Psoriasis

Messages for medical professionals treating young people with psoriasis

Based on their experiences of having psoriasis, the young people we talked to had advice for health professionals. Sometimes these messages also applied to others, such as their family, friends, partners, school/teachers and university/lecturers, and work colleagues. Many highlighted the emotional impacts of psoriasis that can be overlooked if only the physical symptoms are focused on.

Key messages for health professionals treating young people with psoriasis were: Some people also wanted information on lifestyle factors. Russell finds diet and a lack of sleep has a “big impact” on his skin, but weren’t mentioned by his doctors. Sofia says that doctors “should try and explain in a way that a small child will understand” rather than talking only to their parents or guardians.
  • be aware that the emotional and social impact of psoriasis on young people can be enormous
Let people know it is okay to talk about emotional distress and that support (like counselling) is available. Don’t rely on the young person to raise the topic. Ask the young person how psoriasis affects them, physically but also emotionally and in their daily lives. A few people had completed questionnaires about the emotional impact of psoriasis at their dermatology appointments. However, they were often disappointed that the results are never discussed with them as they would like more of a conversation about these with their doctors and nurses.
  • be friendly and respectful
Megan felt “inspired” by the medical professionals she had seen because they tried to cheer her up. Steven finds rapport and light humour help him feel comfortable with medical appointments. Hannah thinks the age of the patient should be “factored in” by medical professionals treating them. She says that psoriasis and treatments can add extra pressures on young people that many of their peers don’t have, such as worrying more about ill health and impact on socialising.
  • give people treatment choices
Don’t automatically re-prescribe the same thing if the person doesn’t find it’s helping or if they’re struggling with side effects. Simon feels it would have been easier to manage his psoriasis if he had been given a steroid topical treatment for his scalp sooner (rather than a medicated shampoo). Be careful when talking about changing to new treatments though, the uncertainty of whether the psoriasis might return or become more severe can be frightening. Aspects of treatments, such as the smell, feel and look of topical treatments should be considered as these can be off-putting and draw unwanted attention to the person with psoriasis. This was a key reason why some young people stopped using the treatments prescribed.
  • talk to the young person about how much medical help they would like
Adam appreciated that his GP suggested seeing him weekly for a short appointment to keep an eye on his skin.
  • listen to what the person with psoriasis has to say and be open to talking to them about things they’ve read online, heard from others or tried out for themselves
This includes over the counter/shop bought products and alternative therapies. Be careful not to come across as dismissive, but do talk to them about why another approach could work better.
  • stay up-to-date with research and information about psoriasis, which you can share with the young person
Many people felt their GPs didn’t know much about psoriasis or, at least, that they didn’t share it with them in detail. For Carys, this meant a long and frustrating wait before she was diagnosed and phototherapy was the first treatment option.

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