While your dermatologist can give you prescription medications to treat psoriasis, your choice in over-the-counter products (moisturizer, shampoo, etc.) significantly improves the appearance of a sensitive epidermis and prevents adverse reactions. Here are the experts' top picks.

The right dermatologist can make a big difference for your psoriasis. Here’s how to decide if it’s time – and make it happen.

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Sometimes you and your dermatologist are not a match made in medical heaven. Find out when it's time to move on.

10 Clues That It’s Time for a New Derm

10 Signs It’s Time to Change Dermatologists 

10 Clues That It’s Time to Switch Dermatologists

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Goodbye, guesswork. Here are the over-the-counter skin and scalp products that psoriasis warriors can confidently stock up on.

Aisle Do's: Drugstore Psoriasis Products That Derms Love

Holly Singletary, M.D.

Medical Reviewer

Dermatologist-Approved Drugstore Buys for Psoriasis

Clean Sweep: CeraVe Psoriasis Cleanser

Raise the Bar: Dove Gentle Exfoliating Bar

Super Suds: Aveeno Positively Radiant Exfoliating Body Wash

Water Works: Neutrogena Hydro Boost Body Gel Cream

Smooth Move: AmLactin 12% Moisturizing Lotion

On the Spot: Eucerin Roughness Relief Spot Treatment

Dream Cream: CeraVe Psoriasis Cream

Moisture Lock: Vaseline Intensive Care Essential Healing Lotion

Get a D: Vitamin NOW Solutions Vitamin D-3 Cream

Flake Out: Kamedis Anti-Dandruff Therapy Shampoo

Coal Mine: Neutrogena T/Gel Therapeutic Shampoo

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A strong doctor-patient bond can make the difference in getting clear skin with psoriasis. Here's how to make — and keep — the relationship humming.

Welcome to Team Psoriasis!

Can you imagine cringing at the thought of giving a high-five? 

If you have psoriasis on your hands, you know the feeling. This type of contact with another person can be both embarrassing and painful.

“Patches of psoriasis affecting the thick skin of the palms tends to crack, bleed, and cause painful fissures,” says Joel Gelfand, M.D., a professor of dermatology and epidemiology at the University of Pennsylvania in Philadelphia. 

This can be so disabling that doing anything with your hands during a flare can feel impossible. Plus, it’s awkward to explain to a curious outsider what’s going on with your skin. If you have hand psoriasis (or think you might), here’s what’s going on and how you can keep it from disrupting your life.

### There Are Four Types of Hand Psoriasis

__Palmoplantar Psoriasis__

This form of psoriasis appears on the palms and/or the bottoms of the feet, and it affects about 5% of those with the condition, according to the Journal of the American Academy of Dermatology. This is the kind that makes those high-fives and handshakes really uncomfortable, and in some cases, the symptoms can seriously disrupt your life.

In at least one [study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4165651/), people with palmoplantar psoriasis were significantly more likely to have problems with mobility, self-care, and other everyday activities.

Treatment for palmoplantar psoriasis can be tricky. The condition is likely to lead to secondary fungal infections and people sometimes have allergic reactions to the topical medications they’re using for treatment. Those with palmoplantar psoriasis also tend to be hypersensitive to touch. 

“Making matters even more difficult is that palmoplantar psoriasis is often resistant to treatment," Dr. Gelfand says. "Current treatments, even our newest biologics, often have limited benefit for psoriasis of the palms.”

__Dactylitis__

This is sometimes referred to as “sausage” fingers, and it often involves painful swelling along your entire finger or toe, not just around one of the joints. It's can be one of the first signs of psoriatic arthritis—even if you do not have psoriasis on your hands. Anti-inflammatory drugs, either over-the-counter or prescription, such as non-steroidal anti-inflammatory drugs (NSAIDs), may provide some relief. If your fingers start to swell, let your doctor know as soon as possible because early treatment can improve later outcomes.

__Enthesitis__

This is the swelling of the entheses, or the connective tissue that joins ligaments and tendons to the bones in your hands. Enthesitis can also occur even if the skin on your hands has been clear. Because psoriasis is a systemic inflammatory disease, that inflammation can happen anywhere in your body. Your fingers may feel stiff and painful, but unlike dactylitis, you may not have visible swelling. Your rheumatologist or dermatologist may suggest an oral or injectable steroid to relieve the ache.

__Nail Disease__

Psoriasis causes your skin cells to reproduce much more quickly than they should thanks to an overactive immune system. Since your nails are part of the skin, psoriasis can develop under the cuticle and wreak havoc on the growth and health of your nails. As a result, you may see pitting, vertical ridges, discoloration, and separation from the nail bed. [Estimates](https://www.healthcentral.com/slideshow/how-to-have-beautiful-nails-with-psoriasis#slide=2) of nail psoriasis range from about 50 percent to as high as 80 percent in those with psoriasis.


### 6 Ways to Cope With Hand Psoriasis

While there's no cure for psoriasis, there are some things that you can do to ease symptoms that affect your hands. 

#### See Your Dermatologist

Even if you have psoriasis on other parts of your body, you want to make sure that your new hand outbreak is indeed psoriasis and not another condition. According to the [American Academy of Dermatology](https://www.aad.org/public/diseases/eczema/eczema-resource-center/controlling-eczema/eczema-vs-psoriasis), dry and itchy skin can be caused by a number of conditions, including eczema. It's not only difficult to tell the difference between the two (especially in kids), but you can have both at the same time. Similarly, if your finger joints are suddenly sore, you will need to rule out overuse, psoriatic arthritis, rheumatoid arthritis, osteoarthritis, or a virus such as Lyme disease.

