5 tips on improving quality-of-life for psoriasis patients

| Melissa Leavitt
Richard Fried, M.D., of Yardley Dermatology Associates in Yardley, Pennsylvania, is a dermatologist and a psychologist. Early in his career, Fried recognized that a person’s skin condition affected their emotional state — and that a state of emotional distress could show up as a skin flare
The impact of conditions like psoriasis can ripple out into every area of life, including work, relationships and even a person’s private thoughts and feelings. “I think that the mind and skin are almost never separated,” Fried says.
Fried, who is also a member of the NPF medical board, offers five tips to his fellow dermatologists to help their patients overcome the emotional impact of psoriasis:
1. Let your patients know you understand what they’re going through.
Fried takes a few moments of the office visit to find out whether someone is having trouble coping with their disease. “Sometimes by just giving one or two more seconds of eye contact and asking that direct question, ‘Is it tough? Do you hate it?’ you have communicated to them that you get it. You understand that this can be a devastatingly difficult thing to live with,” he says.
2. Teach patients how to manage stress and anxiety.
“What can I do to make people feel less of a sense of dread and more hopeful and optimistic? Give them tools,” Fried says. Stress-management strategies that can make patients feel more empowered include mindfulness meditation, yoga, tai chi or therapy, Fried says.
3. Keep in mind that telling patients to manage their stress can make them more stressed out.
It’s important to assure patients that if they still continue to flare after starting these strategies, “it’s not their fault because they failed to manage their stress and distress well enough,” Fried says. Many things can trigger a flare, not just stress.
4. Point your patients toward the right resources.
If a patient opens up to you about their depression, refer them to a specialist in skin-emotion issues. “I always advise dermatologists and primary care docs, ‘Align yourself with someone who’s got a strong interest in skin, be they psychologists, be they psychiatrists, be they social workers.’ And that way they are at your disposal to refer patients to,” he says.
5. Recognize there is more to psoriasis than meets the eye.
“We never dare to be so audacious as to assume that we can assess psychological impact based on clinical severity,” Fried says. Even patients with mild psoriasis may feel an extreme emotional impact from the disease.
He believes all dermatologists are equipped to relieve the emotional burden of psoriasis.
“Anytime we express a true understanding and empathy, we are doing psycho-dermatology and we are helping people to heal,” Fried says.  
More resources

Download this free fact sheet on the emotional impacts of psoriatic disease.

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