Finding A Healthcare Provider
Psoriasis is a chronic, lifelong condition with symptoms that may come and go during periods of flare-up and remission. Depending on how severe the psoriasis is, patients may need to be treated by certain types of healthcare providers who specialize in autoimmune and/or skin conditions. Key members of a psoriasis patient’s healthcare team may include:
- Primary Care Provider (PCP)
What role does the primary care provider play in treating psoriasis?
A primary care provider (PCP) will often be the first to make a diagnosis of psoriasis, based on the patient’s symptoms1. Usually, the patient will have one or more psoriasis plaques on the skin that allows the PCP to make the diagnosis. A skin sample will sometimes be needed, but not always.
If the patient has milder psoriasis, then the PCP may be able to recommend a course of topical treatments to help manage the symptoms. If the psoriasis symptoms are more severe and cannot be controlled well enough with the topical treatments, then the PCP may refer the patient to a dermatologist for care.
What is a dermatologist?
A dermatologist is a physician who has years of special training in the treatment of skin, hair, nails, and mucous membranes (such as the inside lining of the mouth, nose, and eyelids). Dermatologists specialize in treating many different types of conditions, including psoriasis.
It is important to find a dermatologist that is qualified and experienced in treating psoriasis. In the United States, dermatologists are usually members of the American Academy of Dermatology (AAD), and will have the letters “FAAD” after their names2. These are also called “board-certified” dermatologists. Not all dermatologists specialize in treating psoriasis, however. For example, some dermatologists focus on more cosmetic-type procedures, such wrinkle reduction, and beauty treatments. Looking at the dermatologist’s website, a reputable provider directory, speaking with someone in the office, and/or meeting the dermatologist in person can help in finding a specialist who has expertise in treating psoriasis.
A dermatologist can provide different, more powerful types of treatments for psoriasis than a PCP can. This can help with more severe symptoms that topical medicines alone cannot manage well. For example, dermatologists can provide different types of light therapy, which uses doses of light to slow down skin growth and reduce inflammation. Dermatologists can also prescribe oral systemic medicines that treat psoriasis by affecting the way that the body’s immune system works.
What is a rheumatologist?
People with psoriatic arthritis may be referred to a specialist called a rheumatologist. Rheumatologists have special training in the treatment of diseases related to the joints, muscles, and bones. This includes autoimmune conditions such as psoriatic arthritis, which causes inflammation, pain, and stiffness in and around the joints.
In the United States, rheumatologists are usually members of the American College of Rheumatology4.
Patients who have psoriasis with skin symptoms have an increased risk of developing psoriatic arthritis. If a patient has joint pain that lasts for more than a few days, the PCP or Dermatologist may refer the patient to a rheumatologist to find out if the joint symptoms are being caused by psoriatic arthritis. If so, then the rheumatologist can start the patient on a course of treatment to manage the symptoms and prevent joint damage.
What is a nutritionist?
Some people with psoriasis find that consulting with a nutritionist can help with some of their symptoms. Nutritionists are not usually physicians but are healthcare providers who have specialized training and can provide advice and recommendations about how diet and nutrition can affect a person’s health.
Nutritionists can work with a patient to design a diet that may improve the patient’s overall health and help the patient to maintain a healthy body weight, both of which can have a positive effect on psoriasis for some patients. People with psoriasis have a higher risk of developing conditions related to the cardiovascular system, such as heart attack and stroke, so eating a heart-healthy diet is very important.
A nutritionist can also give advice about certain foods that will trigger or make psoriasis symptoms worse in many people. For example, the nutritionist may recommend avoiding foods such as1:
- Dairy products, such as milk products and cheese
- Red meats, such as beef, game, and sometimes pork
- Processed foods
- Foods containing refined sugars
- Vegetables from nightshade plants, such as tomatoes, potatoes, and peppers
Nutritionists can also provide advice about vitamins and supplements that can be used to make sure the patient is consuming all of the right kinds of vitamins and nutrients for the body to function well.
Tips for dealing with a team of healthcare providers
Living with psoriasis can have a huge impact on a person’s life, both physically and emotionally. It is important for a patient to have a team of healthcare providers that are working together to ensure that the patient is receiving the best possible course of treatment for the condition3. Patients can help with this by keeping all members of the healthcare team informed and on the same page. Tips for doing this include:
- Getting your own copies of all your test and lab results that you can share with different healthcare providers directly
- Taking notes and keeping records about all of your treatments in a notebook or computer that you can bring to each appointment
- Letting all of your healthcare providers know if your condition has gotten worse or better, or if your treatment regimen has changed