#### Work With an Occupational Therapist

If stiffness and swelling are significant issues, you may benefit from working with an occupational therapist. “Many occupational therapists specialize in hand therapy and provide a variety of treatment options to assist with hand discomfort,” says Aleksandra Radjen, Ph.D., a physical therapist at the Cleveland Clinic. What's more, they help you improve the use of your hands and maintain the skills you need to live your everyday life.

#### Stay on Top of Your Overall Treatment Plan

By treating your psoriasis aggressively, you can help lessen its impact on your body overall. So take your meds regularly and on time, keep your body moving, and try to stick to a plant-based diet. 

#### Protect Your Hands

Preventing hand injuries is extra important if you have psoriasis. Wear gloves or other protective gear whenever possible, including when you're doing everyday chores like washing dishes or weeding the garden. New lesions can develop from a cut, bruise, or burn, a tendency known as the Keobner phenomenon (named after the dermatologist who discovered it, Heinrich Koebner).

#### Practice Good Nail Care

They need to be protected just as much as your skin: Use tools instead of your fingernails to open packaging; keep them short to prevent ripping; and avoid the harsh chemicals that can be found in some nail polishes and polish removers, which can weaken your nails even further. And don't forget the moisturizer. 

“Moisturize them every day with an emollient cream or ointment,” says Tamy Buckel, M.D., a dermatologist in Chestertown Maryland. (Check out these [derm-approved picks](https://www.healthcentral.com/slideshow/dermatologist-recommended-skin-and-scalp-psoriasis-products).)

#### Talk to a Mental Health Pro

If you feel self-conscious, embarrassed, or if your hand psoriasis is preventing you from doing the things you enjoy, it may be time to talk to someone about it. A counselor, therapist, or even a psychodermatologist can be a great addition to your care team. Never heard of a [psychodermatologist?](https://www.healthcentral.com/article/could-you-benefit-from-psychodermatology) That’s probably because it’s a new subspecialty of dermatology and psychiatry, and it was created because healthcare professionals who recognized that having a skin condition can cause stress and anxiety. (About time, right?!) Learn more about how psychodermatology can help, and to find a specialist in your area, click [here](http://www.psychodermatology.us/Find-Psychodermatologist).

__See more helpful articles:__

[How to Have Beautiful Nails With Psoriasis](https://www.healthcentral.com/slideshow/how-to-have-beautiful-nails-with-psoriasis)

[10 Differences Between Osteoarthritis and Rheumatoid Arthritis](https://www.healthcentral.com/slideshow/6-differences-between-osteoarthritis-and-rheumatoid-arthritis)

[Crating With Psoriatic Arthritis](https://www.healthcentral.com/slideshow/crafting-with-psoriatic-arthritis)

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Psoriasis on your hands can cause cracked, bleeding, painful palms. Here’s why it’s happening and how you can get relief.

Psoriasis is no fun anytime, but it can be particularly difficult when it affects your hands. We've got tips to help you cope.

Best Advice for Hand Psoriasis

Help for Hand Psoriasis

Gone are the days of setting aside an entire chunk of the day to wait in your doctor's office. Thanks to 21st-century technology, virtual dermatology appointments are now an official thing. Known as teledermatology, these services provide care for patients in a way that does not require an in-person exam. 

For people with chronic conditions like psoriasis, virtual appointments are the next best thing to having a derm on 24-hour call. While they can't fully replace face-to-face visits--you still need those in-person full-body cancer checks and they aren't appropriate for actual skin emergencies--they can make managing your symptoms a whole lot easier. But are they effective? In short, yes. A study published in the *Archives of Internal Medicine* found that for certain routine illnesses, an online doctor appointment could be just as effective as seeing a physician in real life.  

“Dermatology is a field in which we rely on visual examinations more than anything else, so it makes sense for us to strongly consider adding this technology into our practices,” explains Erum Ilyas, M.D., a dermatologist at [Montgomery Dermatology](https://montgomery-dermatology.com/) in King of Prussia, PA. It doesn't hurt, either, that most smart phones today come with high-quality cameras that can literally be your doctor's eyes. 

### The Benefits of Virtual Dermatology

When it comes to chronic skin diseases (like psoriasis and eczema), virtual appointments are clutch, since they can provide closer--and quicker--surveillance of progress. “Normally, when a new psoriasis patient is seen, topical prescription medications are the first-line treatment depending on the severity of their condition,” explains Dr. Ilyas. “If these work, improvement is typically noted by the patient within two to three weeks; however, if the treatment is not working effectively or quickly enough, it can be frustrating and very uncomfortable for patients to wait for their next appointment to establish a new course of treatment.” 

And, if you live in a rural area? Wait times for appointments can be on the order of months for specialist care, which can unfortunately lead some patients to seek care through urgent-care centers or even the ER. “The problem our psoriatic patients find is that dermatologists don't really work in urgent care," says Dr. Ilyas. "The doctors there will often attempt to give patients fast relief by offering oral steroids, and while these drugs might initially clear their flare up they also have a high risk of ‘rebound psoriasis,’ where symptoms come back with a vengeance.” Teledermatology improves accessibility, especially among Medicaid participants, according to a [study](https://jamanetwork.com/journals/jamadermatology/fullarticle/2519453) published in *JAMA Dermatology*. And when you can see the right doctor at the right time, there's a darn good chance you'll get the right treatment too. 

