Psoriasis
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Psoriasis key facts
Psoriasis is a condition that appears as scaly patches on your skin and is thought to be caused by problems with the immune system. There is no specific cure for psoriasis, but lifestyle changes can help manage the symptoms. Here, we will take a closer look at the causes, symptoms, types and treatment options available for psoriasis.
What is Psoriasis?
Psoriasis is a skin disease thought to be caused by an overactive immune system, that results in the rapid growth and build up of skin cells. Psoriasis appears as plaque on the skin, most commonly between the ages of 15 and 25. It is not however contagious and can not be passed directly, from person to person.
Types of Psoriasis
There are many types of psoriasis, each with its own symptoms, affecting different areas of the body.
- Plaque Psoriasis: This is the most common type of psoriasis, making up 80% of cases according to the American Academy of Dermatology. Symptoms include dry, red skin lesions covered in silver scales. Plaque psoriasis may appear anywhere on your body but normally appears on the knees, elbows, scalp or lower back. In the most severe cases, skin may crack and bleed around the joints
- Guttate Psoriasis: This appears as drop-shaped sores, less than 1cm, on your arms, legs, chest, or scalp. Some people may develop plaque psoriasis. Guttate Psoriasis may occur after a strep throat infection and is more prevalent in children, teenagers and young adults
- Pustular Psoriasis: Characterized by pus-filled blisters surrounded by red skin, primarily affecting the hands and feet. Pustular psoriasis is a rarer type of psoriasis. Different types of pustular psoriasis affect different parts of the body
- Inverse Psoriasis: These appear as large smooth red patches in skin folds, beneath the armpits, breasts, between the buttocks or groin. This is made worse by sweating and friction
- Erythrodermic Psoriasis: A rare and severe form of psoriasis that covers large areas of the body and requires immediate medical attention. Erythrodermic Psoriasis causes discolouration of the skin and the shedding of scales on sheets. It may be triggered by bad sunburn, certain medications, infections, and stopping psoriasis treatment
- Scalp Psoriasis: This can occur on all or part of the scalp. Symptoms may include red patches of skin with thick silvery-white scales. Scalp psoriasis can feel extremely itchy, or cause no discomfort at all. In more serious cases it can cause hair loss. This, however, is usually only temporary
- Nail Psoriasis: Nail psoriasis affects about half of all people with psoriasis, causing your nails to become discoloured, develop tiny dents or pits, or grow abnormally. Nails can become loose and detach from your nail bed. In more severe cases, your nails may crumble
- Palmoplantar Pustular Psoriasis causes pustules to appear on the palms of your hands and the soles of your feet. They appear as circular brown, scaly spots, which peel off
- Acropustulosis: Pustules appear on your fingers and toes, then burst, leaving bright red areas, which may ooze or become scaly. Acropustulosis may also lead to painful nail deformities
- Erythrodermic Psoriasis is a rare type of psoriasis, affecting nearly all the skin on your body. It causes intense itching or burning and can also cause you to lose fluids and proteins, causing you to develop infections, dehydration, malnutrition, hypothermia and heart disease
Symptoms of Psoriasis
Symptoms can vary based on the individual and the type of psoriasis. Symptoms include:
- Inflamed patches of skin covered in scales
- Itching, burning, or stinging
- Dry, cracked skin that may bleed
- Nail abnormalities, such as pitting or ridges
- Joint pain and stiffness
Symptoms range from mild to severe and may come and go in cycles. Speak to a healthcare professional for a diagnosis and an appropriate treatment plan.
Causes of Psoriasis
Psoriasis is classed as an autoimmune disease. The exact trigger is not fully understood, but it is thought that genetics and environmental factors play a major role.
- Genetics: Family history of psoriasis increases the likelihood of developing the condition. Certain genes related to immune system function are thought to contribute to the development of psoriasis
- Immune system dysfunction: In individuals with psoriasis, the immune system mistakenly attacks healthy skin cells, leading to inflammation and rapid cell turnover
- Environmental factors: Infections, such as streptococcal infections, can trigger or exacerbate psoriasis symptoms. Other factors, such as stress, skin injuries, smoking, and obesity, may also contribute to the development or worsening of psoriasis
- Other medications: Beta blockers, other high high blood pressure drugs, antimalarials, lithium and other mood stabilizers, NSAIDs and antibiotics
Who is at risk?
Certain factors may increase the risk of developing psoriasis and flare-ups. These include:
- A family history of psoriasis
- Age, with it being most common between the ages of 15 and 25
- Psoriasis is more common in certain ethnic groups, with higher rates in those of European descent
- Smoking, obesity, and certain medications can all increase the risk of developing psoriasis
Diagnosing Psoriasis
Your healthcare provider will carry out a physical examination and review your medical history. They may also carry out a skin biopsy to confirm your diagnosis. You should let your healthcare provider know about any family history of psoriasis, or of any other risk factors that make your symptoms worse.
