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Doctor Discussion Guide: Talking About Your Progressing Psoriasis

By EmpowHER
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You may have noticed that your psoriasis has flared or is spreading. This development may prompt you to contact your doctor. Knowing what to discuss at your appointment is key. Psoriasis treatments have changed in scope and approach in recent years, so you’ll want to present the latest information to your doctor.

Start with the basics

When you visit your doctor, start with essential information. Your doctor will want to know more about the current state of your condition as well as your overall health. Describe your symptoms in detail as well as any changes to your health status. Bringing a journal with notes of your recent history may help you remember what to share with your doctor.

Psoriasis can be triggered by several factors, so make sure to mention any of the following if it applies to you:

  • You’ve had an infection or illness recently.
  • Your skin has been damaged, even slightly.
  • You’re taking new medications or adjusted dosages.
  • You’re feeling stressed.
  • Your eating, exercising, or sleeping habits have changed.
  • You smoke or drink in large quantities.
  • You’ve been exposed to extreme temperatures.

Any one of these factors may be reasons why your psoriasis is spreading. You may also be experiencing a flare for another reason altogether. Every person has different triggers, and your immune system could be reacting to something new in your life, resulting in a flare.

Discuss your current treatment plan

You and your doctor should discuss your current treatment plan. Have you adhered to it as directed? Even though symptoms may disappear, your doctor may want you to keep up with certain medications and skin care products. Some treatments if discontinued cold turkey might make your condition even worse.

Be honest with your doctor about your management plan, and be sure to mention if you find it difficult to maintain or if it’s too costly.

It’s a good time to evaluate whether your current management plan is keeping your symptoms at bay and whether it would be a good time to modify your plan.

Present new ideas

You may want to present recent developments in treating psoriasis with your doctor. Chances are your doctor is aware of these changes, but there is no harm in educating yourself about them first.

The entire philosophy behind treating psoriasis has changed in recent years. The new approach is called “treat to target.” This involves setting up treatment goals that you and your doctor agree upon. This approach aims to minimize your psoriasis symptoms to meet a certain goal, such as only affecting a particular percentage of your body within a set period of time. The National Psoriasis Foundation outlines goals for those with plaque psoriasis with this target: Only 1 percent (or less) of their body is affected by the skin condition within three months. As a reference, 1 percent of the body is roughly the size of the palm of your hand.

There are a few advantages to this new treatment approach. One study concluded that a goal-based approach to psoriasis treatment can result in reaching the treatment’s desired effect as well as help establish a standard of care for psoriasis.

“Treat to target” is meant to create a dialogue between you and your doctor while reducing your symptoms and providing a better quality of life. This approach allows you and your doctor to determine whether the plan works for you. Your discussion may lead to a change in your plan or sticking with the status quo.

Several new ways of treating psoriasis are available, beyond having a better dialogue with your doctor. Combination therapies are gaining more ground, especially as new, more effective drugs come on the market.

Historically, your doctor would only treat your skin affected by psoriasis. This overlooked other aspects of your body, such as your immune system. There is now an understanding that treating psoriasis involves more than just surface-level care.

Recently, researchers developed an algorithm that guides doctors in their care of moderate to severe psoriasis. Doctors should review several aspects of your health when devising your care, including:

  • comorbidities, or conditions you’re at higher risk of developing because of psoriasis
  • signs or symptoms of psoriatic arthritis
  • medications that may worsen psoriasis or interfere with your treatment
  • triggers that may make your condition worse
  • treatment options for your psoriasis

By looking all of these factors, your doctor should be able to suggest a combination treatment that reduces your symptoms and increases your satisfaction with the treatment. Your doctor may decide you need one or more of the typical treatments for psoriasis. These include topical treatments, light therapy, and systemic therapy.

You may want to talk to your doctor about new medications available in treating psoriasis. Biologics are the most recent variety available to treat moderate to severe psoriasis. Biologics target specific parts of your immune system to down-regulate T-cells and certain proteins that cause psoriasis. These drugs can be costly and require injections or intravenous administration, so you should talk to your doctor about whether this is a practical treatment for you.

The takeaway

It’s important to have continued conversations with your doctor about your psoriasis. There are several ways your appointment will be more beneficial to you:

  • Be prepared before you talk to your doctor.
  • Write down your current symptoms and any factors that may contribute to your psoriasis flare.
  • Discuss whether new approaches to treating psoriasis may help you.

Working with your doctor to develop a treatment plan may result in feeling more satisfied and your condition becoming more controlled.

Read more in Psoriasis Resources
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