Even for people who live in metro areas with lots of doctors, getting an appointment isn't always easy...and that can be a problem when a flare strikes. With teledermatology, they're able to receive care within hours, as opposed to the weeks it would take them to get into a physical clinic. And that's not even including the hours it can take for the appointment itself. “My patients are often taking a half-day or even the entire day off to come see me in clinic with Bay Area traffic,” says [Justin Ko, M.D.](https://stanfordhealthcare.org/doctors/k/justin-ko.html), director and chief of medical dermatology at Stanford Health Care in Palo Alto, whose practice offers virtual visits to established patients in the practice and e-consults with other physicians in the network.

In many circumstances, the timeliness of care translates into faster diagnosis and treatment, which can make a big difference when it comes to serious skin conditions like skin cancer and melanoma. In fact, Dr. Ko and his team have made many diagnoses of skin cancers including melanoma as a result of these virtual- care interactions. 

### How to Schedule Your Virtual Dermatologist Appointment 

A virtual visit with a dermatologist can be made in one of several ways. Many practices use their patient portal to "see" you. Dr. Ilyas uses this type of platform to monitor medication usage, evaluate efill requests, and help triage skin lesions between skin-exam appointments for established patients. 

Since there is no specific threshold a psoriasis patient must meet to dictate when they switch from topical therapy, phototherapy or systemic therapy, Dr. Ilyas encourages patients to communicate as much information as possible in regards to their lifestyle, pain or discomfort level, whether the psoriasis is affecting sensitive areas such as under the arms, under the breasts, groin or face, and what treatments they’ve tried in the past.

Another viable method is using an app, such as DermatologistOnCall, First Derm, SkyMD, or  Spruce. You'll complete a personal health history, upload photos of your skin (they guide you through the process), and then wait for a dermatologist to respond to both the photos as well as any additional questions you may have had. Many of these apps are free to download, but require a fee for the visit itself, which can sometimes be covered by insurance. Though most apps discourage using FaceTime, they do provide a HIPAA-secure method for texting.

No matter which app you choose, you’ll want to verify the physician’s credentials beforehand. Find their website and look up their certifications to make sure they are, in fact, board-certified. You can do this by visiting the [American Academy of Dermatology](https://www.aad.org/) or [American Board of Dermatology](https://www.abderm.org/) websites. Then, follow these steps to secure your consultation. 

### Step 1: Log into the platform.

Whether you’re using a mobile app or signing up for your visit through a patient portal, create a profile and fill out all the necessary forms required. 

### Step 2: Read the fine print.

It’s important that you thoroughly understand what coverage options and expectations exist before scheduling your virtual dermatology visit. First, find out if your insurance will cover the appointment. There is an evolving recognition of the value of care delivered in this way, and many insurance companies are providing reimbursement. Still, not all do, so make sure you know ahead of time what your financial responsibility will be, says Dr. Ko.    

### Step 3: Follow the instructions on taking photos.

Most teledermatology apps and portals offer recommendations or guidance for how to take photos. They also include what kind of information patients should send. Be sure that the photos you take are of high enough quality and appropriate for your physician to be able to make an assessment. When Dr. Ko performs virtual visits for his established patients, he provides a tip sheet on how to take photos that makes it easier for him to assess and help with next steps: “Use good lighting, ideally natural lighting, keep areas of interest in focus, and take photos of both affected and unaffected areas if different areas of the body are involved (for example, the elbow that has a rash and the other that's clear),” he says. Additionally, include all relevant information, such as your health history, family health history, and chief concerns.

### Step 4: Check back with the app or platform for guidance from your dermatologist.

Don’t be afraid to check in and message the dermatologist if you haven’t heard back in the time expected. “There can sometimes be technical issues, or messages can get stuck in in-baskets or work queues,” says Dr. Ko. If all the information and situation is appropriate for a treatment plan to be started or modified, these prescriptions or labs/diagnostics can be ordered in the same way as for an in-clinic visit.

### Step 5: Follow recommendations from your virtual derm.

After you receive an assessment and/or next steps, it’s important to try to follow the recommendations, or follow up if you have any questions or don’t agree with the plan. Dr. Ko also suggests utilizing the app to update your physician or their team on how things are going. “If there is any concern or things are not going according to plan, make sure to check in and let your care team know!” he says. 

__See more helpful articles:__

[Cold Weather Travel Tips With Psoriasis](https://www.healthcentral.com/slideshow/winter-travel-tips-with-psoriasis)

[Psoriasis Vacation at the Blue Lagoon](https://www.healthcentral.com/article/psoriasis-vacation-at-the-blue-lagoon) 

[Living With Psoriasis: Travel Tips](https://www.healthcentral.com/slideshow/living-psoriasis-travel-tips)

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New-age technology has made virtual dermatology appointments a thing. Here, you’ll learn all about teledermatology, the service that provides care without an in-person visit to the doctor.

Now you can see your dermatologist from your phone...in your pj’s...while making a cup of coffee.

The Step-by-Step Guide to Booking a Virtual Dermatologist Appointment

How to Book a Virtual Dermatologist Appointment

Now you can see your dermatologist from your phone..in your pj’s…while making a cup of coffee.

About a year and a half ago, I started dropping coffee cups. It was the first sign that my psoriasis was getting to me on a deeper level, and it was the first time I really felt worried about my condition. Even though the anxiety-fueled jitters and restlessness are now more or less controlled, they're still always with me.

