are you really bothered by scalp psoriasis? Do you want to feel more comfortable wearing a swimsuit in the summer? If your treatment isn’t giving you the results you want, ask if there’s some other way to obtain them.
“Everyone has different goals, so your dermatologist won’t know [what yours are] unless you speak up,” says Ferris. “Bring up how important it is to you, and what treatments you’re willing to try to get better.”
8. What Other Aspects of My Health Should I Be Thinking About?
“Be sure to ask questions about what else you can be doing to take care of your health,” explains Ferris. That’s because psoriasis can increase your risk of developing other conditions, ranging from depression to heart disease to cancer.
Depending on your risk for these related health complications (called comorbidities), your dermatologist may refer you to other specialists who can better help you mitigate and manage these risks, adds Fernandez.
9. What Else Can I Do to Manage My Psoriasis?
In addition to medical treatments, making certain lifestyle changes can help some people manage their psoriasis symptoms. “You can work on modifiable risk factors—weight, smoking, overconsumption of alcohol, diet, and exercise,” says Ferris.
In particular, weight loss may help improve psoriasis severity. “And most psoriasis medications work better in people at a healthier weight,” adds Ferris.
However, notes Fernandez, lifestyle modifications are not a substitute for following your psoriasis treatment plan.
Remember: No question is off-limits. Ask your doctor everything you’re wondering about regarding your condition. It may help to jot questions down between appointments and to bring the list with you to each appointment, so you don’t forget a thing.
“Getting educated about your disease is one of the most important things you can do,” says Fernandez. And getting answers to your questions is part of the learning process. “You should feel comfortable asking any question that comes to mind,” he adds. “No question is silly or inappropriate.”
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