How to Make the Most of Your Psoriasis Checkups

From everydayhealth.com

Your doctor’s time is precious — and so is yours. Take these steps to speak confidently with your dermatologist and better manage your psoriasis 

If you feel like doctor’s appointments are short, it’s not your imagination. Research shows the average length of a primary care visit is around 18 minutes — hardly enough time to address your health concerns in depth.

But when you’re managing a chronic condition like psoriasis, every minute counts. You want to make sure you have time to share and get all your questions answered. 

Unfortunately, people with psoriasis don’t always get equal face time with their doctors. Research shows that the amount of time dermatologists spend with psoriasis patients may fluctuate based on the individual’s racial and ethnic background. And the findings suggest Asian people with psoriasis receive significantly less time with dermatologists.

Howard Chang, a psoriasis patient advocate and long-time Everyday Health blogger based in California, isn’t surprised by these findings. The son of Chinese immigrants, Chang recalls when both of his parents were diagnosed with psoriasis in 2014. When seeing a dermatologist, “They wouldn't really engage too much,” he notes. “It’s a very cultural thing. Just listen to the doctor, and the doctor is the authority.” 

Language barriers may also be a factor if someone isn’t comfortable speaking English, Chang adds. A lack of communication can lead to worse health outcomes if your doctor doesn’t know how you really feel or how closely you’re following your prescribed treatment regimen. 

That’s why it’s important to take steps to make the most out of every minute you get with your dermatologist.

What to Expect at a Psoriasis Checkup

To maximize each psoriasis check-up, you need to know what to expect.

During each visit, your dermatologist will ask how much of an impact psoriasis has on your day-to-day quality of life. They’ll also ask whether you have any new or worsening symptoms, including joint pain, which can be due to psoriatic arthritis. 

Your dermatologist will likely examine all of your skin. “We’re looking at the psoriasis — not just at the distribution or how much is involved, but also how thick the individual plaques are,” says Marisa Garshick, MD, an assistant clinical professor of dermatology at Weill Cornell Medical Center and dermatologist at MDCS Dermatology in New York City. 

What’s also important is a head-to-toe exam to check for skin cancer, which you may be at higher risk for if you’ve undergone phototherapy for psoriasis. 

If you have ongoing psoriasis symptoms, you’ll also discuss whether you may benefit from a change in treatment. You may even get in-office treatments, such as cortisone injections, to help calm any active psoriasis flares. 

          Developing a good relationship with your dermatologist can help you stay on top of the condition. Adobe Stock

Strategies to Try at Your Next Psoriasis Checkup

Now that you know what to expect, use these steps to get the most out of your next doctor’s appointment for psoriasis:

1. Check in online. Many healthcare systems now offer an online check-in process that you can fill out a day or so before your appointment. This gives you the chance to make any necessary updates to your contact info, pharmacy details, and insurance information. You’ll also be able to review any copays or balances owed to your dermatologist. Filling out this information before your visit can help make your life easier once you get to the appointment. “That way, there are no surprises when you check in,” says Chang.
2. Write down what you want to get out of the visit. This might include asking for medication refills, going over new symptoms, or talking about new treatment options. Chang uses a checklist in the Notes app on his iPhone to keep a running list of questions and answers from his dermatologist visits. “As I go through the appointment, I’ll check things off,” he says. “And the doctor, she knows now about my list, so she’ll point at my phone and say, ‘Anything else?’” 
3. Bring a friend or family member. An extra set of eyes and ears can be a big help. Your loved one can help remember what questions you wanted to ask and what the doctor says, Dr. Garshick notes. If there’s a language barrier, it can be especially helpful to bring along someone who is fluent in English — or ask for an interpreter — to make sure you understand all of the information, she adds.
4. Arrive early. Even if you’ve completed the check-in process online, it can still be helpful to arrive 15 minutes early for your appointment. Having downtime beforehand can be extra beneficial if doctor’s visits tend to stress you out. “If they’re going to do a blood pressure check, it’s nice to get there a little early, so you’re calm by the time they take the measurement,” Chang says.
5. Tell your doctor about every medication you’re taking. That includes any that aren’t for psoriasis, as some treatments for other conditions can actually worsen psoriasis. “Beta-blockers (which are sometimes used for blood pressure or heart rate), some antimalarial medications, and coming off of steroids can all trigger psoriasis,” says Garshick. Also, tell your dermatologist if you’ve just had an infection or were recently on antibiotics, which can contribute to psoriasis.
6. Be honest about how you’re feeling. Your dermatologist can’t help you if they don’t know what’s going on — even if it doesn’t seem related to your skin. “Reflect on anything that feels new or different for you,” says Garshick. That includes whole-body symptoms, such as fatigue, or joint pain. “Your dermatologist may not be able to address all your symptoms, but they might be able to guide you on whether or not certain things are connected to psoriasis or not,” she notes.
7. Speak up if something isn’t working for you. “I used to be ashamed if I wasn’t following the doctor’s orders perfectly,” says Chang. “Let’s say I was supposed to apply an ointment twice a day, and I was doing it every other day instead. I didn’t want the dermatologist to be upset with me, so I might not tell her. But in the end, it’s your health. If you’re not able to follow instructions, there may be something else you can do.” So, speak up and be honest with your doctor. 
8. Get your to-dos in writing. Ask for a written summary of the visit, so you can confirm exactly what you’re supposed to do, including your treatment plan and when to schedule your next visit. “If you’re just learning about psoriasis medicines, ask for brochures,” Garshick says. You can also research medication options on the National Psoriasis Foundation (NPF) website, she adds.
9. Take advantage of the patient portal between visits. If you need time to process what your dermatologist says or to ask questions after the visit, you can often do so through your healthcare system’s online patient portal. “Sometimes, in the moment, you forget something you want to ask, or you feel like it’s hard to say something,” says Chang. Sending your doctor a message through the patient portal is a good way to follow up.
10. Follow your treatment plan. Chang has found that following his psoriasis treatment plan exactly as prescribed allows him to see if a specific treatment really works for him. It’s also helped strengthen his relationship with his dermatologist. “If something’s not working out, I can say, ‘Hey, I did this, and I’m thinking of trying that now,’” he says. “Your doctor is likely more willing to consider what you want when you’ve already built trust by doing what you’ve agreed to do before.”
11. Take time after your visit to think about what feels best to you. “Remember that psoriasis is a chronic condition. So find a doctor that you feel comfortable with, so you can establish a long-term relationship,” says Garshick. If you aren’t seeing results or you feel uncomfortable with your doctor, don’t be afraid to try someone else. “Not all dermatologists are specialized in certain kinds of psoriasis or are up on the latest medications,” says Chang. “If you can’t work with your doctor, or they don’t have the expertise you need, then you might need to make a change.” The NPF has a directory of doctors who specialize in treating psoriasis. 

For more tips on how to make the most of your check-up, download the NPF Appointment Prep Kit.

https://www.everydayhealth.com/psoriasis/how-to-make-the-most-of-your-psoriasis-checkups/