Living with psoriasis can involve itching, scaling, pain, and unpredictable flare-ups. Finding a treatment that works and getting access to care can also take time. For people who also have psoriatic arthritis (PsA), joint symptoms may add another major challenge.

Recently, we asked MyPsoriasisTeam members which challenge currently has the biggest impact on their daily life. Their comments showed how itching, persistent symptoms, treatment frustrations, and related health concerns can affect work, sleep, mobility, and emotional well-being.

Itching, pain, and flare-ups led the poll, with finding an effective treatment close behind. Members also frequently brought up PsA, fatigue, and the emotional impact of symptoms.

No two experiences with psoriasis are the same. Your challenges may depend on your symptoms, other health conditions, and how well treatment is working. Your healthcare team can help you understand which treatment and support options may be right for you.

Members described itching, plaques, scalp symptoms, and unpredictable flares. For some, symptoms affected sleep, work, social situations, and their ability to keep up with everyday activities.

One MyPsoriasisTeam member described how uncomfortable scalp itching could become while working: “The worst is when I was serving food … in the nursing home and hospital, and it itches so bad, I literally have to go to where they can’t see me just scratch my head. I didn’t want anyone to think I had critters.”

“It itches so bad, I literally have to go to where they can’t see me just scratch my head. I didn’t want anyone to think I had critters.”

 

— A MyPsoriasisTeam member

Another member described difficulty getting restful sleep: “My biggest challenge/complaint is being able to sleep, getting to sleep, staying asleep, feeling rested after sleep does come.”

What May Help

If itching, scaling, or flare-ups interfere with sleep, work, or daily activities, tell your dermatologist. Ask whether your current treatment is adequately controlling your symptoms and what options might help with persistent itching or discomfort.

You can also explore tips for managing psoriasis itching and talk with your healthcare team about gentle skin care, moisturizers, and ways to track possible triggers.

Keeping track of when symptoms worsen may help you and your healthcare team recognize what is happening.

One-third of respondents said finding the right treatment or care approach was their biggest challenge. Members described trying different approaches, dealing with side effects, and sometimes finding that a treatment helped one symptom but not another.

Psoriasis treatment plans should be individualized to a person’s needs. The goal may include reducing symptoms such as itching and preventing psoriasis from getting worse.

One MyPsoriasisTeam member described the frustration of finding relief without seeing their psoriasis clear: “There is nothing that seems to work. I can stop the itching, but nothing clears it up.”

“I can stop the itching, but nothing clears it up.”

 

— A MyPsoriasisTeam member

What May Help

If your psoriasis treatment isn’t providing enough relief or is causing bothersome side effects, talk with your dermatologist. You might ask:

• How long the treatment may take to work
• What results to expect
• Whether other approaches might be appropriate

One treatment option is light therapy (phototherapy) for psoriasis. Ask your dermatologist whether it might work for you. Phototherapy should be planned and monitored with a healthcare professional, especially if you experience burning or have concerns about light sensitivity.

Like other psoriasis treatments, phototherapy doesn’t work for everyone and can cause side effects. One MyPsoriasisTeam member shared: “Trying phototherapy but keep burning. Did phototherapy work for anyone?”

If you experience burning during phototherapy, tell your dermatologist so they can adjust your treatment.

Not every member’s biggest challenge involved visible skin symptoms. Some described PsA, an inflammatory condition that can affect the joints and areas where tendons and ligaments attach to bones, as well as overwhelming fatigue. Not everyone with psoriasis develops PsA.

One MyPsoriasisTeam member described how joint pain had severely limited their mobility and daily activities: “The psoriatic arthritis is my biggest issue right now. ... I have been pretty much bedridden for a month. Barely able to do what daily life requires of me.”

“The psoriatic arthritis is my biggest issue right now. ... I have been pretty much bedridden for a month.”

 

— A MyPsoriasisTeam member

Another member described persistent exhaustion: “Trying to fight the fatigue. It is all-encompassing and never-ending.”

What May Help

If you have psoriasis and develop joint pain, swelling, or stiffness, tell your healthcare provider. These symptoms may be signs of PsA, which can require additional evaluation and treatment. A rheumatologist may be able to help.

Fatigue related to PsA can have several causes, and there are ways to ease the symptom. Ask your healthcare team whether fatigue could be related to PsA, sleep problems, medications, or another health condition.

About 8 percent of respondents chose affording or accessing care as their biggest challenge. Members described insurance denials, high medication costs, and difficulties getting prescriptions filled. For some, these barriers interrupted treatments that had previously been helping.

One MyPsoriasisTeam member described losing insurance coverage for an effective medication: “Having insurance deny coverage of medication after several years of use with good results.”

Another member described how problems with medication coverage and co-pay assistance interrupted treatment: “I am in between medications. ... I lost my co-pay card for the name brand and couldn’t afford the generic. ... I’ve been without medication for two weeks. Having a bad psoriasis flare.”

“I lost my co-pay card for the name brand and couldn’t afford the generic. ... I’ve been without medication for two weeks.”

 

— A MyPsoriasisTeam member

What May Help

If cost or insurance problems make it difficult to get your prescribed treatment, tell your healthcare team before you run out of medication. Ask whether there are covered alternatives, financial assistance programs, or other resources that could help you continue care.

The National Psoriasis Foundation offers a list of financial assistance options for psoriasis medicines, including co-pay assistance and other programs. The nonprofit’s Patient Navigation Center can also help people understand insurance, find treatment-access resources, and locate dermatology or rheumatology care.

Your dermatologist’s office may be able to help with insurance appeals or prior authorization requests. A pharmacist or patient navigator may also be able to explain coverage options and help you find additional support.