Unfortunately, as a person with chronic psoriasis, I am not alone. According to the National Psoriasis Foundation, almost one in five of us struggle with anxiety. Often, depression is in the mix as well. Wherever you fall on the anxiety-depression spectrum, it's important to know that you don't have suffer alone and help is there when you need it. You just need to know where to look. 

### Understanding the Psoriasis-Anxiety Connection

You don't need to have an M.D. after your name to understand that the stress of living with a long-term skin condition can lead to anxiety and even depression. Psoriasis can be highly stigmatizing and extremely difficult to get under control. 

But there may also be a biological connection as well. The proteins the fuel the inflammtory reponse in your skin are also linked to mood disorders, creating a vicious cycle that perpetuates stress and anxiety, according to research published in the [*Journal of Clinical and Aesthetic Dermatology*](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928455/). Flares can trigger anxiety, which can in turn trigger more flares. And your life is stuck in the middle of all it. 

If you have psoriasis and find yourself anxious a lot of the time, don’t just dismiss it as a done deal, says Mohammad Jefferany, M.D., associate professor of psychology at Central Michigan University in Mount Pleasant, MI.

He says you’ll know it’s time to take action if you find anxiety interrupting the rhythm of your normal everyday behaviors. For me, that moment came when I ran out to buy a long sleeve shirt to cover my arms before meeting my son’s new girlfriend—even though it was incredibly hot outside. That may seem like a small thing, but the thought of her seeing my skin made me incredibly uncomfortable. Being sweaty seemed a small price to pay, but it's one I shouldn't have had to pay at all. 

### How to Manage Anxiety About Your Skin

The first step is simply to tell your derm how you're feeling. It's really important to speak up since untreated anxiety and depression can impact your response to psoriasis therapies, says Dafna Gladman, M.D., a senior scientist at the Krembil Institute in Toronto.

Your doctor may then opt to step up your psoriasis treatment. That's because reducing your overall inflammation could also lessen the biological response related to your stress, improving your mood. According to [findings published in the journal *Nature Reviews Immunology*](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5542678/), elevated levels of inflammatory proteins may deplete some of the key mood messengers in your brain such as serotonin and dopamine. 

If you're not already working out regularly, expect your derm to encourage it now. Exercise is not only good for anxiety, but it can also help your psoriasis. Just 20 weeks of exercise and improved diet can reduce psoriasis in people with active disease who also happen to be overweight or obese, according to a [study published in the *British Journal of Dermatology*](https://onlinelibrary.wiley.com/doi/full/10.1111/bjd.12735),.

Still need more support? Your doctor may refer you to a psychologist or therapist who can teach you coping strategies. Some practice [cognitive-behavioral therapy (CBT)](https://www.healthcentral.com/article/10-reasons-to-consider-cbt), a form of psychotherapy that’s been shown to be highly effective for anxiety. Medication may also be an option. 

And depending on where you live, you may even have another option: seeing a [psychodermatologist](https://www.healthcentral.com/article/could-you-benefit-from-psychodermatology). Practitioners in this growing field are dermatologists with special interest and expertise in the psychological component of skin disease. Start your search for this kind of specialist through [The Association for Psychoneurocutaneous Medicine of North America (APMNA) website](http://www.psychodermatology.us/Find-Psychodermatologist).

Insurance coverage will vary depending on your plan and which dermatologists are covered in your area.

Regardless of whether a dermatologist, a primary-care physician, or a psychodermatologist is helping you with your anxiety and psoriasis, the most important thing is that you’re addressing the issue in the first place. It's smart self-care. And if you’re anything like me, when your psoriasis is under control, so is your anxiety.

__See more helpful articles:__

[Doctor’s Orders: Your Psoriasis Needs a Vacay](https://www.healthcentral.com/slideshow/stress-reducing-vacation-psoriasis-skin)

[Could You Benefit From Psychodermatology?](https://www.healthcentral.com/article/could-you-benefit-from-psychodermatology)

[How Psoriasis Impacts Your Mental Health—And How to Feel Better](https://www.healthcentral.com/article/psoriasis-impacts-mental-health-how-to-feel-better)

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If you're still looking for proof of the mind-body connection, look no further than the link between psoriasis and anxiety. We've got advice for how to heal both.

If you're still looking for proof of the mind-body connection, look no further than the link between psoriasis and anxiety. We've got advice on how to heal both.

Getting a Handle on Psoriasis and Anxiety

Psoriasis and Anxiety: How to Break the Cycle

We "heart" our dermatologists, but when it comes to getting 360-treatment for psoriasis, there are a few other medical and wellness superstars you'll want on your side. We've compiled a list of go-to helpers who can recommend skin products, maximize your treatment, and treat your psoriasis from the inside out. They'll be your very own dream team!

### Physician Assistant or Nurse Practitioner

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When you're having a flare that needs quick medical attention, it may take weeks to get face-to-face with your derm. In fact, a study published in [*JAMA Dermatology*](https://jamanetwork.com/journals/jamadermatology/fullarticle/2653790) showed that the average wait for a dermatologist appointment was 56 days. On the other hand, the average wait to see a physician assistant (PA) or nurse practitioner (NP) was 19 days. Many derm practices may actually have PAs and NPs on staff, and they often serve as a primary provider. 

Both PAs and NPs can diagnose illness, develop and manage treatment plans, and prescribe medication. They'll consult--and refer--to a physician on complicated cases, but for routine care, you'll be in good hands. 

