Hi, everyone.

Welcome. I'm here with Dr. Walter. We are going to get into everything plaque psoriasis, so don't go anywhere. We are about to dive into it. Hi, my name is Scott Walter, and I'm a board certified dermatologist practicing in Denver, Colorado. And I can't wait to really have this conversation with you about everything plaque psoriasis and the journey that you've been through.

So just to introduce myself, my name is Victoria Voos. I am a creator online and I go by the name of @FlyforaGinger. I live in San Diego and work full time as a social media and marketing manager. I use social media as a way to connect with my audience who maybe experience plaque psoriasis themselves or even other skin concerns because I like to share my experience, see if we can connect about that.

And also just to show some visibility. A lot of people might have it where it's not seen and not visible and maybe feel like their voice isn't being heard. So I like to try and be a voice for those folks and for us to have conversations and connect. I learn from them just as they learn from me.

It has been a long journey of finding the right treatment for me, but it has been really rewarding to talk about it on social media. So that was kind of like my healing journey or my way of managing my own plaque psoriasis was part working with my dermatologist and part social experiment of finding my community online. I also create content on social media as @DenverSkinDoc.

With social media, I get a different perspective, so I create a lot of educational content, because unfortunately there is a lot of misinformation out there regarding plaque psoriasis. So I think I use social media as a tool to provide more information, just basic information about A, what is this rash? But B, what can you do about it? And C, like, when should you go to the doctor?

Victoria, can you walk me through your plaque psoriasis journey? How did it start? And you know, what challenges have you faced throughout that time? Just let me know kind of what you've been through. I have been dealing with plaque psoriasis for well over ten years. I've been through it all, so I have a lot of advice and opinions to share for sure. My plaque psoriasis journey started, I would say, after college. I don't know exactly what triggered it.

Maybe the stress, maybe all the homework. But I started to notice my plaque psoriasis coming down from my forehead. And so as my plaque psoriasis maybe started to cover some of my face and my body, it actually impacted a lot of choices that I would make day to day. Sometimes it would affect how I do my makeup, whether I use some redness corrector, more coverage, less coverage. And it also affects the kind of clothing that I wear. I might choose a different kind of fabric that's a little more gentle on my skin and maybe even avoid darker colors so that when I scratch my head and get those flakes on my shoulders, it's maybe not as obvious.

What were some of the early misconceptions you had about plaque psoriasis? So something that I thought psoriasis was all about was just the skin and that I learned is a misconception. It is not just on the skin, on what you see on the outside. It has a lot to do with what's on the inside as well. And that did come into play with finding treatment options that were right for me as well.

The other issue is some patients might not realize that the plaque psoriasis can appear elsewhere the nails, the scalp, the groin.So finding the right treatment option earlier on can make a huge difference later. And I think it's really interesting how the plaques show up really differently. Sometimes it for me it’ll feel like a scab or sometimes it's actually really smooth and not raised at all, but just like red. So it even shows up super different on different parts of my body and on different people too.

And sometimes it's hard to diagnose to because of that. You know, it can look like, you know, just a standard, you know, typical plaque in some patients. And sometimes it's much more kind of rashy and ill defined in other patients. But yeah, you're right. It can show up in totally different ways. You know, and the nails, on the scalp. Yeah. So like a quick Google search of like what's plaque psoriasis or what's wrong with my skin, it's going to look totally different on different people. So googling isn't always the best way to identify your skin issues. Yes, that is for sure. How do other plaque psoriasis patients describe their experience?

That's a great question. You know, I think it really varies on the patient because psoriasis can plaque psoriasis can affect so many different parts of the body. So sometimes it's, you know, on the scalp, sometimes it's under the arms or in other hidden places, or sometimes it's right out in the open, which affects them, you know, differently. So, you know, we, you know, try to tackle the plaque psoriasis in different ways with different medications and really trying to tailor the treatment for each individual patient so that they can get better. But I find that patients are often hesitant to bring it up or talk about it often when it is in those hidden places or if it is affecting their life in negative ways.

Sometimes they're embarrassed to bring that up to me at the office visit. So then, you know, I have to really get that out of them. How did you bring that up with your doctor? So I didn't actually know plaque psoriasis was anything more than just my skin, but I knew there were other concerns that I had. For instance, if I scratched my scalp, it would snow on my shoulders. And that meant maybe experimenting with different colors of clothing or different fabrics.

