It’s not the kind of day you put in your journal. Seemingly out of nowhere, you wake up with thick, red, rough, scaly patches on both elbows.
After a few minutes of searching online, you will suspect psoriasis. What now? Can your GP treat this condition with a prescription? Or do you need to find a dermatologist and other specialists? How do you find specialists who are included in your health plan, have experience in psoriasis treatment and are a personal match for you?
First take a breath. It is important not to overtake yourself at this stage and there is no need to. Although psoriasis is a complex condition that may require a team approach to your treatment, this article will familiarize you with the various doctors and specialists and give you tips on how to research and choose them.
How your GP can help
Arranging a conversation with your GP is a smart first step, says Dawn Davis, MD, dermatologist with the Mayo Clinic. “They often do a fantastic job treating rashes,” she says. “Primary care is a great place to diagnose psoriasis and get basic skin treatment.”
Your GP will update your medical history, examine you, and likely prescribe a topical steroid cream or medicated shampoo to relieve your symptoms. Your doctor can also suggest ways to take better care of your skin and test for conditions commonly associated with psoriasis, a common problem doctors call “comorbidities.” These are often long-term (also known as chronic). Some examples of what could accompany psoriasis include psoriatic arthritis (swelling and stiff ligaments and joints), heart disease, high blood pressure, anxiety, and depression.
If the tests are positive for any of these conditions, your GP may be able to treat some of them, such as: B. Hypertension. Or they can refer you to a specialist, either in the same health network or hospital, or maybe someone who is not affiliated.
“It’s important to remember that psoriasis isn’t limited to the skin; it’s really part of an inflammatory disease that affects multiple systems in your body, ”explains Davis. “Sometimes psoriasis can be diagnosed if you’re being treated for psoriatic arthritis and you won’t even show skin problems.”
When to see a dermatologist
Suppose a steroid cream isn’t enough and the pain and itchiness keep getting worse, or psoriasis occurs on your palms and fingernails.
You could benefit from UV light therapy (also known as phototherapy) or special drugs called biologics that target your immune system. This means that you should probably see a specialist.
“Someone with advanced skin disease whose psoriasis is starting to spread uncontrollably needs to see a dermatologist,” said Paul Benedetto, MD, dermatologist at Cleveland Clinic Florida.
“You want to see a medical, not a cosmetic, dermatologist. A small number of dermatologists who specialize in advanced skin conditions, but for almost any general dermatologist, psoriasis is the only treatment. “
Choosing a dermatologist
Your health insurance company’s directory will list dermatologists in your area, and your doctor will likely be able to offer referrals, especially if they are specialist doctors. For more options, try the following:
You can consider choosing a dermatologist and treating the first appointment as an interview. Or maybe you find out some prospects and ask their offices for information. In any case, these questions will help you make an informed decision:
- Is the dermatologist certified or at least board qualified (i.e. recently trained) by the American Board of Dermatology? “The board certification shows a level of competence of the dermatologist,” says Davis.
- How many psoriasis patients does the practice see? Does this include people with both simple and complex psoriasis?
- Does the practice have a phototherapy device?
- Who else would I see from practice and how does the team work together?
- Does the dermatologist advocate any particular treatment approach?
- Is the dermatologist comfortable with more advanced psoriasis treatment, such as prescribing biologics?
- How does the practice handle referrals to specialists for the treatment of comorbidities?
Above all, says Benedetto, you should have the feeling that you are having an open dialogue with the dermatologist. “People don’t want a 5-second exam in front of the door. They want someone who takes the time, puts them on a dress, and really examines their skin. “
Davis agrees, adding that if you prefer a doctor who can have a conversation and offer you multiple treatment options, then you need to be purposely looking for someone who matches the description. Ditto if your ideal doctor is direct and recommends the best approach.
“Dermatologists are in short supply in most parts of the country and skin diseases are common,” she says. “Sometimes it can be difficult to choose a dermatologist carefully, and they choose the first one to meet with.” That’s not what you want to do.
Also, depending on your symptoms, you may be referred to specialists or need to visit, such as:
- A rheumatologist used to treat psoriatic arthritis
- A physical therapist if the joint discomfort from arthritis makes it difficult for you to move
- A cardiologist if your heart problems seem severe
- A psychologist or therapist if the stress of psoriasis is causing anxiety or depression, or interfering with your work or personal relationships
In group practices, dermatologists sometimes order x-rays and tests on behalf of an affiliated rheumatologist before your first appointment. Otherwise, you will likely do your prep work in the rheumatologist’s office.
Dermatologists often refer people with psoriasis directly to psychologists and psychiatrists, Davis says, but rarely to physical therapists. So you would have to rely on your own research.
“A multidisciplinary approach to psoriasis treatment is always helpful,” says Benedetto.
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