Things You Should Never Say to Someone with Psoriasis

If you have psoriasis, you’ve probably heard all sorts of questions and comments about the disease. You may have even gotten well-intentioned but incorrect advice from friends and family.

“It’s incredibly frustrating, because I feel like there’s still so much misinformation out there about psoriasis,” says Sabrina Skiles, 33, a business- relations specialist and blogger.

“That’s the main reason I’m so passionate about getting the right kind of information out there,” adds Skiles, who’s had psoriasis for more than 15 years.

If you have a friend, relative, or colleague with psoriasis, you may want to think twice before making one of these less-than-helpful remarks.

1. “That looks contagious.”

This is a common mistake that many people who don’t have psoriasis make about the disease. “Psoriasis is not a contagious disease,” says Anna K. Dewan, MD, an assistant professor in the division of dermatology at Vanderbilt University Medical Center in Nashville, Tennessee. “It’s a disease of the immune system, and affected skin is actually very unlikely to become infected.”

So why do so many people think psoriasis is contagious? “Psoriasis is an inflammation. Both inflammation and infection can appear raised, red, and angry, so it's not surprising that people sometimes fear they can catch psoriasis just by touching it,” explains Lisa Pawelski, MD, a dermatologist at Dermatology Care in Pittsburgh. “But infections are caused by bacteria, fungi, viruses, and other organisms that can be passed from person to person. Psoriasis is not.”

2. “Just put lotion on it.”

Psoriasis causes itchy, scaly plaques of thick, red, dry skin. As the National Psoriasis Foundation points out, “keeping the skin lubricated on a daily basis is an important part of psoriasis care because it reduces redness and itching and helps the skin heal.” But people who aren’t familiar with the disease often think it can be managed with simple skin treatments.

“It’s not just dry skin,” Skiles says. “It’s actually an autoimmune disease, and it’s more than skin-deep. There is no magical, ‘cure-all’ lotion.”

Topical treatments applied directly to the skin are usually the first option for treating mild to moderate psoriasis. These therapies may be over-the-counter or prescription creams and ointments. But many patients require more than topical treatments to manage their symptoms.

3. “My friend has psoriasis, and it doesn’t look like that.”

Not all cases of psoriasis are alike. Indeed, there are different types of the disease, including guttate, pustular, inverse, and erythrodermic psoriasis.

Plaque psoriasis is the most common type. Symptoms typically develop on the elbows, knees, scalp, and trunk of the body, but they can occur anywhere.

“Psoriasis affects and appears differently for every single person,” Skiles says. Its symptoms can range from dandruff-like scaling to major eruptions that cover large areas of skin. It can also cause pus-filled bumps (in the case of pustular psoriasis) and thickened, pitted, or ridged nails.

4. “It’s probably something in your diet.”

There’s no definitive medical evidence linking psoriasis and diet. “While we encourage healthy eating and exercise for all our patients, psoriasis is not caused by particular foods,” Dr. Dewan says.

Some skin conditions may be worsened by wheat, for instance, but “little scientific research supports a gluten-free diet for psoriasis,” says Paul Yamauchi, MD, of the Dermatology Institute and Skin Care Center in Santa Monica, California.

Still, many people with psoriasis believe that eliminating certain foods and drinks can offer some relief from symptoms. Among the things people often cite as triggering psoriasis flare-ups are dairy, red meat, citrus fruits, and alcohol.

If you think specific foods may be helping or hurting your psoriasis, talk to your doctor. Don’t just start eliminating foods from your diet — you may be sacrificing essential nutritional benefits.

5. “Your doctor can give you something to make it go away.”

There’s no cure for psoriasis, although effective treatment can usually keep symptoms under control. Most psoriasis therapies aim to stop skin cells from growing so quickly and to smooth out the skin.

Treatment options include topicals, systemic or biologic drugs that work throughout the body, and light therapy.

Unfortunately, psoriasis treatments can stop working, and your doctor may have to suggest different medications and therapies. The good news, Skiles says, is that “there are many medical advances being made every day.”

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