And so those were things that were making me uncomfortable, maybe even a little embarrassed. But I knew it was important to give my doctor the full scope of what was going on with me. A lot of it was because my lack of knowledge, right? I need my doctor to know what all is going on with me to help find the best treatment options. So I would share if my skin was being affected in maybe uncomfortable, embarrassing places that most folks might not want to talk about. But I knew it was important because they need the full picture to get the right treatment plan for you.

That's so true. You know, I think we need the full picture to really understand, you know, everything about you, the patient, you know, the plaque psoriasis. You know how it's affecting you outside of, you know, just your skin. So and that's how we, you know, hopefully come up with a great treatment option. Right. And how do they know what's bothering you if you don't say anything? I have plenty of patients who come in with plaque psoriasis and they think it's mild enough where they don't need to do treatment. Or maybe they've tried treatments in the past that didn't work or were too messy and they're just really not interested because they think they can just live with it.

But as a dermatologist, you know, I find my role is really about educating them about what plaque psoriasis is and all the different treatment options out there, because there's many options available nowadays that can be quite helpful. There's pills available. And the nice thing about those is they, you know, tackle the plaque psoriasis at the source.

So the inflammation inside the body. And at the end of the day, really, patients shouldn't just feel the need to just live with it because we have so many great treatment options. So what do you say to the patients who believe that they don't really need another treatment? Yeah, so that's a common thing I see with patients is that they think their disease is just mild and they don't really need treatment.

So when that happens, I take a step back and try to educate them about what plaque psoriasis is in the first place, and that it's more than just skin deep. It's actually a systemic autoimmune disease that creates inflammation on the inside of the body, but also the skin. And then we move forward with all the different treatment options available. So when I'm explaining that to the patient, I try to just go over everything so that we can make a decision together.

There's lots of options out there. Usually we start thinking with topicals. So those are creams, foams, solutions, which you apply topically once or twice a day. Then we also have pills, which you take orally. And then we also have injections or what we call biologic medications which are injected in the skin. So how did you find the right doctor when you are navigating, you know, the treatment options out there for you?

Finding the right doctor can be a journey, but making sure I did some of my research as well as ensuring there's some good dialogue and conversation between patient and doctor is really important to me. So I wanted to find someone who was going to work with me, with my lifestyle and take into account all of the different ways I was experiencing my plaque psoriasis.

Sometimes it was trial and error with the treatment options, and sometimes it was trial and error with the dermatologist, him or herself. So, you know, knowing that there are different doctors to speak to as well as different treatment options was really helpful to figure out how to better manage my plaque psoriasis. Yeah, I think it's, you know, a great point. You want to have a really good open relationship with your physician so that you can have that honest conversation with them.

You know, if something's not working that way, you can look at the other options. So how many dermatologists have you been to over the years? Like, did you have trouble finding the right one? I definitely had trouble finding the right dermatologist. I feel like way back in middle school, I saw someone for the back of my scalp. I had this it was like a crack right there and it would crack and bleed and hurt so bad. And he prescribed something that just burned terribly.

And it was awful. And you had to do it like multiple times a day. And it smelled gross and it hurt. And so I just kind of like, never did it again and really didn't have too much of an issue with my skin until after college, but had no idea that it was plaque psoriasis until I was eventually diagnosed. Then when it was, you know, a big issue. So I've seen lots of different dermatologists done lots of different treatments.

So sometimes they work, sometimes they don't. Sometimes they work for a while and then stop. I've been through a lot oh my gosh. Yeah, yeah, it's really tough, you know, but it's important to, you know, vibe well with your dermatologist.

Yeah, I think it's similar to like finding the right therapist or even finding like the right anxiety medication. It can be trial/error. Sometimes you don't vibe, but it's super important to go look for something else that might be better.

Totally. Victoria, what's one piece of advice you'd like the audience to take away from this conversation? I think if the audience can take anything away from this conversation, it's how important it is to feel empowered to advocate for yourself with your doctor. It's so important to give them a clear picture about what's going on with you because as we've mentioned, psoriasis is more than just your skin.

It is inside of your body. It's a systemic issue and your doctor really needs a clear picture of what's going on to find the best treatment for you. Thanks, Victoria, for having this conversation with me today. It's been really fun chatting with you about your psoriasis journey. I think that was really helpful for our audience.

Yeah, and thank you for answering all of my questions. I feel like I learned a lot. I hope our audience did too. So thank you so much for joining.