Did You Know Approximately 1 Million Canadians are Battling Psoriasis?

I am one of them.

Breaking the stigma? What does that actually mean? Well, when it comes to psoriasis, I feel now – more than ever – that some of the experiences I share will be relatable for a lot of you, or at least educate you on some of my daily struggles.

For years, I have dealt with plaque psoriasis, a chronic inflammatory skin condition that causes painful, itchy red plaques, all around my scalp. Let’s just say it hasn’t been an easy road. I will always remember getting my hair done and being looked at with disgust. Since then, my insecurity living with psoriasis has become even more real.
To this day, there are times I propose wearing my hair down, because I’m having a flare up, or I just spend my day fixing my hair nonstop, just so no one sees it. 

It has taken me some time, but I feel that since I have the most important job – being a mom – it’s important for me to not let psoriasis take over and define who I am. Instead, I have taken the steps to embrace this, share some of it with all of you, and never feel embarrassed about something that is beyond my control. 

I have learned there is nothing more frustrating than feeling like you have been defeated, that nothing is going to help you, and that no matter what you do, it’s just not good enough. I have tried so many different options or remedies and even delayed seeing the doctor during the pandemic. I feel I’ve just started saying to myself, ‘this is something I’m going to have to “deal” with’!  But the truth is, that’s not fair to myself.

Another reality is that COVID-19 is impacting psoriasis care for all patients, but something I can’t stress enough is: don’t wait to have a conversation with your doctor. For all skincare issues, it’s important to seek a dermatologist referral and an in-person visit.

So what’s next for me?

I will be meeting with dermatologist Dr. Geeta Yadav, the founder of Skin Science Dermatology in Toronto, to get her help and to begin to really dive into everything. Basically, start from a clean slate and find out what is going to help me with my ongoing battle. There are so many treatments out there and when you have a connection with someone you can trust, they will help you gain control and figure out what will work best for you. I am looking forward to meeting with her in person because there is nothing more important than having that open dialogue with your practitioner!

And that brings me to where I am now. I will be meeting with Dr. Yadav and will have the opportunity to speak with her to answer some questions we all may be wondering. 

I am so happy to be able to take all of you on this psoriasis journey with me.

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Here are some of the questions I had for Dr. Yadav!

Georgia: How does one get psoriasis?

I constantly blame myself as to why this happened to me, when I didn’t have it for years.

Dr. Yadav: When I think of psoriasis what causes it, the last thing I think about is a patient being responsible for this. There are a few different factors that affect someone’s predisposition towards getting psoriasis. 

 Psoriasis affects about 2% to 3% of the world’s population, but in Canada and US the prevalence is a bit higher. One of the main drivers of psoriasis, we believe, is a genetic predisposition, and depending on the study you look at, anywhere from 40% to 90% of people who have psoriasis will report a family history of someone with psoriasis. In addition to the genetic component, a person’s environment can also aggravate the disease and cause it to manifest or flare. For example, for many people, their psoriasis is worse in the winter because of the dryness, and then for others, the psoriasis gets better in the summer because the sun exposure can reduce the presence of plaques. 

For some people, they’ll find their psoriasis flares due to stress. There isn’t one specific gene, but there have been strong linkages with multiple genetic factors that show an increased risk for developing psoriasis with environmental factors playing a role as well. 

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Georgia: What are the most common triggers for psoriasis?

Dr. Yadav: 

Psoriasis can be triggered by many different things, for example stress, climate or even infection (for example, strep throat or HIV) or illness. Certain medications can cause psoriasis to flare and so can alcohol consumption, smoking and obesity.

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Georgia: Does psoriasis ever “go away”?

Dr. Yadav: 

It can “go away” in that sometimes people experience periods of remission, but there’s no mechanism to cure it. Newer therapies for psoriasis, however, can effectively clear the skin in a large majority of patients. For those patients, taking an injectable medication like Skyrizi once every three months – for example – and having clear skin, feels like a cure. 

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Georgia: How will we figure out what will work best for ME?

Dr. Yadav:

There are many factors that come into play when a doctor sits with a patient to discuss a therapeutic approach to treating the skin. Everything from the patient’s expectations to how much their condition impacts their quality of life comes into play.  I often try to understand what patients perceive as risky treatment and if they are open to systemic therapies even if that’s what I think they need. On the other hand, I meet many patients who are tired of using topical treatment after many years of suffering with psoriasis and don’t want another cream.

Treatment plans are not cookie cutter; they really are a collaborative effort, which is part of why it’s really important for patients to meet with their dermatologist to discuss the risks and benefits of their treatments as well as new treatment options.  

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Georgia: Once you have psoriasis, can it spread to other parts of your body?

Dr. Yadav:

It doesn’t spread in a classic sense, where some people think of an infection spreading, but it can appear in other sites of your body – especially if some of the environmental triggers are present (like stress or winter conditions). 

I will say psoriasis is one of those special dermatologist diagnoses that can also specifically appear in a site of trauma, so if someone has surgery and has a knee replacement, they can get psoriasis in that surgical site, but the “spread” is not in a traditional sense of an infection creeping up your arm or that you can transfer it from one location to the other. 

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Georgia: Can you tell me about available treatment options?

Dr. Yadav:

Treatment falls into three broad categories: topical treatments, phototherapy, and systemic treatment. For systemic treatment, this includes newer systemic agents known as biologics, which are targeted injectable therapies that effectively only block the precise chemical signal causing psoriasis in your body. Clinical trials are even currently underway for additional therapies for psoriasis so we really are at a time when patients have lots of excellent choices to manage their condition. 

References:

1. Canadian Psoriasis Network. Psoriasis Journey to Stability National Report. Winter 2018. https://www.canadianpsoriasisnetwork.com/wp-content/uploads/2018/09/JTSFinal-r.pdf. Accessed on August 26, 2021.  
2. Dermatology. Edited by Jean L. Bolognia, Julie V. Schaffer, Lorenzo Cerroni. Fourth Edition, China: Elsevier, 2018, ISBN 978–0-7020–6275–9.
3. Solmaz D, Bakirci S, Kimyon G, Kasapoglu Gunal E, Dogru A, Bayindir O, et al. The impact of having family history of psoriasis or psoriatic arthritis on psoriatic disease. Arthritis Care Res (Hoboken). 2020;72(1):63–8. 
   
4. HOLGATE MC. The age-of-onset of psoriasis and the relationship to parental psoriasis. Brit J Dermatol. 1975;92(4):443-448. doi:10.1111/j.1365-2133.1975.tb03106.x.