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Psoriasis: How the Pandemic Changed the Doctor-Patient Relationship

Medically Reviewed by Brunilda Nazario, MD on September 13, 2021

When the COVID-19 pandemic came into full swing in early 2020, chances are your doctor had to make big changes to the way they deliver care for psoriasis -- and some of the changes are here to stay.

Many dermatologists chose to see their patients virtually. It's a type of care called "telehealth" or "telemedicine." Telehealth virtual visits can include services like screening, diagnosis, treatment, and follow-up care.

What Is Telehealth Medicine?

Telehealth is a type of health visit in which your doctor or other health care experts can provide care without you having to visit them in person at an office, clinic, or a hospital. It can include phone calls, emails, or texts, using smartphones, tablets, or a computer.

Types of Telehealth Medicine

Video/audio chats. This type of doctor's appointment may include real-time audio-video chats with your doctor or other health care providers on a phone, tablet, or a computer. You may have to make an appointment just like you would for an in-person visit.

The doctor may use this virtual appointment to do a remote evaluation. This can include things like questions about your psoriasis symptoms, follow-up questions about your condition and medications, and addressing concerns you may have about your skin.

For appropriate psoriasis care, you can take a photo of your affected skin and send it to your doctor via email, text, or patient portal. During your appointment, your doctor can take a closer look on video in real-time or review your skin through the photos.

If your doctor isn't able to address your concerns remotely, they may suggest an in-person visit for a thorough check. In certain cases, you may have a hybrid in-person health test with a nurse, physician assistant, or other type of health care provider. This can include blood pressure and blood sugar checks or a physical exam to check if your rashes have changed. This information may be passed on to the doctor to help them get a better picture of your health.

Online patient portals. In this type of remote care, images, messages, and other important information is uploaded to a secure messaging website. Your doctor may evaluate this separately at another time and respond to it, order prescription drugs, or provide health advice based on the information available. Both you and your health care provider will access the secure portal to exchange information and messages.

Remote patient monitoring. Sometimes you may need specific or specialized type of skin care that may not be easily available where you live. In such cases, you may have to reach out to a specialist remotely from a distance.

Email or text communication. Your doctor or someone from your doctor's office may securely send test results or information about follow-up visits through email or text. This could include email attachments, images, and PDFs.

Telehealth and Psoriasis Care During a Pandemic

Here are some things to keep in mind when you seek care for your psoriasis during the COVID-19 pandemic:

  • Don't put off getting your psoriasis treatment if you're unable to manage it with over-the-counter medications. Reach out to your primary care doctor or a dermatologist right away.
  • If you're nervous about a virtual appointment with a doctor, ask a family member or a friend to join you. If they can't meet you in person, ask them to join via phone or video chat. This may ease your tension.
  • Understand that the COVID-19 pandemic has not only made health care difficult for you but also for the health care providers, too. The virtual appointment may be the best option to keep you and the health care staff safe and limit the spread of the virus.
  • Virtual doctor appointments may feel awkward. But just as you would in an in-person appointment, if you feel like you're not getting the right care, don't hesitate to get a second opinion. This may be available virtually, too.
  • If living with psoriasis has made you depressed or anxious, don't hesitate to reach out to mental health professionals for help. Many psychologists, therapists, and counselors offer virtual sessions, too.

If your doctor or health care providers believe you need to be seen in person for a certain treatments such as light therapy or injectable drugs, closely follow instructions to limit infection and stay vigilant about your health and safety. Ask your doctor if home light therapy is an option for you.

As dermatology care often includes physical touch during a checkup, take precautions to protect yourself against COVID-19 infection. Use sanitizer, wash your hands with skin-friendly soaps, and limit family visits if you're at the hospital for treatment.

Benefits of Virtual Psoriasis Care

The benefits of telehealth for your psoriasis and your overall health can include:

  • Screens people who may have symptoms of COVID-19 so they won't risk spreading illness to others.
  • Lets you know if you may need additional medical consultation or assessment.
  • Gives you access to specialists, including those for mental health and chronic health conditions.
  • Helps you manage your prescription drugs.
  • Provides coaching and support for various migraine issues, including lifestyle and nutrition counseling.
  • Lets you take part in physical therapy or occupational therapy.
  • Monitors your blood pressure, blood glucose levels, and other key measurements.
  • Gives you access to top medical care, especially if you live in a rural area or have limited ability to move or visit your doctor in person.
  • Provides remote follow-up appointments after you've been hospitalized. This helps to lower your exposure to any virus or bacteria if your immune system is compromised.

Dermatologists have been testing telehealth services to treat skin conditions for a while now. In 2018, one study to check for quality of care through telehealth services looked at 296 people with psoriasis and their care for a 12-month period. The participants were split into two groups: online visits and in-person care.

The study found that the psoriasis patients' disease severity and quality of life were the same whether they visited their doctors through video chats or consulted them in person. In fact, people who received online virtual visits showed greater improvement in terms of psoriasis severity on the skin.

Limitations of Telehealth

While a virtual visit may save you time and a trip to the doctor's office and keep you safe during a pandemic, there are several limitations you may face.

These include:

  • Doctor's office and health care regulations may vary state to state.
  • Your medical insurance may not cover out-of-state doctor visits. Depending on the type of care you may receive during your virtual visit, your insurance company may not cover the charges. And your insurance may not cover out-of-state doctor visits.
  • Virtual doctor visits may make it hard to discuss sensitive topics, especially if you have physical or emotional discomfort or certain privacy concerns.
  • Virtual visits require technology and internet access. If you live in a remote area, internet access could be an issue.
  • Without in-person physical exams, your doctor may miss or misdiagnose underlying conditions.
  • Virtual visits cannot fully replace emergency medical care.
 

Show Sources

SOURCES:

CDC: "Using Telehealth to Expand Access to Essential Health Services during the COVID-19 Pandemic."

Breastcancer.org: "Special Report: COVID-19's Impact on Breast Cancer Care."

JAMA: "Effectiveness of Online vs In-Person Care for Adults with Psoriasis: A Randomized Clinical Trial."

National Psoriasis Foundation: "Your Doctor Will See You Now -- Where is telemedicine headed?"

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