• Psoriasis treatment is important for overall health and well-being.
• Your dermatologist can help you determine your best treatment option during the COVID-19 pandemic.

Due to the rapidly evolving situation, interim guidance on disease management during the pandemic disseminated by medical societies is subject to change. The information contained in this article represents what are believed to be the relevant COVID-19-related publications and guidance for patients with immune-mediated inflammatory diseases as of Dec. 14, 2020.

Finding the right way to manage psoriasis remains important even amid the COVID-19 pandemic. This includes changing or starting a new therapy. If you are newly diagnosed with psoriasis, or if you are not happy with the results of your current treatment, there are many options available. With the help of your dermatologist, you can decide on the right approach and whether to start a new treatment.

In the early days of the pandemic, there were lots of questions and unknowns about medications that affect the immune system. People with psoriasis and other chronic illnesses worried whether their medications made them more likely to contract the novel coronavirus and develop serious complications of COVID-19. Scientific understanding of the relationship between psoriasis treatments and COVID-19 has advanced since March 2020, giving doctors additional information to help people with their treatment decisions.¹

The Importance of Psoriasis Treatment

Managing psoriasis is important for quality of life and overall health. Treatments for psoriasis can help reduce pain and itching and may reduce inflammation in the body that could contribute to other health problems.²

Finding the right therapy for psoriasis may be even more important during the pandemic because of the impact stress can have on symptoms.³ In one survey, 926 people with psoriasis in China were asked about their skin condition during the pandemic. The results of the survey showed that restrictions on outdoor activity and loss of income due to COVID-19 were associated with worsening psoriasis symptoms and symptoms of anxiety and depression. Nearly 44 percent of respondents reported at least moderate worsening of symptoms.⁴

Shared Decision-Making When Discussing Treatments

Choosing a treatment for psoriasis is always an important decision, but COVID-19 adds complicating factors. The National Psoriasis Foundation (NPF) task force recommends a shared decision-making process between doctors and people with psoriasis to determine which treatments are best in the context of COVID-19. Shared decision-making emphasizes partnership and communication between doctors and their patients.¹

Your dermatologist can work with you to determine the best approach for managing your psoriasis during the pandemic based on your individual situation, including determining whether to start a new therapy. In September 2020, the Journal of the American Academy of Dermatology published guidelines for psoriasis treatment during the COVID-19 pandemic. The guidelines, developed by a task force of physicians and the National Psoriasis Foundation, are designed to help people with psoriasis and their doctors make the best treatment decisions for overall well-being.¹

The guidelines recommend that people with psoriasis continue treatment in many cases, and that dermatologists inform newly diagnosed people and those who are not currently on treatment of the potential consequences of not being on treatment. Additionally, the guidelines recommend that individuals who test positive for COVID-19 or who have signs or symptoms of COVID-19 should stop treatment until they have recovered from COVID-19. Finally, anyone considering taking a systemic therapy that can affect the immune system should ask their doctor to evaluate and explain the risks and benefits prior to starting therapy, on a case-by-case basis.¹

The NPF task force recommends considering the following when developing a treatment plan:¹

• An individual’s level of risk exposure based on work setting, living situation, or other factors
• An individual’s risk for severe COVID-19 complications
• Current disease activity
• Experience with past treatments

Be sure to be open and honest about your psoriasis and treatment goals with your dermatologist, so you can work together to reach them.

Telehealth

Depending on your needs and local restrictions, a virtual appointment may be appropriate for discussing psoriasis management with your doctor. A telehealth visit may be an option for someone newly diagnosed, depending on individual factors and local rules. Talk to your doctor or an office representative about their current recommendations. The National Psoriasis Foundation offers tips for a successful telehealth appointment.

In-Person Visits

If you and your doctor have determined that an in-person appointment is right for you, you may have to wait for an opening. Your dermatologist’s office may be seeing fewer people each day to maintain social distancing in the waiting area. They also may be backed up with appointments that were postponed in the spring, when many doctors were only seeing urgent cases. Dermatologists may be triaging appointments and prioritizing skin cancer cases over chronic conditions like psoriasis.⁵ It’s best to remain patient in the face of these backups.

If you do attend an in-person appointment, discuss safety protocols with your provider in advance so you know what to expect. You will almost certainly be required to wear a face covering — some offices provide masks — and you may have to have your temperature taken before entering the building or office. You may also not be permitted to sit in a waiting area before your appointment time.⁶

Read tips for staying safe during the COVID-19 pandemic.

Patience and Persistence

COVID-19 has upset daily life and impacted the way health care professionals provide care. The pandemic doesn’t mean you can’t access the health care you need to treat your psoriasis, but it may require more flexibility. It is important to remember that doctors, nurses, and other health care staff are doing their best to meet everyone’s needs during a challenging time. Do your best to have patience with the challenges health care staff are facing, but remain persistent in seeking the care you need.

Finding Support

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