Life With Psoriasis

Living with psoriasis can be challenging. Some areas that people commonly struggle with include:

  • Self-esteem issues
  • Pain and discomfort
  • Interrupted or loss of sleep
  • Anxiety
  • Depression
  • Avoidance of intimacy
  • Avoidance of certain types of clothing

Psoriasis can impact every aspect of an individual’s life, including one’s ability to work and maintain relationships.

As a result, the psychological impact of psoriasis can be high.

The emotional impact of psoriasis on a person’s life does not depend on the severity of the lesions. It is determined by how each person feels about symptoms like itchiness, pain, discomfort and the visibility of plaques.

Now That I know I Have Psoriasis, What Should I Be Doing?

When you’re diagnosed with psoriasis, it is normal to experience a whole range of emotions at first. Try to keep in mind that now you know what you have and you can start the treatment and healing process.

This section takes you through some tips and ideas for living well with your condition.

Think about your physical and mental health
  • Take some time to let your diagnosis sink in and take this time to learn more about it. Share how you’re feeling by talking to a trusted member of your family or a friend or journal what you are going through… it may be helpful to express how you’re feeling.
  • Patients with psoriatic disease are at a higher risk of depression, anxiety and suicide than people without this condition. If you are feeling anxious, depressed or have suicidal thoughts, then you should share this with a trusted friend or family member and/or a health care professional.
  • It is important to let your primary care provider or dermatologist know about any emotional or psychological difficulties you may be having.
  • Recognize the chronic relapsing nature (waxing and waning) of psoriasis – your needs, feelings and experiences may change and adapt throughout the course of living with this condition. This is normal for many people.
Recognize and minimize triggers
  • Find out what causes worsening of your psoriasis by documenting any changes that happen before a flare-up in a journal. If you see any patterns emerge, try to prevent or avoid them.
  • Limit or eliminate alcohol consumption, which is known to cause flare-ups or interfere with psoriasis treatments. Ask your doctor or other health care provider for help if you need to.
  • Experts agree that quitting smoking is one of the best things you can do for your general health. Quitting also lowers the risk of heart disease and a host of other health conditions that occur at increased rates in psoriasis patients.  Again, your health care team is there to help you.
  • Although there is no evidence that certain foods will affect psoriasis, it is important to eat a healthy diet, especially when you have a chronic disease and obesity has been linked to psoriasis and psoriatic arthritis.
  • According to Canada’s Food Guide, a healthy diet includes eating a variety of fruits and vegetables of all colors (visually: half your plate) and whole grains (visually: a quarter of your plate). Eat protein foods (visually: a quarter of your plate) and if you eat meat, focus on lean cuts and fish. Incorporate low-fat dairy options and make water your drink of choice.
  • Discuss any triggers and diet issues with your health care provider. Your health care provider can also provide you with helpful resources and tips to best minimize exposure to triggers, such as medications to help quit smoking.

 

Keep track of your path to a “controlled” disease.

Everyone is different so what acts as a trigger for one person is different than what triggers someone else.

To help you track your journey to stability, consider keeping a journal. Use it to set goals and help you along the way. Ask yourself:

  • How do you feel?
  • What are you trying?
  • What seems to be working and what doesn’t?
  • What questions do you have? For whom?
  • What are the answers you received or that you found?
Common triggers include:
  • Emotional stress
  • Injury to the skin
    • Koebner phenomenon: Describes the appearance of new areas of skin disease where there has been injury to the skin.
    • Examples of injuries which may lead to Koebner phenomenon include bites, burns (including sunburns), shaving, pressures, scratches, vaccinations, and tattoos.
  • Infections
    • Streptococcus infection (i.e. strep throat) can cause a flare-up of psoriasis.
    • A flare-up may also follow an earache, bronchitis, or a respiratory infection.
  • Drugs
    • Examples include:
      • Lithium
      • Antimalarials (i.e. hydroxychloroquine)
      • Propranolol
      • Quinidine
      • Indomethacin
    • A medication that triggers one person’s psoriasis may not do the same for another person. Certain medications’ benefits outweigh their risks, depending on the individual. Make sure to discuss with your health care provider if you suspect a medication you are on is a psoriasis trigger.
  • Weather
  • Diet
  • Allergies
  • Intense sun exposure
  • Alcohol consumption
  • Smoking cigarettes

 
What might aggravate someone else’s psoriasis may have no effect on your condition.