### Certified Personal Trainer

personal trainer with woman in the gym lifting weights 

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Although psoriasis shows up on your skin, it's actually a systemic inflammatory disease. That's why lowering your overall level of inflammation can help you heal from the inside out. One of the best ways to do that? Exercise. In fact, as little as 20 minutes of physical activity can make a difference, according to a [study](https://www.hindawi.com/journals/drp/2015/409637/) in *Brain, Behavior, and Immunity*. And you don't have to work out hard to benefit, either. 

Same goes for losing weight, says Luigi Naldi, M.D., a professor of dermatology at the University of Milan in Italy. Even a limited weight loss can improve psoriasis symptoms in people who are overweight or obese.  

If you need help getting started, connecting with a certified personal trainer will be hugely beneficial. Getting one-on-one attention in the gym may be especially helpful if it has been a while since you exercised or are experiencing any joint pain. A trainer can help you increase your activity level safely. Find one in your area through the [American Council of Exercise](https://www.acefitness.org/education-and-resources/lifestyle/find-ace-pro/). 

### Pharmacist

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Many of us think of a pharmacist as someone who counts pills and puts them in bottles. But a knowledgeable pharmacist can save you time and money and serve as a safety net to make sure you are getting the best care. Case in point: They're on the front lines protecting you from harmful drug interactions. Registered pharmacists are extremely well-educated—they have to earn a doctorate of pharmacy degree and pass a state licensure exam in order to practice.

Along with helping you compare costs of brand-name versus generic drugs, your pharmacist is also there to fill you in on potential side effects, says Patricia Draper, a registered pharmacist at Edwards Pharmacy in Centreville, MD. So when the cashier asks if you have any questions for the pharmicist, take advantage: "That information helps patients adhere to their treatment plans better," Draper says. 

And if you need some advice on over-the-counter products to supplement your prescriptions, your local pharmacist can help you figure out which ingredients to look for or to avoid. (Check out these [derm-approved shampoos, cleansers, and moisturizers](https://www.healthcentral.com/slideshow/dermatologist-recommended-skin-and-scalp-psoriasis-products), too.)

### Medical Esthetician

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You may have psoriasis, but that doesn't mean you can't have beautiful skin. A medical esthetician can help you achieve it through safe-for-you treatments as well through personalized product recommendations. 

"An esthetician can help you determine your skin type," says Betty Wilder, director of the Chesapeake School of Esthetics in Annapolis, MD. Just like many women don't know their correct bra size, most people don't know their skin type either, she says. "And if you get that wrong, then you could be using the wrong products on your skin." 

While the training requirements vary from state to state, estheticians usually attend an esthetics school or school of cosmetology and then must pass a state exam. Estheticians who have met advanced training requirements can attain a national esthetician certification. The best place to start to find one? Your dermatologist. 



### Mental Health Provider

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Those of us living with psoriasis have an increased risk of being diagnosed with depression and anxiety. Not only is there a stigma that goes along with having skin that looks different, but the inflammation behind your condition may also impact brain function, increasing your susceptibility to mood disorders, according to a study published in the journal *[Dermatology Research and Practice](https://www.hindawi.com/journals/drp/2015/409637/)*. 

Your dermatologist can be an amazing resource if you are feeling anxious or depressed. However, you may also benefit from being able to talk to a therapist about how your condition makes you feel. You'll not only be able to just get it all out (always a relief), your therapist can also help you learn how to change negative thought patterns. And if appropriate, she can work with your derm to recommend anti-anxiety or antidepressant medication, even if just for the short-term to get you back on track. 

Also an option? Seeing a [psychodermatologist](https://www.healthcentral.com/article/could-you-benefit-from-psychodermatology)—someone who specializes in the psychological aspect of a skin disorder. Bottom line: Take your mental health as seriously as your physical health!

### You

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Don't forget that *you* are also a valuable member of your healthcare dream team. Nobody knows your body as well as you do. Staying up-to-date on the latest available treatments, taking good notes between visits, and making sure your team is working together will help you get the best overall care for your psoriasis. It may literally take a village to successfully manager your psoriasis, but that can be a really great thing. You never have to go it alone.

It’s about more than managing flares—these professionals can help you with everything from skincare to anxiety and depression.

Meet Your Psoriasis Dream Team

360-Treatment for Psoriasis

When you’re living with psoriatic disease, you must be strict with your diet. Here are examples of trigger foods that may be aggravating your condition.

The wrong sheets can aggravate your psoriasis, here’s how to choose the best skin-friendly bed linens, including fabrics that won't irritate your skin and recommendations for pillows and duvets.

Stretching-in-bed-ThinkstockPhotos-677030428

Don't let the wrong sheets aggravate your psoriasis. Here are 12 tips for choosing the best skin-friendly bed linens.

The Best Sheets For Psoriasis?

Psoriasis Friendly Bed Linens: 12 Tips for Choosing Sheets

11 Tips for Choosing Bedding When You Have Psoriasis

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In a perfect world, the best diet would be to eat a little bit of everything. Unfortunately, when you’re dealing with a chronic condition such as psoriatic disease, you must be strict with your diet. Food is known to trigger your immune system, causi...

Foods to Avoid When Living with Psoriasis

Carmen Roberts, M.S., R.D., L.D.N.

Health Professional, Medical Reviewer

Sugar

Dairy

Gluten 

Grains

Corn

Genetically Modified (GM) Foods

Why say no to GMOs?

Conclusion

Psoriasis can show up in the most unexpected places. Typically, [psoriasis](http://www.healthcentral.com/slideshow/8-things-i-wish-i-d-known-about-psoriasis) affects the knees and elbows but can be found on any part of the body, including the genitals. 

