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Three Psoriasis Questions You Shouldn’t Be Afraid to Ask Your Derm

Sometimes your dermatologist appointment can be stressful. Luckily, Dr. Beleznay shares some questions that may help you.

Kate

Dr. Katie Beleznay is a clinical Instructor with the University of British Columbia Department of Dermatology. She focuses her research and specializes in the areas of acne, rosacea, psoriasis and urticaria. You can follow Dr. Beleznay on Twitter here or on LinkedIn here.

Speaking to your dermatologist isn’t always easy. It isn’t effortless like chatting with your best friend – although we wish it was! On the other hand, it’s not like you are talking to a complete stranger – unless they are a complete stranger because it’s your first appointment (I digress…).

Psoriasis can affect so much more than just your skin. From sex to stress and everything in between, psoriasis finds a way into almost every aspect of your life. And divulging your deepest, darkest feelings to your dermatologist might feel a bit odd. Specifically, the “And how does that make you feel?” question might be one you try to avoid answering.

Of course, this is not something that you should feel embarrassed about. It’s common that people feel uncomfortable discussing their emotions and emotional symptoms. This may be why many individuals I meet with want to make sure they are asking the right questions once they finally muster up the courage to do so.

In case you’re still working through this, I thought it may be helpful to provide a list of three important - but challenging - questions to ask at your next dermatologist appointment. They cover the emotional side of psoriasis, and can help you uncover the answers you need to find the best path forward.

1. Does my psoriasis have anything to do with how I’m feeling emotionally?

Short answer: Perhaps, and speaking with a doctor will help you figure out the answer. With conditions such as psoriasis, there is often a connection between the skin and mental conditions. In some cases, it is difficult to tell whether the skin condition is making a mental condition worse or vice versa, which is why it’s important to ask this question. As dermatologists, we may want to attempt to separate the two as they need to be dealt with differently. The physical manifestations on the skin are best addressed by a dermatologist, while the mental condition may often be evaluated by a mental health professional. Although both may require two separate treatment options, both can be discussed when initially speaking with your dermatologist about your skin condition.

2. Why/how should I track my mood when dealing with flare-ups?

It is an essential part of the process to track of your mood, as well as anything that causes stress in order to identify any potential triggers of your flare-ups. This leads to the very important DLQI test, which you should consider taking if you haven’t already. The DLQI assesses how psoriasis is impacting your quality of life.1,2 You can actually take the DLQI here.

For some patients, I recommend they keep a journal. It can be very beneficial to keep note of your mood. If writing in a journal is not something you want to do, you can also record a short memo on your phone each morning and evening to track how you are feeling. There is also the Psoriasis Tracker app that does a great job of recording your symptoms and mood.

3. What should I be aware of/looking for when tracking my mood?

If you are consistently tracking your mood – whether it be paper, phone app or another way – there are a few things to keep an eye on. First, don’t just track your mood, try to track your symptoms as well. You are looking to see how moods and symptoms are related, and are looking for a pattern.

If you are struggling to notice patterns, here’s a tip: For both physical symptoms and mood, you should be aware of your “baseline”. A baseline shows how you are regularly feeling and what your skin condition is typically like. From there, make note if you are feeling happy/unhappy, content/agitated, calm/anxious. Add in your physical symptoms (if experiencing any) as well to the mix. Whether your mood change is directly or indirectly related to your psoriasis symptoms, make note of it.

I firmly believe that those who come to my office would feel better about how they are managing their psoriasis if they simply asked me these questions. Living with a skin condition is often challenging, and sometimes talking to a dermatologist can make people uncomfortable. But there is no need to worry; dermatologists, just like any other doctor, are here to help you. So please, talk to us!

  1. Dermatology Life Quality Index (DLQI)--a simple practical measure for routine clinical use. Finlay AY, Khan GK. Clin Exp Dermatol. 1994 May;19(3):210-6. http://www.ncbi.nlm.nih.gov/pubmed/?term=8033378
  2. Two considerations for patients with psoriasis and their clinicians: what defines mild, moderate, and severe psoriasis? What constitutes a clinically significant improvement when treating psoriasis? Krueger GG et al. J Am Acad Dermatol. 2000 Aug;43(2 Pt 1):281-5. http://www.ncbi.nlm.nih.gov/pubmed/?term=10906652

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