Talking to your dermatologist is a key part of gaining control of your psoriasis. Completing the Wardrobe Challenge or Self-Care Challenge is the perfect opportunity to talk with your doctor about the ways psoriasis affects your daily life. If the idea of discussing details with your dermatologist about how psoriasis affects you physically, socially, or emotionally feels uncomfortable, you’re in good company. A recent survey of 129 MyPsoriasisTeam members found that many members struggle with talking to the health care provider who treats their psoriasis.

Survey results showed:¹

• Only about half (46 percent) of respondents said they are able to have meaningful conversations with their health care providers.
• Just 28 percent reported their health care provider listens and understands their needs.
• Only 15 percent said they have discussed pain and depression with their health care providers.

Add a comment below: Do you and your doctor discuss how psoriasis affects your daily life?

Your quality of life living with psoriasis is important, and good communication with your dermatologist is necessary to find effective psoriasis treatment options. There are many different options for treating psoriasis, so don’t be discouraged if your current treatment isn’t meeting your goals. You can use your completion of the Wardrobe Challenge and the Self-Care Challenge as an opportunity to discuss your current psoriasis treatment and whether it is effectively meeting your treatment goals.

Sign Up for the Gaining Control With Psoriasis Challenge Email Series

If you have regular appointments with your dermatologist, you can use an upcoming check-in to discuss the Gaining Control With Psoriasis Challenge and how you’re feeling about your current treatment. If you don’t have an appointment scheduled, this challenge can be the motivation that you need for scheduling time with your doctor.

Depending on your needs, it may be important to have an in-person visit with your dermatologist. You may also have the option of a telehealth visit, sometimes called telemedicine or a virtual appointment. When you call to make an appointment, your dermatologist can help you determine what type of visit is right for you.

Telehealth has gained popularity during the COVID-19 pandemic, and many people prefer the convenience of skipping the commute and the waiting room. Telehealth can be a great option if you’d like to discuss your symptoms and your treatment options with an established health care provider.

Below is a discussion guide for talking to your dermatologist about the Gaining Control With Psoriasis Challenge.

Preparing for a conversation with your doctor can help you feel more confident and ensure you get the most out of your appointment. You can start preparing for your visit by consulting your Gaining Control With Psoriasis Challenge journal. The observations you’ve recorded about symptoms in your journal — or in posts and comments on MyPsoriasisTeam — are important to share with your doctor.²

Describing your symptoms as clearly as possible can help you and your doctor determine the best course of action. Below are some tips to help you communicate the full picture of your symptoms to your doctor.

• Describe your pain or itching using a scale of 0 to 10.²
• Specify the location of each skin symptom. For example, note if you have plaques on your legs but not your arms.²
• Note the ways your symptoms have gotten better or worse over time.²
• Explain any ways in which your symptoms are limiting aspects of daily life. For example, tell your doctor if pain and itching are preventing you from exercising or wearing certain clothes.³

Many people with psoriasis experience mental and emotional difficulties related to their symptoms, including embarrassment, social problems, and stress.⁴ Among surveyed members of MyPsoriasisTeam, 68 percent reported feeling depressed and 67 percent reported feeling anxious.¹ You may have experienced some of these emotions during the Wardrobe Challenge or the Self-Care Challenge.

While it may feel awkward to raise emotional concerns with your dermatologist, it is completely appropriate to discuss all the ways psoriasis affects you. Below are some ways to share your concerns with your doctor:

• Discuss your personal goals and any times psoriasis gets in the way. For example, tell your doctor if embarrassment about your skin is preventing you from dating or swimming.³
• Share if your symptoms made it difficult to wear the clothes you like in the Wardrobe Challenge.
• Let your doctor know if sadness, embarrassment, or stress related to your skin is preventing you from going about your daily life.⁴
• Tell your doctor if difficult emotions prevented you from participating in the Self-Care Challenge to improve your nutrition and exercise routines.
• If you feel unable to articulate your specific concerns, consider asking your doctor about screening tools used to assess quality of life and mental health in people with psoriasis. These assessments include the Psoriasis Index of Quality of Life and the Psoriasis Life Stress Inventory.⁵

You may have never thought deeply about your treatment goals, or you may have never discussed specific goals with your doctor. Not everyone’s treatment goals for psoriasis will be the same, and it’s important to discuss your priorities with your dermatologist.

Consider your reflections on how psoriasis impacts you mentally and emotionally. Feelings of self-consciousness or stress related to psoriasis can help you identify ways your current treatment may not be supporting your goals. Before your appointment, try writing out three goals. They can be focused on concrete symptom changes or general quality of life improvements. For most people with psoriasis, the goal is total skin clearance. Other goals may include improving enough to wear shorts or go swimming without embarrassment, or feeling well enough to exercise.

Ask these questions about your psoriasis treatment to make sure you know what to expect:⁶

• How much improvement can I expect from a treatment? How is improvement measured?
• How long will it take before I see changes in my symptoms?
• What should I do if I don’t see improvement in the allotted time frame? What should I do if the improvement doesn’t sufficiently improve my quality of life?
• What side effects should I expect, and do they usually persist or go away after a period of time?

You might not achieve your treatment goals if a treatment is difficult for you to take or keep up with. It’s understandable to feel nervous to tell your doctor you’re having trouble sticking to a prescribed treatment. However, it’s important for your long-term well-being that you find an option that works for you. Be honest about your challenges, so you and your doctor can work together to find solutions that will help you stick to your existing treatment or find a better alternative for your lifestyle.

Journaling after your appointment is a great way to remember what you learned and reflect on how you felt raising your concerns. Did you feel confident speaking up about your needs? Do you feel satisfied with the conversation? Do you feel positive with the next steps your doctor suggested? Whether you’re feeling optimistic about your treatment plan or nervous about next steps, pat yourself on the back for raising your questions and concerns. You can also share your experience with others by leaving comments below.

The goal of this challenge is to improve your relationship with your dermatologist. If you come away from this appointment feeling heard, understood, and supported in your treatment goals, you’ve taken a valuable step toward controlling your psoriasis.

If you find that your doctor is not willing to partner with you by listening to your concerns and recommending more effective approaches to manage your psoriasis, it may be time to consider switching health care providers. One benefit of using telehealth is improved access to specialists, including those located outside your immediate area. Telehealth makes it easier than ever to consult with a new doctor and receive a second opinion.

References

1. Schneider, B. (2020) Impact of Psoriasis on Quality of Life. Unpublished manuscript
2. Dermatologist. (n.d.). Retrieved October 02, 2020, from https://www.psoriasis.org/dermatologist/
3. 10 Tips for Building a Doctor-Patient Relationship. (n.d.). Retrieved October 02, 2020, from https://www.arthritis.org/health-wellness/treatment/treatment-plan/you-your-doctor/10-tips-for-building-a-doctor-patient-relationship
4. Bhosle, M. J., Kulkarni, A., Feldman, S. R., & Balkrishnan, R. (2006). Quality of life in patients with psoriasis. Health and quality of life outcomes, 4, 35. https://doi.org/10.1186/1477-7525-4-35
5. Kemmerling, S. (2013, January). Identifying Patients with Depression in the Dermatology Setting. The Dermatologist. Retrieved October 2, 2020, from https://www.the-dermatologist.com/content/identifying-patients-depression-dermatology-setting
6. Treat to Target. (n.d.). Retrieved October 02, 2020, from https://www.psoriasis.org/treat-to-target/