Other types of medications can also present challenges — like side effects and cost — but given the array of options available for treating psoriasis, these types of challenges usually can be overcome.
When to Speak Up
Self-trust is key to fine-tuning your psoriasis treatment. Don’t second-guess your gut feeling, advises dermatologist Steven Feldman, MD, PhD, a professor at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina, and a member of the medical board of the National Psoriasis Foundation. Honesty is important as well. Let your doctor know if your treatment plan isn’t working for you. “The more open you are with your doctor, the better,” Dr. Feldman says. “There are endless ‘next steps’ in psoriasis treatment,” he says. There’s no reason you should not ask about them. Here are seven signs it may be time to talk to your doctor about new ways to manage your psoriasis.
1. You can’t or don’t want to use your medications as prescribed.
Feldman says even medical experts are surprised to learn how few people follow their treatment plan exactly as outlined. And when it comes to the messiest psoriasis treatments — especially thick topical creams, moisturizers, and scalp preparations — some people don’t even fill the prescription.
2. Your prescriptions are too pricey.
Let your doctor know if your budget is limited and/or your insurance won’t cover your psoriasis medication. Don’t be embarrassed or assume you don’t have options. There is likely to be an effective treatment approach that won’t force you to choose between managing your psoriasis and paying for other necessities.
3. You have ongoing psoriasis flares and it’s bumming you out.
Your quality of life is more important than your quantity of flares: “Your doctor won’t determine if it’s time to change your psoriasis treatment based on how many skin lesions you have,” Feldman says. “The reason to change treatment is if you’re unhappy with how you’re doing in general.” If your treatment isn’t preventing flares, let your doctor know and be specific about the problems, such as flares making it difficult to feel your best in professional or social settings.
4. Your current treatment isn’t working as well as it used to.
It’s possible your psoriasis is changing, or perhaps you’ve had life changes that are making it more difficult to control. Either way, another treatment approach may be more effective.
5. You’re unhappy with certain side effects.
Talk to your doctor about the benefits and risks of treatment alternatives. “Don’t forget some of the basic psoriasis treatments,” Feldman adds. You may, for example, be able to do phototherapy (light therapy) at home. It’s effective for many people with psoriasis and virtually free of serious side effects.
6. Lesions begin to show up on body parts that weren’t previously affected.
Psoriasis most commonly appears on the elbows, knees, lower legs, and scalp. However, a study published in the British Journal of Dermatology identified 26 different areas of the body where plaques can form. If you start to develop lesions on previously clear skin, talk to your doctor.
7. You’re noticing signs of psoriatic arthritis.
Psoriasis isn’t just a cosmetic issue; it’s also linked to an increased risk of a number of other health conditions. Among the most common of these is psoriatic arthritis, which affects nearly 20 percent of people with plaque psoriasis, according to research published in the Journal of the American Academy of Dermatology. According to the Arthritis Foundation, the symptoms of psoriatic arthritis include:
Stiff, painful jointsSwelling that causes fingers and toes to take on a sausage-like appearancePain in tendons and/or ligamentsSkin rashesNail changesFatigueReduced range of motionEye problemsIncrease in flares
Tell your doctor if you begin to experience any of these; they may determine you need a stronger medication, says Feldman. With the number of psoriasis treatment options available today and new ones being introduced all the time, there’s no reason to feel you have to live with out-of-control flares or hard-to-use medications. Talk to your doctor so together you can develop a new treatment strategy that will be more effective in keeping your skin clear and comfortable.
