People With Psoriasis On The Best Questions They’ve Asked Their Doctors

From glamourmagazine.co.uk

A psoriasis diagnosis can be overwhelming. Suddenly you’re told you have a chronic skin condition with no cure – and that’s a lot to take in. So it’s totally understandable if you go through the rest of your doctor appointment in a daze. Once you come out of it and process this information, you probably have questions. Like, a lot of questions.

While your doctor will probably run through the basics – symptom management, recognising flares, treatment options – they can’t cover everything in one appointment or even know all of the details you need for your particular lifestyle. That’s why connecting with other people who have psoriasis can be helpful.

With that in mind, we spoke to several people living with psoriasis to learn the best questions they’ve asked their doctors – and why the answers were so helpful. Keep these on the back burner for your next doctor visit if you’re still navigating the nuances of this disease.

1. Can psoriasis affect my health beyond my skin?

Fitness and nutrition coach Lauren Scholl was diagnosed with psoriasis when she was 16 years old, and at the time she didn’t fully understand how the condition could impact her overall health.

“Everyone suffers from psoriasis differently,” she says. “I had it on my elbows and ankles and I was like, Nobody notices those things. I’ll live with it.” But Scholl, now 34, says it wasn’t until she started asking questions that she learned psoriasis could be linked with other symptoms she was experiencing, like joint pain.

When she was 28 Scholl was diagnosed with psoriatic arthritis, a chronic inflammatory arthritis that affects roughly 30% of people who have psoriasis. “I definitely never would have thought that my skin patches could be linked to joint pain,” she says. “Nobody ever asked me if I had joint pain. If they had, I would have said ‘yes,’ and I could have been properly treated sooner than I was.”

2. What do I need to know about my type of psoriasis?

Sarah Boutwell was diagnosed with psoriasis when she was 12 and psoriatic arthritis when she was 23. Now, at 37, Boutwell says she’s struggled with symptoms like red, itchy patches on her elbows and knees and smaller red dots on her legs and arms.

“I have red spots on 85% of my body most of the time,” Boutwell says. “But now that I’m at an age where I don’t care what people think anymore, I’m no longer afraid to wear shorts and other clothes that show my skin. My skin deserves to see the sun without being judged for my spots.”

Boutwell says it’s been helpful for her to find out more about her particular form of psoriasis: guttate psoriasis. (Psoriasis can appear in many forms, including plaque psoriasis, which is the most common type, as well as guttate psoriasis, inverse psoriasis, pustular psoriasis, and erythrodermic psoriasis, all of which have unique symptoms that affect the skin differently.)

“Asking what the different types [of psoriasis] are and how they affect the body was important for me,” Boutwell says. For example, she learned that guttate psoriasis in particular is likely to flare after an infection. Knowing the nuances has helped her better predict and prevent flares and find the right medication, Boutwell says.

3. Are there other medications that might work better for me?

Scholl says she was originally given a diagnosis of dermatitis, which is a more general term to describe skin inflammation. But the patches on her skin didn’t get better with the mild treatments she used. “Generally doctors don’t prescribe strong medications for that type of condition,” she says. When she finally got a biopsy of her patches and learned that she had psoriasis, she was put on stronger, more effective biologic medication. Biologic medications, which are often recommended for people with more severe psoriasis, alter the immune system to interrupt the disease cycle, according to the Mayo Clinic. 

“That was so helpful,” Scholl says. “Psoriasis is an autoimmune condition, and a lot of people need stronger treatment, depending on how much their symptoms bother them.” Being upfront with your doctor about your symptoms and how a medication is or isn’t working for you is essential for finding the very best treatment regimen for your needs.

4. Are there any topical medications that actually help?

Scholl didn’t get complete relief from her biologic medication, which is why she asked about other options. One medication she was given is a prescription foam (made of a corticosteroid and vitamin D, to help knock out inflammation and slow the growth of skin cells) that’s applied directly to her psoriasis patches. “That’s worked really well for me and is just topical,” she says.

She also started using medicated tape over her patches. “It was the only thing that worked,” she says. “It would hold the medication on my skin and would provide relief from the itchiness.” Unfortunately the tape was discontinued, so she had to get creative with her doctor’s guidance. “I started using cortisone cream and wrapping it,” Scholl says. “That’s been helpful for some specific spots.”

5. What skincare products should I use and avoid?

Linda Tran, 33, was diagnosed with psoriasis when she was 20 years old. At the time, she had small red rashes and dry, flaky skin on her legs, back, and along her hairline. But Tran says that since then she’s experienced flares here and there that can cover more of her body. In addition to asking her doctor how her treatment should change as the severity of her disease fluctuates, she also specifically asked her doctor which skincare products could help with her symptoms. 

Her doctor recommended using a thick moisturiser that’s rich in ingredients that help protect the skin barrier, like ceramides and hyaluronic acid. She says she also uses a traditional healing ointment – but “not too much because it will clog my pores” – to help seal the hydration in.

Tran says her doctor also suggested using a gentle soap without fragrance or exfoliating beads. “Those can affect my skin when I’m scrubbing myself,” she explains. Asking your doctor about the skincare treatments they specifically recommend for you will help you find the right products that won’t further irritate your skin during flares.

6. Is this medication safe to use while pregnant and breastfeeding?

Tran says she’s considered taking biologics, but she also plans to start a family in the next few years. “I asked my doctor if it would be safe if I wanted to get pregnant in the next year or two, or if this medication would affect the baby,” she says. And she’s glad she asked: Her doctor said there was a possibility that the medication could have a negative impact on the pregnancy, so she was steered toward different treatment options for this time in her life.

That doesn’t necessarily mean you must avoid biologics while pregnant. It ultimately depends on the specific medication in question and how necessary it is for your health and well-being. Some biologics have been shown to cross the placental barrier, which means the medication may reach the foetus. In some instances this has been connected to birth defects; in other cases the risk is unclear. But most doctors recommend erring on the side of caution. Some classes of biologic medications, though, are considered safe during this time—the amount, if any, that seems to cross the placenta is small enough that it likely doesn't impact the foetus. 

Ultimately, taking medication during pregnancy is a very personal decision, and it’s important to weigh the pros and cons – depending on how severe the psoriasis is and how it’s impacting a pregnant person’s physical and mental health, staying on a biologic through pregnancy may be the best option. It’s important to work with your doctor to figure out the best course of treatment for you if you’re pregnant or planning to become pregnant soon.

7. Can the kind of clothing I wear help my symptoms?

Bianca Michelle, 44, was diagnosed with psoriasis in 2007 after she developed spots on her legs, back, arms, stomach, and ears for a year. (Michelle says that her mother has psoriatic arthritis and that she knew what her symptoms meant but didn’t want to seek treatment right away.)

Michelle says her psoriasis was “mild at first,” but she went to see a dermatologist after her condition worsened. She ended up taking a biologic medication, which has helped improve her symptoms, but she’s also learned that certain fabrics are more irritating for her than others.

“I wear a lot of natural clothing and have found brands that make very stylish clothing made of hemp, cotton, and bamboo,” she says. Generally she finds that synthetic fabrics—such as nylon, polyester, and spandex—are “very uncomfortable” when dealing with untreated psoriasis.

Of course, this totally depends on the person and where the psoriasis patches are located, which is why it’s always a good idea to ask your doctor about what they recommend when considering the location and severity of your symptoms—because even a small change could make a huge difference in your day-to-day comfort.

https://www.glamourmagazine.co.uk/article/psoriasis-questions-to-ask-doctor