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The National Psoriasis Foundation's Dr. Tell Me Blog is written by experts in dermatology, rheumatology, mental health and wellness as a way to deliver the latest information on psoriasis and psoriatic arthritis care.

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Difficulty Dressing

I’m having a very difficult time buttoning my shirt. What can I do about it? The first thing I would suggest is see a physical therapist or an occupational therapist. They can evaluate you and help you come up with ways to make that task much easier for you. There is a lot of adaptive […]



Effectiveness of Biologics After Stopping and Restarting

When someone using a biologic stops it and uses no other systemic drug, can they go back on a biologic a few years later and have it still be effective for them? The answer is yes, but it’s not a good plan. There are several reasons why you should stay on a biologic and continue… Read more »



Treatment vacations and psoriatic arthritis

Should someone with mild psoriatic arthritis only take meds during a flare? If one has a modest case of psoriatic arthritis is it necessary to treat and will there be joint deterioration if it’s not treated? I will tell you that you can completely get rid of the pain of psoriatic arthritis and continue to… Read more »



Methotrexate and alcohol

I’m on low-dose methotrexate. Is it OK to have a single glass of wine each night, not on a day of dosage? When I put a patient on methotrexate I tell them they should never drink, ever. I figure if I tell them that they might have one or two drinks a year. Some of… Read more »



Heat or Cold for Psoriatic Arthritis Pain Relief

Is heat or cold recommended for pain relief? I find heat much better but some say that increases the inflammation and I should use cold. I find cold makes me ache more. Can you advise? I would go with what you’re using. If it’s comfortable, I don’t see any reason not to recommend the heat…. Read more »



Psoriatic Arthritis Effect on Tendons and Ligaments

Why is there pain not only of the joints but throughout the body? Can psoriatic arthritis affect only the muscle tendons and not the joints? I’ll answer the second one first. It definitely can just affect tendons or ligaments, it doesn’t have to affect joints. If you had someone who had a tendonopathy that was… Read more »



Differences Between Psoriatic Arthritis and Osteoarthritis

How can I tell the difference between my psoriatic arthritis and my osteoarthritis, and does it really matter? I would say it definitely matters because if you have active psoriatic arthritis, there are going to be medications that your doctor might want you to take. You can actually get into big trouble if you are… Read more »



Nothing seems to work. Any tips?

I feel like I’ve tried every treatment and nothing works. I feel my doctor doesn’t listen to me. Do you have any tips to cope with this frustration? First of all, there are so many treatments for psoriasis – from biologics to phototherapy to topicals — that when patients feel like they have tried everything,… Read more »



Side effects of coal tar treatment

What side effects should I watch out for while using coal tar? Coal tar can irritate the skin. It may also cause photosensitivity, meaning that you are more likely to burn when in the sun. Coal tar is carcinogenic (causes cancer) in animals. There is debate about coal tar’s potential to cause cancer in humans…. Read more »



Genetic risk of developing psoriasis

Will my child have psoriasis? One of my patients with psoriasis recently became pregnant. This was her first pregnancy and she was excited about welcoming this new joy into her life. At the end of her visit, she asked, “What are the chances that my child will have psoriasis, too?” This is an important question… Read more »



Military service and psoriasis

Why does having psoriasis disqualify you from military service? In my opinion, psoriasis should not necessarily disqualify someone from military service. I believe that if someone with a history of psoriasis wants to serve in the military, the decision about their eligibility should take into account the severity of their disease and its affect on… Read more »



Psoriasis and the shingles vaccine

I have psoriasis. Can I get the shingles vaccine? If someone I live with is eligible for the vaccine and decides to get it, am I at a higher risk for getting the zoster (shingles) virus? The shingles vaccine is approved for people ages 60 and over to prevent or decrease the likelihood of developing… Read more »



Psoriasis and tanning beds

Can tanning beds be used to treat psoriasis? Are they a safe alternative to phototherapy units? There are differences in the purpose and delivery of light used in tanning salons. For one thing, most of the energy of a tanning bed is within the ultraviolet light A (UVA) wavelength spectrum of light. This spectrum doesn’t… Read more »



Vitamin D and Psoriasis

Vitamin D has been in the news quite a bit lately. Almost every magazine and every news channel had something to say about vitamin D. Most of the scientific reports are contradictory to each other about vitamin D and overall health. We certainly know one thing and that’s the sales of vitamin D supplements are… Read more »



Waxing and waning of psoriasis

Why does my psoriasis “wax and wane”? Psoriasis is a condition that can have good moments and bad moments. Despite being on therapy, your psoriasis may be clear one day and suddenly worsen the next day. Bacterial or viral infections, certain medications and trauma can all cause psoriasis to worsen. Sometimes it worsens for seemingly… Read more »



Hair loss from scalp psoriasis

Will scalp psoriasis cause my hair to fall off? Scalp psoriasis, when severe, may cause an increase in shedding of hair, along with scales in the thick plaques. However, this is not a permanent scarring type of hair loss, and hair growth can recover following effective treatment. Although scalp psoriasis is one of the most… Read more »



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