What help can I get from medical professionals for psoriasis?
- General Practitioners (GPs)
- Dermatology consultants and nurses (healthcare professionals specialising in skin)
Those who saw a dermatologist sometimes still saw GPs for repeat prescriptions of steroid cream or to get antibiotics for infections. Pharmacists sometimes helped by recommending over-the-counter things that don’t need a prescription like medicated/tar-based shampoos for scalp psoriasis. Young people visited medical professionals for:
- a diagnosis of psoriasis
- treatments, including emollients, soap/shampoo substitutes, topical steroids, phototherapy or systemic medicines, and advice about how to use them
- advice and treatment for complications and conditions associated with psoriasis, like psoriatic arthritis
- information about alternative and complementary therapies
- to find out about triggers
- check-ups – e.g. to see if treatments were working or about side effects
- for dermatology referrals – a GP (general practitioner/doctor) can ‘refer’ a person to a dermatologist (skin specialist doctor)
- mental health support for dealing with the emotional and psychological side of psoriasis
- a ‘fit note’ (or a ‘sick note’) for time off or other special arrangements with work, school or university, such as extra time in exams
Doctors usually examined the person’s skin. Most people said they were okay with this because they saw it as part of the doctor’s job. Skin examinations were painful for Zara though as the doctors would spread her toes apart to see the psoriasis. Lucy had a biopsy (a small skin sample) to confirm the diagnosis of psoriasis.
Many people talked about how treatment decisions were made. This included choosing a treatment, the dosage and the best way of using it. Some trusted their doctors to make decisions for them, but others preferred to have more of a role. Not everyone was happy with the treatment choices they were offered, but didn’t know of alternatives or feel confident speaking up. Simon thinks his GP gave him “the wrong kind of medication [tar-based shampoo]” for his scalp psoriasis at the start which wasn’t enough – he thinks a topical steroid would have “nipped [it] in the bud”. For those who had psoriasis most of their life, their parents had usually first taken them to see doctors. As they got older, they went more on their own but sometimes talked to family members about what had happened at appointments. Some people liked having someone with them at their medical consultations. Zara’s mum drives her to her dermatology appointments and sometimes sits in – she finds this helpful as “I always feel mum can explain it better”. Everyone we talked to had seen doctors about psoriasis more than once and for some repeat visits to medical professionals was part of ‘having psoriasis’. You can read more about this here.
Mental health support referrals
A couple of people had asked for professional help or a referral for mental health and self-esteem issues related to psoriasis. Many people felt doctors should be more aware of the emotional impacts of psoriasis and raise it in appointments. Adam and Damini think doctor appointments are usually too short to go into enough detail about the everyday experience of having psoriasis.
Some people talked to their doctors or filled in questionnaires about how psoriasis affects them. Megan’s dermatology doctors and nurses ask her about how she’s “dealing with it” and try to make her feel better. Filling in a questionnaire wasn’t as helpful as some people wanted, as many didn’t get a chance to talk to their doctors about their answers. The questionnaire score was sometimes calculated with their PASI (Psoriasis Area Severity Index) score so doctors could consider the emotional impact with the severity of their psoriasis. People said it can feel dismissive being told that your psoriasis isn’t ‘that bad’ when it’s causing them lots of distress.