Speak Clearly: Perspectives on psoriasis

Do you get nervous waiting for your doctor in the exam room? Forget everything you wanted to say to them in the first place? You’re not alone. Many people can be intimidated by doctors for a variety of reasons, but I’ve seen firsthand how patients withholding information can stop them from reaching their treatment goals. I know it’s not always easy being open, so here are some tips for taking on common anxieties so you and your doctor can better manage your psoriasis—together.

DO talk about all of your concerns–even if they don’t involve your skin

As dermatologists, we’re experts on the skin—but as doctors, we recognize that health is holistic. Especially in chronic inflammatory skin diseases such as psoriasis, we know that external factors, like impending social activities or even clothing choices can induce stress.¹ Stress can be a trigger for flare ups and other symptoms, which then leads to more stress, self-consciousness, and the cycle continues.¹

Anxiety and depression are commonly reported in psoriasis patients—if you’re struggling with these feelings, consider discussing it with your dermatologist, too.² Just because your dermatologist is focused on caring for your skin doesn’t mean your overall well-being isn’t relevant for your psoriasis care. We may be able to provide you with resources to help you manage daily stressors caused by your psoriasis or refer you to specialists who can better help you navigate your concerns. 

DON’T feel embarrassed to talk about sensitive topics

Everyone is different, but to some, talking about delicate topics, like intimacy, can feel a bit awkward. So, when you have a more personal psoriasis-related concern—whether it’s flares in the genital area or how to broach psoriasis with a new partner, it’s understandable you may feel embarrassed to bring it up with your dermatologist. However, I’m here to assure you that doctors can and will approach any intimate concerns from a medical and scientific standpoint—your questions will never be judged.

And if we don’t have the exact words for talking to your loved ones about your psoriasis, we have access to patient resources to point you in the right direction. If you’re feeling too embarrassed or anxious to discuss these topics in-person, ask your doctor if you could write down your questions or ask them via a patient portal.

DON’T be intimidated by your doctor

Your doctor is there to support you. We joined the dermatology field because we want to help people manage skin conditions so they can live life to the fullest. It can help to think about your doctor not as an authority figure, but as part of your larger support system that includes partners, friends and family. Bring them along the management journey with you.

No-one knows how psoriasis affects you better than you. Sometimes, you may be in the position of having to tell your dermatologist something they recommended didn’t work for you—and that’s okay. That’s something we want and need to know in order to help you manage your psoriasis to the best of our abilities. Always be honest if a treatment isn’t helping you meet your goals so we can work together to find a solution.

DO conquer anxiety with empathy—together

In my dermatology practice, I use a technique called motivational interviewing with my patients. This method supports patients to explore their own solutions to any factors and behaviors that may influence their psoriasis and treatment. This method recognizes that the best treatment plans are holistic and co-created with patients, not handed down by a doctor. In this sense, the dermatologist and their patients are truly on the same team, and that’s how it should be.

This also requires patients to be open and honest with their doctor, something that is harder in practice. But sometimes, what you aren’t saying could be what’s really important. So, speak up—we’re listening.

For additional tips to help you prepare for your upcoming appointment, check out this doctor discussion guide.

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References:

1. National Psoriasis Foundation. Causes & Triggers. Available at: https://www.psoriasis.org/causes/. June 7, 2021.
2. Sahi, F., et al. Association Between Psoriasis and Depression: A Traditional Review. Cureus. 2020;12(8):e9708. Aug 2020. doi:10.7759/cureus.9708.

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