  • Check out other sections on this website that talk more about treatments, lifestyle considerations and how to work with your care team.
  • Take an active role in your treatment by asking questions and keeping your primary care provider or dermatologist informed of your concerns.
  • Talk to your primary care provider or dermatologist about your options, especially if you are not seeing improvement after using a particular treatment, or if you are having uncomfortable side effects. He or she can adjust your treatment plan or modify your approach to ensure the best possible control of your symptoms.
  • Check out questions for your doctor.
  • Join CPN as a member. It’s free and you’ll get updates and information about psoriasis as well as opportunities to be involved!

Understand your health care team

Your health care team may change depending on your needs over the course of your condition. Understanding their roles can help you navigate your care.

  • This includes a family doctor or nurse practitioner.
  • This is the first health care professional you get in touch with when you have a new, non-emergency health concern.
  • In Canada, visits with primary health care providers are generally publicly funded, meaning you do not have to pay for the visits out of your pocket.
  • Consulting a primary health care provider via telemedicine is generally not publicly funded at the time, meaning you or your private insurance plan may need to cover the cost.
  • Diagnoses and provides treatment for a variety of health concerns.
  • Provides referral to specialists (i.e. dermatologist, rheumatologist) if needed to help with a specific condition.
  • Supports management for chronic illnesses.
  • Prescribes medications.
  • Provides routine check-up visits and screening tests.
  • A registered nurse with additional education and experience.
  • Can provide most services that family doctors are able to, but with some exceptions (e.g., unable to prescribe certain medications).
  • If needed, they can always consult with a physician or connect you to a physician or other health care providers who can help you.
  • Medical specialist physicians who have completed five-year residency training in prevention, recognition, and treatment of diseases of the skin, hair and nails.
  • Generally, you can consult a dermatologist only if you have a referral from a primary care provider.
  • Medical specialist physicians who have completed five-year residency training in rheumatic conditions, which include many different types of arthritis (including psoriatic arthritis) and autoimmune diseases (diseases resulting in inflammation due to the immune system attacking one’s own body).
  • Generally, you can consult a rheumatologist only if you have a referral from a primary care provider.
  • Experts in medications and their management.
  • General role includes collaboration with patients and other health care providers to ensure appropriate medication use and to help navigate the health care system (e.g., finding ways to access certain medications) in the community or in hospitals.
  • Can be consulted directly by patients in community pharmacies (e.g., answering your questions about medications).
  • Role is expanding, now including prescribing for certain medical conditions, extending refills on existing prescriptions, and immunizing.

Questions for your doctor

Consider these questions for your dermatologist. A dermatologist will not be able to answer all of these questions on your first visit, so consider preparing your most urgent questions.

  • What kind of psoriasis do I have?
  • Do I have psoriatic arthritis?
  • If I don’t have arthritis now, am I likely to develop it?
  • What severity is my psoriasis?
  • Will severity or type change over my lifetime?
  • What can trigger a flare of my psoriasis?
  • What kind of things can I do for fast relief of a flare?
  • What are some things I should do or avoid to help the symptoms I’m experiencing?
  • What are some symptoms of conditions associated with psoriasis that I should watch out for?
  • Should I let you know if my symptoms change?
  • How often should I come for checkup?
  • What should my daily skin care routine include?
  • What is the most important thing (or few things) that I should be aware of regarding my condition?
  • How do I easily explain to people what psoriasis is?
  • What are the treatment options available?
  •  What should I expect from this treatment?
  •  What are the possible benefits of this treatment?
  •  When I start a treatment, how long should it take before I see a difference? How long do I wait before knowing it is not working for me?
  •  What are the possible side effects, including mental, emotional, and physical side effects?
  •  What are the side effects that I should be sure to notify you about?
  •  What are the financial costs of this treatment?
  •  Do the benefits of the treatment outweigh the costs enough for me to try this?
  •  If the treatment doesn’t work, what is next on the treatment path?
  •  What if this treatment is not enough?
  •  Do you recommend any alternative or complimentary therapies?
  •  Are there things I should do (or avoid) that would maximize the impact or efficacy of the treatment?
  • If I decide I want to stop or change the regimen, what is the process to safely do so?
  • Who do I contact if I have follow-up questions before my next appointment?
Visit Treatment Decisions for more in-depth content to support you with assessing your treatment options, making treatment decisions, and working with your care team throughout your experience living with a psoriatic condition.
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