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COVID-19 Guidelines for People With Psoriasis
The National Psoriasis Foundation’s COVID-19 task force recently updated its recommendations on how to stay healthy during the pandemic. By Howard ChangFor The Itch to Beat PsoriasisReviewed: July 30, 2020Everyday Health BlogsFact-CheckedAvoiding potential coronavirus exposure remains a key way to reduce COVID-19 risk.Yulia Zaikina/iStockWay back in March, I wondered if having psoriasis or taking psoriasis medications increased my risk of contracting the novel coronavirus (SARS-CoV-2). At the time, there was no guidance from medical experts about what to do. A week before our local authorities in Yolo County, California, issued shelter-in-place orders, my wife and I decided to play it safe and stay home. The news each day reveals more about the coronavirus and the illness it causes, COVID-19. In early June, the National Psoriasis Foundation’s COVID-19 task force released recommendations for the psoriatic community in response to the pandemic, with an update on July 7. Below, I summarize my takeaways from the recommendations and how they impact me as a person living with severe psoriasis. RELATED: A Guide to Living With Psoriasis During the COVID-19 Pandemic Help Resources and Making a Personal Checklist Recommendation Lower Your Exposure Risk
The task force recommends practicing physical distancing, wearing face coverings in public settings when physical distancing is difficult, and washing hands regularly. Even though I feel fatigued trying to follow these recommendations month after month, I stay vigilant. Recent news suggests that COVID-19 might not go away for a while yet. So I will continue to do my best to lower my exposure risk, even if I don’t always do it perfectly. That means washing my hands regularly and moisturizing them afterward, since they become irritated or dry if I forget. I try not to touch my face, although I struggle with eczema itchiness. I regularly wear face coverings in public, although sometimes the moisture buildup irritates my face. I’m also avoiding seeing friends and family in person — the part of my pre-pandemic life that I miss the most. RELATED: Preventing Coronavirus Exposure When You Have Psoriasis and Eczema Recommendation Maintain Your Current Medications
A major question I had from the beginning of the coronavirus pandemic is whether I should continue taking my biologic, Skyrizi (risankizumab). While I’m not a scientist or medical professional, I understand that psoriasis stems from an overactive immune system. Since my injectable biologic works by suppressing my immune system, I reasoned that it might raise my coronavirus risk. But the task force recommends that people with psoriasis continue biologic or oral therapies. Here’s its statement: “While some uncertainties remain, initial data suggest that the benefit of continuing treatments for psoriatic diseases outweighs the hypothetical risks associated with immune-modulating treatment of poor COVID-19-related outcomes for most patients.” The task force also encourages each individual with psoriasis or psoriatic arthritis to consult with their healthcare provider, who can discuss a therapy plan while considering factors such as a patient’s age, disease characteristics, current treatments, underlying medication conditions, and personal concerns. I appreciate the task force’s acknowledgment that treatment decisions are unique for each person. To discuss my own options, I messaged my dermatologist a couple of months ago. We decided at the time, and again at my most recent telemedicine appointment, to continue my biologic therapy. Without the biologic I would be at risk for a major flare, something I would like to avoid if possible. Because I mostly stay at home and am younger than 65 — two factors that reduce my risk of coronavirus exposure and complications — my dermatologist and I decided that controlling my psoriasis outweighed any possible risk associated with my medication. I feel at peace with this treatment course, knowing I can contact my dermatologist any time to discuss changes as necessary. RELATED: Why You Shouldn’t Skip Your Dermatology Appointment During COVID-19 Recommendation Discuss Treatment Options With Your Doctor if You Get Infected
I don’t like to think about what might happen if I become infected with COVID-19. I’d rather spend my time and energy minimizing exposure to prevent it from happening. But if I do contract the disease, I’m glad the task force addressed what to do. As with other recommendations, they advise talking to a healthcare professional about whether to stop biologic or oral therapies while infected with COVID-19. In past years, when I had a bacterial infection or the flu, my dermatologist advised me to stop any medications that affected my immune system. But with COVID-19, the situation may be different. The task force makes the point that psoriasis medications could potentially even treat COVID-19: “While it is generally advised to hold immune-modulating treatment during an infection, in the case of COVID-19, several different immune-modulating treatments used for psoriasis and other immune-mediated or autoimmune diseases are being studied in experimental placebo-controlled trials to treat or prevent severe COVID-19 illness in those infected with SARS-CoV-2.” An April 2020 article in the American Journal of Clinical Dermatology explains how this class of psoriasis medications might impact COVID-19: “Some selective immunosuppressants or immunomodulatory drugs might be useful in controlling the ‘cytokine storm’ associated with a poor outcome of COVID-19.” A cytokine storm can occur when the coronavirus pushes the immune system into overdrive, which can trigger hyperinflammation and cause potentially deadly damage to organs such as the lungs. I look forward to hearing more about this research as it unfolds. It’s fascinating to think that psoriasis medications might one day help treat COVID-19. RELATED: Scientists Fast-Track Research for Coronavirus Treatment and Vaccine Recommendation Consider Starting Treatment if You re Newly Diagnosed
The task force recommends that people who are newly diagnosed with psoriatic conditions or living with untreated psoriatic disease consider initiating therapy: “Untreated psoriatic disease is associated with serious impact on physical and emotional health, and in the case of psoriatic arthritis, can lead to permanent joint damage and disability.” I know that without treatment my skin would be covered in psoriatic lesions that would lead to a lot of physical discomfort and emotional distress. The task force also notes that stress is a potential trigger for worsening psoriasis. That has been true for me. My psoriasis and eczema worsened at the beginning of the pandemic, and I have experienced some sleepless nights worrying — insomnia is another psoriasis trigger for me. Furthermore, the task force mentions that there have been “reports of psoriasis flares associated with COVID-19 illness.” These serve as additional reasons to consider seeking treatment. Of course, all of these considerations entail a conversation with your healthcare provider. RELATED: Facing My Anxieties During the Coronavirus Crisis I’m grateful for the task force’s work but am still left with my original question: Does having psoriatic disease elevate my risk of contracting the coronavirus or ending up with a worse COVID-19 outcome? The task force doesn’t seem to have an answer for me yet; I’ll keep an eye out for their next update. Important: The views and opinions expressed in this article are those of the author and not Everyday Health.See More Most Recent in Psoriasis
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