Genital psoriasis can show up in the genital areas, upper thighs, or in the crease in your buttocks. It is generally symmetrical but the appearance can be different, based on the area where it is located.

- When in the genital area, it often appears as [inverse psoriasis](https://www.healthcentral.com/article/what-is-inverse-psoriasis). You might have patches of red, shiny skin that are highly sensitive, painful, and itchy. 
- Psoriasis on the upper thighs may appear as small, round patches that are red and scaly. It can become inflamed because of irritation from your thighs rubbing together or from tight pants. 
- When it appears in the skin folds, such as between the thigh and the groin, it is often smooth and reddish-white in color. In these areas, you might notice skin fissures or cracks in the skin that can become inflamed and infected.
- On the penis, psoriasis can appear as small, red patches. It can affect both circumcised and uncircumcised males. It might look similar to contact dermatitis. 
- When located in the crease of the buttocks, it shows up as red patches, with or without scales. 

Genital psoriasis should be diagnosed by a medical professional. It can sometimes look like [contact dermatitis](https://www.healthcentral.com/article/the-skinny-on-common-skin-allergies). 

Genital psoriasis is treated with either topical creams or [Ultraviolet light therapy](https://www.healthcentral.com/article/hope-for-psoriasis-patients-with-ultraviolet-light-therapy). Because there isn’t a cure for psoriasis, treatment is aimed at lessening the intensity and frequency of flares, and reducing the itching and stinging that accompany the rash. 

Your doctor might prescribe a low-dose topical steroid cream. This is because genital psoriasis occurs in areas that are usually covered by clothing, which makes treatment more effective. Stronger doses can cause problems with thinning skin and stretch marks. If you do require higher doses, your doctor might ask you to come in more often for office visits to check for possible skin damage.

According to the [National Psoriasis Foundation](https://www.psoriasis.org/advance/genital-psoriasis-how-to-treat-it-how-to-manage-it), having genital psoriasis “increases the severity of psoriasis, and it recommends discussing [systemic](https://www.healthcentral.com/article/are-systemic-or-topical-steroids-best-for-psoriasis) or [biologic treatments](https://www.healthcentral.com/article/how-can-biologics-help-psoriasis), especially skin it has not responded to topical treatments. 

__Complications__

Because genital psoriasis is located in moist areas of the body, you might be more susceptible to developing [yeast](http://www.healthcentral.com/slideshow/yeast-infection-complications) and fungal infections. If this happens, your doctor might suggest adding antifungal or antibacterial agents to your topical steroids.

Women might also notice an increase in [vaginal infections](https://www.healthcentral.com/article/when-to-see-a-doctor-for-a-vaginal-yeast-infection). This is sometimes hard to discern, especially if you believe the pain or itch is due to the psoriasis. Genital psoriasis can appear on the labia and the vulva but it rarely occurs inside the vagina. If you experience pain or itching inside the vagina, talk with your doctor.

Sex during an outbreak might be painful. Irritation from rubbing and skin-to-skin contact can cause discomfort. Using a lubricated condom might help. Make sure to tell your partner if you are using any topical treatments so they can notice and treat any skin reactions. 

__Tips for home care__

Use [moisturizers](https://www.healthcentral.com/article/which-moisturizer-is-best-for-you) liberally. Look for products that don’t contain perfumes or other additives that can irritate your skin. Your doctor can also prescribe emollients that can help you feel more comfortable. 

Talk to your doctor about vitamin D creams you can directly apply to affected areas. Watch for irritation, however. <a href="http://www.papaa.org/further-information/genital-psoriasis" target="_blank">The Psoriasis and Psoriatic Arthritis Alliance</a> indicates that while some vitamin D creams are helpful, some can cause further irritation. 

Use high quality, soft toilet paper. If clean-up after defecation causes irritation, consider a fiber supplement to make stools softer. 

Wear loose-fitting underwear. For males, boxer shorts and for females, boy shorts are the best choice.

Wear soft, loose-fitting clothes to avoid rubbing and irritation. 

__See more helpful articles:__

[Natural Remedies for Psoriasis vs. Medical Treatments](https://www.healthcentral.com/article/medical-and-natural-treatment-options-for-psoriasis)

[Questions to Ask Your Doctor about Your Psoriasis Treatment](http://www.healthcentral.com/slideshow/questions-ask-your-doctor-about-your-psoriasis-treatment)

[11 Foods That May Fight Psoriasis](http://www.healthcentral.com/slideshow/six-foods-that-may-fight-psoriasis)

[Psoriasis Treatment: How to Find the Best Doctor For You](https://www.healthcentral.com/article/psoriasis-treatment-how-to-find-the-best-doctor-for-you)

[Psoriasis Treatment Strategies: What to Try Next](https://www.healthcentral.com/article/psoriasis-treatment-dissatisfaction-whats-next)

iS-What You Need to Know About Genital Psoriasis-iStock-187422897

Genital psoriasis can be confused with other conditions, and it can be hard to treat. Learn more about the complications and get home care tips for this challenging condition, including picking the right moisturizers, creams, and toilet paper.

Psoriasis can show up in some unexpected places. If you have genital psoriasis, try these home care tips for this difficult condition.

What You Need to Know About Genital Psoriasis

Genital Psoriasis: What You Need to Know

It’s important for people with psoriasis to learn how to incorporate stress management techniques into their everyday lives.

