6 Answers You’ll Need When You Get Diagnosed with Psoriasis
A diagnosis of any kind often comes with a laundry list of questions. For psoriasis, the dermatologic condition that affects more than 8 million people, that’s particularly true. After all, the chronic autoimmune condition is incurable.
Everyone’s psoriasis is also different: While common forms, like plaque psoriasis, tend to look the same (dry, scaly, sometimes itchy patches of skin), there are many different forms of treatment, from topicals to immune-suppressing injectables.
Some people notice their psoriasis improves in the sunshine; others notice gluten sends them spiraling toward flare-ups.
When diagnosed, your doctor will likely give you the run-down of what psoriasis is. Yet they may not answer all of your questions. Allow us to answer these 6 common ones.
1. How did I get psoriasis in the first place?
Your genes were probably at play. You likely have or don’t have the propensity to develop psoriasis all along, says Corey L. Hartman, Men’s Health advisor and founder of Skin Wellness Dermatology in Birmingham, AL.
Some research finds that if both of your parents have psoriasis, you have a 50 percent chance of developing it; if only one parent does, the risk is about 16 percent.
All in all, there’s a genetic contribution in just under half of people with psoriasis, Evan A. Rieder, M.D., a dermatologist at NYU Langone says.
That said, genetics aren’t always to blame. Some people with no family history of psoriasis get the condition. A triggering event like an infection, stress, or disease can change your immune system, pushing it over the edge, so to speak, causing symptoms of psoriasis to rear their head.
2. How often does psoriasis get worse?
It’s hard to say. Some people with psoriasis get a few spots and patches and they stay like that forever; other people progress. Some forms can come on after an infection like strep throat. They might go away or they might stick around.
The disease can be somewhat unpredictable, says Dr. Hartman. That said, there are many highly-effective treatments that can definitely stave off worsening symptoms and even take psoriasis from severe to negligible with few or no side effects.
Topicals—creams or lotions (corticosteroids or synthetic forms of vitamin D, for example)— or phototherapy (light therapy) are great for localized forms of psoriasis (the kind that’s only on your knee, for example).
Phototherapy, oral meds, or newer injectables called biologics—targeted medications that suppress the parts of the immune system impacted by psoriasis—are helpful with more widespread or severe psoriasis.
One study out of Portugal found that people on systemic therapies (pills or injections) were more satisfied with their psoriasis (26 to 63 percent) than those on topicals (only 24 to 27 percent), too.
Be sure to talk to your doctor about the best treatment for your particular psoriasis.
3. Is there anything I can do besides take medication to keep psoriasis from getting worse?
Definitely. There are behavioral risk factors for both the development of and the worsening of psoriasis. Smoking, drinking, obesity, and metabolic syndrome (a cluster of conditions like high blood pressure that increase your risk of heart disease, stroke, and type 2 diabetes), some prescription drugs, stress, diet, and more all play a role, says Dr. Rieder.
Keeping up with your lifestyle—on top of ensuring you’re on the right path of treatment — are both key to feeling better.
4. My psoriasis doesn’t seem to be that bad. Do I really need to care about it?
You do. “While psoriasis may not look like much on the skin, it can be indicative that there's something else going on inside the body,” says Dr. Rieder.
An example: Widespread inflammation throughout your body due to something like untreated type 2 diabetes or obesity could contribute to inflammation in your skin and cause flares. Treating any existing underlying issues is of paramount importance when it comes to psoriasis.
Here’s the other important reason to pay attention to psoriasis: One-third of people with it go on to develop psoriatic arthritis, a progressive joint disease that — if left untreated — can limit your ability to move.
“If you recognize and treat psoriatic arthritis early, biologics can prevent long-term complications like disability or surgery,” says Adnan Nasir, M.D., Men’s Health advisor and a dermatologist in Raleigh, NC. So pay extra attention to any joint pain you pick up over the years and talk to your doctor about treatment if you do.
5. Will I have to take medication my entire life?
It’s hard to say. There’s no cure for psoriasis, so generally speaking, you’ll likely need to continue the course of treatment that works best for you. Dr. Rieder encourages his patients to think about treatment as a long-term plan.
That said, some people get one flare-up of psoriasis and never notice it again while others do experience symptoms — and continue medication — their whole life. Fortunately, even people with psoriasis all over their body often can get symptoms under control with a biologics injection every few months, says Dr. Rieder, making it a decent trade-off.
There is also “some data that suggests that people can get sustained clearance from some of the newer medications,” he says. But biologics are new; there’s more research to be done.
The good news: “There has never been a better time to have psoriasis because for almost anybody living with psoriasis, we can get them clear or almost completely clear,” says Dr. Rieder.
6. Will I have psoriasis forever?
Again, there is no cure for psoriasis, but Dr. Nasir often tells patients that they will not have psoriasis forever. Surprised? Here’s his reasoning: As your body ages and wears down, the immune system wears down, too, so your body often can’t create as robust of an autoimmune response. And that’s a good thing when it comes to psoriasis, which is marked by overactivity of the immune system.
Says Dr. Nasir: “This is something that is not talked about enough in the general public, but is well-known in the medical community.”
Don’t see your question here? Check The National Psoriasis Association. It has tons of free resources — educational articles, events, and community resources for patients — on its website that can help you get more comfortable with the condition after a diagnosis.
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