Dermatologists are doctors who specialize in treating conditions that affect the skin, hair, nails, and scalp, including psoriasis. A dermatologist can make a diagnosis, prescribe treatments, and offer suggestions for lifestyle changes and self-care practices that may relieve skin symptoms.
After receiving treatment recommendations, it is important for a person with psoriasis to continue to see a dermatologist at regular intervals. The dermatologist will monitor their symptoms, watch for complications, and help effectively treat the condition.
This article discusses how a dermatologist can help with psoriasis. It also explains when a person should make an appointment and how to prepare for the visit.
A dermatologist is a doctor who specializes in dermatology — an area of medicine that focuses on health issues that affect the skin, hair, nails, and mucous membranes. As dermatologists are experts in skin conditions, they have more experience than a primary care doctor in skin-related topics and are able to diagnose and treat more than 3,000 conditions of the skin, hair, and nails, including psoriasis.
When making a diagnosis, dermatologists will likely carry out a physical examination and ask the person an array of questions. They will want to know if an individual has:
- skin symptoms
- joint problems, such as stiffness, pain, and swelling
- unrelated symptoms, as psoriasis may increase the risk of other health conditions
- relatives who have psoriasis
- experienced recent life events, such as increased stress or an illness
In addition, the dermatologist may perform a biopsy, which involves removing a small piece of skin to examine under a microscope. They will be able to use the person’s answers and the results of the physical exam and the biopsy to determine whether a person has psoriasis or another skin condition.
Once a dermatologist has diagnosed psoriasis, they will work with the individual to develop a treatment plan to help them manage the condition. The plan may include:
- recommendations for skin care products and practices
- advice on how to identify and avoid triggers
- prescriptions for medications and other treatments
After prescribing treatment, the dermatologist will usually ask the person to make follow-up appointments. The aims of these visits include:
- seeing how the treatment plan is working
- changing the treatment plan when necessary
- evaluating the risk of developing conditions that are common in psoriasis
- providing realistic expectations for managing psoriasis
- detecting early signs of psoriatic arthritis
Psoriatic arthritis is an ongoing inflammatory condition that affects the joints and the tissues connecting to them, such as ligaments and tendons. A person can experience psoriatic arthritis at any age, but it typically occurs between the ages of 30 and 50 years. Evidence suggests that about 30% of people with psoriasis develop psoriatic arthritis.
If a dermatologist suspects that someone has psoriatic arthritis, they will refer them to a rheumatologist — a doctor who specializes in autoimmune conditions and conditions that affect the joints, tendons, ligaments, bones, and muscles.
The National Psoriasis Foundation (NPF) advises that anyone with symptoms that may indicate psoriasis should see a dermatologist. The symptoms of psoriasis may include thick, raised patches of dry, itchy skin.
The NPF adds that it is particularly beneficial to find a dermatologist who has experience in treating psoriasis if any of the following applies:
- The symptoms are worsening, or a flare-up is occurring.
- The treatments that a primary care doctor prescribed are not relieving the symptoms.
- The individual wishes to try a treatment that their primary care doctor is unfamiliar with, such as phototherapy or a biologic medication.
People who think that they might have psoriasis may wish to schedule an appointment with their primary care doctor, who can likely refer them to a dermatologist. Alternatively, they can visit the NPF’s Patient Navigation Center.
Once a person has obtained the names of some local dermatologists, the American Academy of Dermatology Association (AAD) recommends visiting each of the doctor’s websites to check whether they are board certified.
In the United States, a qualified dermatologist will have certification from the American Board of Dermatology, the American Osteopathic Board of Dermatology, or the Royal College of Physicians and Surgeons of Canada. Some dermatologists with these credentials may have the initials FAAD after their name, which stands for Fellow of the American Academy of Dermatology.
The AAD provides this search tool to find dermatologists in a certain area.
Before making an appointment, a person may also wish to check with their insurance provider whether the dermatologist is in their network and whether their insurance plan covers the visit.
People with psoriasis will likely have many questions for their dermatologist. Individuals commonly ask about:
- how long they will have psoriasis
- how psoriasis treatment may affect attempts to start a family
- nail psoriasis and its treatment
Individuals may also want to ask other questions to get further information on:
- future symptoms to expect
- the treatment options and their duration and side effects
- interactions between psoriasis treatment and treatment for other conditions
- lifestyle practices to follow or avoid to minimize symptoms
A key part of the preparation for a visit with a dermatologist is to track and record all symptoms. Doing this allows for a thorough discussion, which will help the dermatologist create an effective treatment plan.
Symptom tracking is particularly important for psoriasis, which can alternate between flare-ups of varying duration and periods of remission that can last for 1–12 months.
The person should note:
- Intensity: People can use a scale of 1–10 to rate the intensity of each symptom.
- Location: The dermatologist will want to know what part of the body each symptom affects.
- Duration: It is important to note how long each symptom lasts.
- Variation: People should record how any symptoms change over time.
Other preparations may include:
- writing the names and dosages of all prescription and over-the-counter medications and dietary supplements
- checking the medical history of family members
- gathering lab results from tests that another doctor has ordered to bring along
- avoiding wearing makeup, moisturizer, and nail polish
A person may also find it helpful to bring a pen and notebook to the consultation to write down instructions or any unfamiliar terms.
The ideal frequency of appointments will vary among individuals. It will depend on several factors, including:
- the severity of the psoriasis
- the frequency of flare-ups
- the development of any other health conditions
After each visit, a dermatologist will generally recommend when to make a follow-up appointment. It is important to keep these appointments so that the dermatologist can monitor the condition.
If a person suspects that they have psoriasis, a dermatologist can diagnose the condition and put together an individualized treatment plan. In addition to medication, this will likely include recommendations for skin care and advice on identifying and avoiding triggers.
To prepare for appointments, people may wish to keep an ongoing record of the frequency and severity of their symptoms. It may also be helpful to make a list of questions to ask the dermatologist.