If you have psoriasis, getting little beauty rest doesn’t just mean dark circles. It can also lead to increased stress, which can worsen the severity of psoriasis flares. A good night’s rest is essential to reducing stress, and helps your body fight inflammation.

If you have psoriasis, getting little beauty rest doesn’t just mean dark circles. It can also lead to increased stress, which can worsen the severity of psoriasis flares. A good night’s rest is essential to reducing stress, and helps your body fight ...

Getting a Better Night's Sleep with Psoriasis

Getting a Better Night's Sleep With Psoriasis

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Many people living with psoriasis get caught in a cycle of stress. Some report that having high stress may worsen psoriasis symptoms or lead to flare-ups. In turn, living with psoriasis symptoms can increase stress, and the cycle continues. So it’s a...

7 Ways to Manage Stress with Psoriasis 

Get enough sleep

Seek treatment

Find support

Exercise

Yoga and meditation

Find a doctor you trust

Prioritize

Before you decide on a psoriasis treatment, there are many factors to consider, including your lifestyle, insurance coverage, and how much it will cost. Here's the questions you should ask ahead of time.

 Psoriasis advocate Tracy Davenport explains how self care can help keep depression, inflammation, resentment, and other psoriatic disease complications at bay, and why you should not feel guilty putting yourself first.

Confident man standing out in front of his team.

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Man standing out in front of his team

Did you know self care is one of the best ways you can keep depression, inflammation, resentment, and other psoriatic disease complications at bay?  

10 Reasons You Shouldn’t Feel Guilty Putting Yourself First

Life With Psoriasis: Why Self Care is So Important to Your Long-Term Wellness

Life With Psoriasis: 10 Reasons You Shouldn't Feel Guilty Putting Yourself First

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A psoriasis treatment can be a big decision, and committment. Before you start a new treatment, ask these 9 questions to make sure it's right for you.

9 Questions To Ask About Psoriasis Treatments

Considering Psoriasis Treatment? Ask These 9 Questions

How do I know if a treatment is safe?

How frequently will I have to use the treatment?

Am I willing to self-administer injectables? 

How soon should I expect to see results? 

How convenient is it to get treatment?

How much will it cost?

Is there a patient assistance program? Will I qualify?

How easy will the approval process be with my insurance?

Is this option easy to travel with?

9 Questions You Must Ask When Considering Psoriasis Treatment Options

“This isn’t working…” That's what I was thinking as I stood in the UVB light box for at least the 500th time in my life. I was around the age of 16 and had been doing [phototherapy](https://www.healthcentral.com/article/should-your-psoriasis-get-the-light-treatment) on and off for nine years, at least four days a week. It wasn’t working and it never had. But I held on to the hope that eventually something would change, that maybe my body would give in to the laser rays and my psoriasis would finally be defeated, never to resurface again. But after almost a decade of phototherapy with no improvement, the narrative I had hoped for proved not to be a reality.

Unfortunately, my struggle to find an effective treatment is not a unique one. I’ve talked to a variety of people living with psoriasis who complain about the challenges of finding a treatment that is right for them. Here are three major mistakes you could be making which could be hindering you from achieving clear, healthy, psoriasis-free skin.

### Waiting too long to question your treatment

I’ve been guilty of using a treatment for much longer than I should have. This is a mistake I made for the first 10 years of living with psoriasis, but since I didn’t have a huge voice in my treatment options as an adolescence, I didn’t have much control. I exposed myself to a lot of unnecessary ultraviolet light, increasing my risk for skin cancer, when the risk didn’t prove to have a reward. [The National Psoriasis Foundation](https://www.psoriasis.org/treatment-targets/patients) suggests trying a treatment for three months and then evaluating your amount of improvement.  If there is no improvement at all, your doctor may want to increase your dosage; if that doesn’t work, it’s time to try [something else](https://www.healthcentral.com/quiz/is-your-psoriasis-treatment-working).

### Being non-compliant

The more a treatment requires my attention, the less likely I am to comply with what it requires. Topical treatments, for example, typically need to be used 2 to 3 times a day to be effective. I dislike having to use something that many times in a 24-hour period. Topical treatments usually take longer to work, although the side effects are less severe than with [biologics](https://www.healthcentral.com/article/how-can-biologics-help-psoriasis). If you aren’t using your treatment as directed, it will not work. Evaluate all factors with your doctor before starting a treatment. You must be consistent and diligent with any treatment.

### Taking a biologic that isn’t hitting the proper target

There are four parts of your immune system which can possibly send a “faulty” signal, causing psoriasis, including TNF-alpha, interleukin-17A, interleukin-12, and interleukin-23; each has a different purpose in the fight against diseases and each biologic targets a different part. Unfortunately, there is no test to determine which area of one’s immune system is causing the problem; therefore, a lot of trial and error must be done with treatments. If you are using a biologic and do not begin to see significant changes within three months, it could mean it’s not hitting the right target. Talk to your doctor to see if there’s a more suitable biologic.

__See more helpful articles:__

[The Link Between Psoriasis and Osteoporosis](https://www.healthcentral.com/article/the-link-between-psoriasis-and-osteoporosis)

[These Fall Foods Help Fight Psoriatic Inflammation](https://www.healthcentral.com/slideshow/these-fall-foods-help-fight-psoriatic-inflammation)

Doctor talking to patient about treatment options.

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Psoriasis treatments are not one-size-fits-all, so if yours isn’t working, there’s probably a reason. Avoid making these 3 mistakes to help you find the psoriasis treatments that do work for you.

