"I'm a Dermatologist, and I Have Psoriasis"
From managing flares (and emotions) to finding the right treatments, these skin docs know what it’s like to live with psoriasis. by Jenn Sinrich Health Writer
Although most dermatologists are familiar with treating psoriasis, a chronic inflammatory autoimmune condition that affects as many as 7.5 million Americans, few know firsthand what it's like to actually live with the disease. This dermatologist does.
Carolyn Jacob, M.D., founder and director of Chicago Cosmetic Surgery and Dermatology, was first diagnosed with severe scalp and nail psoriasis at age 14, and she says it’s one of the main reasons she chose to become a dermatologist. “I used to have to sleep with a shower cap on my head so the medication cream I was using, triamcinolone, would penetrate more, and I had to keep my nails painted so you couldn’t see how weird they looked with the psoriasis,” she says. “It’s always easier when you can empathize with a patient because of your own struggles with a disease—they feel safer with your recommendations and are openly willing to try meds that you suggest.”
Dr. Jacob’s diagnosis was discouraging, but it also set her on her life’s path. She studied biology as an undergraduate, attended medical school, earned a board certification in dermatology, completed a laser-surgery fellowship at Harvard, and founded her own practice.
If there is one thing she wishes she would of known all those years ago when she was first diagnosed, it’s this: “There is hope to live symptom-free. It didn’t exist in 1984, but it does now!”
The most effective means of treating her psoriasis, she says, is biologic therapy. “It’s pure heaven to forget that you have a chronic inflammatory disease,” she says. “It typically takes about four months on the medication for the skin to get better, but the clearance can be great.” She also recommends the use of a fragrance-free moisturizer, as well as topical steroids prescribed by your derm as needed.
While dermatologist Rita Linkner, M.D., never suffered from psoriasis herself, she did see its impact through her dad’s experience with the chronic condition. “I was just 8 years old when he received his psoriasis diagnosis, and I remember people noticing his skin and worrying that it was contagious,” say Dr. Linker, who's with Spring Street Dermatology in New York City.
It’s not, by the way.
But in Dr. Linkner’s father’s case, as well as many other individuals suffering from psoriasis, it is not simply a disorder of the skin. “Psoriatics are more likely to be diabetic and have high blood pressure as well as heart disease,” she says. In fact, the idea that the inflammation is more than skin-deep is exactly what fueled her interest in dermatology.
Thankfully, today there are many treatment options available that help clear psoriasis. But in addition to taking medication, Dr. Jacob and Dr. Linkner’s father have made the necessary lifestyle changes that also go a long way in treating the condition. Whether or not medication is currently part of your treatment plan, here are the tips that these derms with first-hand psoriasis experience swear by.
Hit the gym before stress hits you.
Exercise can help you stay at a healthy weight, lower your risk of type 2 diabetes and heart disease, as well as reduce psoriatic arthritis pain, according to The National Psoriasis Foundation. Dr. Jacobs, who works out five to seven days a week, says it’s also kept her stress levels in check. Makes sense, since stress and anxiety have been shown to trigger psoriasis symptoms for many people. One study published in the journal British Journal of Dermatology, also found that increased physical exercise, along with an improved diet, reduced the severity of psoriasis in overweight or obese patients. Aim to clock 30 minutes of moderate exercise at least five times each week to keep flare-ups at bay.
We know. We know. This is so much easier said than done. Not only does smoking increase your chances of getting the chronic condition, but it worsens the symptoms of those already suffering from it. In fact, one study published by JAMA Dermatology found that heavy smokers (more than 20 cigarettes per day), had twice the risk of suffering from severe psoriasis.
Eat more fish.
You know the overall importance of eating a healthy diet, but you may not have realized the major role it plays in reducing psoriasis flare-ups. Dr. Jacob was 14 when she was first diagnosed, so she wasn’t really concerned with changing how she ate. “I once tried fish oil as a teen, but it was the 80’s and it tasted terrible,” she says. “Now, I try to remember my omega-3 fish oil by Nordic Naturals, and I eat wild salmon for the most benefit whenever I can.” Fish is full of omega-3 fatty acids (aka good fats) that reduce inflammation. Don’t like fish? Dr. Jacob says walnuts, which contain a plant-based omega-3 fatty acid called alpha-linolenic acid, are just as beneficial.
Resist the urge to scratch.
Sometimes it takes patients longer than expected to get in for an appointment with the dermatologist or maybe your treatment plan hasn’t kicked in yet (remember, it will take up to four months for skin to get better on a biologic). So, what can someone with persistent flares do to minimize itching? While Dr. Jacob waited for her biologic to work, she stuck with the basics and used Cerave lotion to moisturize and prescription-strength topical steroids to keep her skin cool, calm, and collected.
Find your inner yogi.
Researchers have found a link between mindful meditation and clearer skin in patients with psoriasis. And Dr. Linkner believes meditation, specifically through the practice of yoga, is one of the major things that helped dial back her father’s psoriasis. “He would break that concentration only once in a blue moon (usually to scratch a plaque) and really never let his psoriasis stop him physically, which always inspired me,” she says.