Psoriasis treatments are far from one-size-fits-all. If yours isn’t working, one of these 3 mistakes might be the reason.

Why Isn't Your Psoriasis Treatment Working?

Psoriasis Treatment Isn't Working? Don't Make These Mistakes

Why Isn't Your Treatment Working? Three Mistakes You May be Making

Carolyn Jacob, M.D., is a perfect example of the “you don’t look sick” generalization.

Fair-skinned with dark hair and bright green eyes, Dr. Jacob, a mom to twin girls, is the picture of confidence. Her skin is flawless, but it wasn’t always that way.

At age 14, she developed an itchy, scaly rash on her body. Her mother brought her to the local dermatologist, where she was diagnosed with moderate to severe plaque psoriasis.

Her diagnosis was discouraging, but it also set Jacob on her life’s path. She studied biology as an undergraduate, attended medical school, earned a degree in dermatology, completed a laser surgery fellowship at Harvard, and founded the [Chicago Cosmetic Surgery and Dermatology](https://www.chicagodermatology.com/).

There, she presides as medical director over a team of five other dermatologists. The practice covers the spectrum of dermatological specialties, from general care to high-tech laser rejuvenation and aesthetic surgery.

Her interaction with patients also helped her discover the best course of treatment for her own psoriasis. We caught up with Dr. Jacob to discuss her personal experience with psoriasis, as well as how she helps her patients navigate various treatment options and what she wishes other practitioners knew about her disease.  

__Health Central (HC): Did your psoriasis play a role in your career choice?__

__Dr. Carolyn Jacob (CJ):__ Yes! I started babysitting for the dermatologist who diagnosed me, and then I worked in his office. I was already interested in medicine at age 14 so it was great serendipity.

__HC: How does your own health experience inform your practice — both with patients with psoriasis and others seeking dermatological or surgical treatments?__

__CJ:__ I can really empathize with psoriasis sufferers and I believe they are relieved to know I understand what they are going through. Many of my patients know I have the condition or I’ll mention it to them if they ask how I got interested in dermatology. They like to relate and feel like their doctor is a regular person.

__HC: Is there something you wish other dermatologists or health care providers would understand about psoriasis?__

__CJ:__ That it truly is heartbreaking to have — at least it was before biologics! It’s truly uncomfortable and embarrassing.

__HC: How do you treat your psoriasis?__

__CJ:__ I am on adalimumab (Humira), a biologic medication, and it has been life-changing. It’s amazing to not have to worry about your disease on a daily basis!

__HC: Is there a first course of action you take with your patients with psoriasis?__

__CJ:__ We discuss their needs, desires, and concerns. Then I explain the condition and how we can best help them.

__HC: Is there a particular skin care treatment you recommend?__

__CJ:__ If someone thinks they even have "mild" psoriasis, [they should] still see a dermatologist to review the options. There's nothing over-the counter that will truly help and give the results they are looking for with this condition. 

__See more helpful articles:__

[Getting and Staying Confident with Psoriasis](https://www.healthcentral.com/article/getting-and-staying-confident-with-psoriasis)

[Are Products for General Skincare Safe for Psoriasis?](https://www.healthcentral.com/article/are-products-for-general-skincare-safe-for-psoriasis?)

[How Can Biologics Help Psoriasis?](https://www.healthcentral.com/article/how-can-biologics-help-psoriasis)

Carolyn Jacob

As a dermatologist who also has psoriasis, Dr. Carolyn Jacob is in a unique position. Here's how her diagnosis led her to medical school, and the strategies and medications she uses to control her own condition.

Dr. Carolyn Jacob is a dermotologist who knows personally what it's like living with psoriasis. Here's what she's learned about controlling her own condition.

I'm a Dermatologist With Psoriasis

My Experience Living With Psoriasis as a Dermatologist 

What It's Like Being a Dermatologist With Psoriasis 

Here are ways you can control psoriasis instead of letting it control you.

If you’ve been diagnosed with psoriasis, your doctor likely told you that it’s a chronic, lifelong skin condition. While there’s no cure for psoriasis, it is possible to live well despite your skin condition. Here are ways you can control the disease ...

Living Well with Psoriasis  

How to Live Well with Psoriasis

Consider the material

Know your cottons

Splurge on silk (if you can)

Be wary of bamboo

Say no to flannel

Be picky about polyester

Find the right pillows

Choose a cool duvet

Wash your bedding frequently

Protect your hands and feet

Head off discomfort when you’re away from home

Putting yourself first allows you to examine your own diet

Me-time helps you cope with the stress of chronic illness

Taking time away can provide you the sun and warmth you need 

Modeling self care will benefit your children

Taking time away can change your perspective and environment 

Self care helps us stay in shape

Self care can help prevent depression

Me-time diminishes resentment

Self care can help your bad days

Self care is other care

Having an open and honest relationship with your dermatologist is one of the first steps toward successfully treating your psoriasis symptoms. They want to hear all about how you're feeling inside and out, starting with these 10 things. 

Itching to get away? While no single getaway is right for everyone with psoriasis, here are some destinations that may provide immediate relaxation and healing for your skin.

sign post showing many locations next to palm tree

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Set your out-of-office. Hide your to-do list. Here are stress-reducing vacation ideas that can help clear psoriasis flares. 

Doctor’s Orders: Your Psoriasis Needs a Vacay

Vacation Ideas for Psoriasis

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The good, the bad, the not-so-sure-abouts...your dermatologist wants all the details on how you're feeling inside and out. 

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