Treatment options for Psoriasis
The choice of treatment will depend on the type of psoriasis and how severe it is, as well as age, general health, and personal preferences. Mild psoriasis can be treated with creams or ointments such as Fucibet or Dermovate, while moderate and severe psoriasis may need treatment with tablets, injections, or phototherapy. Treatment options include:
- Topical treatments: Vitamin D creams, topical corticosteroid (steroid) ointments, and lotions containing retinoids (vitamin A derivative) applied directly to the affected skin to reduce inflammation and promote healing
- Phototherapy (light therapy): Controlled exposure to ultraviolet light to slow down skin cell turnover and reduce inflammation. Psoralen plus ultraviolet-A radiation (PUVA) combines psoralen with ultraviolet light
- Systemic medications: Prescription medications that target the immune system, (such as methotrexate, acitretin) and reduce inflammation throughout the body
- Biologics and small molecule inhibitors: Advanced therapies (etanercept, adalimumab) that specifically target molecules involved in the immune response, providing targeted relief from psoriasis symptoms
- Lifestyle modifications: Adopting healthy habits, such as managing stress, maintaining a healthy weight, and avoiding psoriasis triggers, can help improve symptoms and overall well-being
It is important to work closely with a healthcare provider to develop an individualized treatment plan that best suits your needs.
Lifestyle changes for Psoriasis management
In addition to medical treatments, certain lifestyle changes can help manage psoriasis symptoms and improve overall well-being. These include:
- Moisturizing the skin
- Avoiding common triggers
- Practicing good skin hygiene
- Maintaining a healthy weight
- Managing stress
- Protecting the skin from excessive sun exposure
Psoriasis and mental health
The nature of the condition can lead to embarrassment, self-consciousness, and low self-esteem and people with psoriasis may be at a higher risk of mental health conditions. It is important to seek support from mental health counselors or support groups.
Psoriasis and Psoriatic Arthritis
Up to a third of people with psoriasis will develop psoriatic arthritis. Symptoms include inflammation, pain, and stiffness in the joints, as well as skin and nail changes.
Treatment options include medications to reduce the inflammation, physical therapy and lifestyle modifications, and a combination of dermatologists, rheumatologists, and other healthcare providers is often needed to manage both conditions effectively.
Conclusion
By understanding the causes, types, symptoms and treatment options available for psoriasis, individuals can develop plans to manage this skin condition.
If you think you have psoriasis and its associated symptoms, speak to your doctor for a diagnosis and advice on the most appropriate treatment for your condition.
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Service Guide
Everything you need to know about Getting Treated Privately
What does the Get Treated Privately service do?
The Get Treated Privately service is a private prescribing service which is designed for adults aged 18 years and over, who are experiencing health issues and who would like to receive a fast-track assessment and if applicable, a treatment plan from a qualified prescribing clinician. Treatments are dispensed and delivered to your home or workplace from our regulated online pharmacy.
Is this a safe service?
Yes. Our formulary of medications prescribed and conditions treated are controlled, governed, and continuously risk-assessed by our Medical Director, Dr. Aseel Hamoud. Unlike other prescribing services which operate using faceless questionnaires, our service is conducted through remote video consultations, also known as synchronous consultations. This builds patient safety and prescribing appropriateness into our service, ensuring our prescribing clinicians can be satisfied with who and what they are treating. There is no guarantee of supply of medications, and any prescriptions supplied are at the sole discretion of our clinician prescriber. There is no charge for the consultation.
What is a prescribing clinician and is it safe for me to use them on the NowPatient platform?
Our prescribing clinicians are board-certified pharmacists, nurses, or doctors who can also prescribe any medicine for any medical condition, subject to accepted accreditation and good clinical practice. They are all registered with their respective regulatory bodies. For example, a pharmacist independent prescriber is registered with the General Pharmaceutical Council (GPhC). Each prescribing clinician undergoes an extensive background check including a disclosure and barring service check (DBS). In addition, they undergo a rigorous license verification process. When you book an appointment with our prescribing clinicians you will see their full name, license number, and any specialized credentials they have.
Is the service available worldwide?
Yes, the Get Treated Privately service is available worldwide.
Do I need to pay for this service?
Yes. This is a private service. You do not need to pay for the consultation. You only pay for the cost of the medication you are prescribed.
How do I book a consultation?
Once you have logged into your account, you will need to navigate to the Get Treated Privately quick action widget which is located at the bottom of your dashboard. You can then select one of the following actions – ‘Search Treatments’ or ‘Search Conditions’.
Depending on the search type, you will be taken to a consultation booking screen. You will then need to select a date and time that is convenient for you, along with the preferred language of the prescribing clinician you wish to choose. You will then see a list of all available clinicians. From this list, you can filter clinicians by gender and then select the clinician you would like to confirm for your booking.
Once you have approved this, you will see a summary of the appointment including preliminary information about the consultation. At this point, you will also be able to add a reminder to your calendar. Always ensure your account health profile is up to date before any consultation. This ensures that our clinicians have the most up-to-date information about your current health status and anything that may influence their prescribing decisions. You will receive a push notification and email reminding you of your consultation, 30 minutes before it is due to start.
You can ‘star’ the Get Treated Privately quick action widget to have it display in the ‘My Favourite Widgets’ section of your dashboard, for ease of future booking or checking active or past orders.
What happens during the remote video consultation?
During the consultation, the clinician will ask you a series of questions that will allow the clinician to diagnose your health condition and consider possible treatment options. At the end of the consultation, the clinician will decide if a treatment plan is a safe and appropriate option for you.
If it is, the clinician will discuss the various treatment options that may be available, so that you can jointly agree on the option that is most suited to you. Once you have jointly agreed on a treatment plan, the clinician will issue a prescription order which will be available in your ‘shopping cart’ at the end of the consultation.
Also, with your consent, the clinician may wish to inform your GP of the treatment that was prescribed. We recommend that you agree to this since your GP is responsible for your overall care and they should have a record of this consultation and medication prescribed. In addition, our clinician may take the opportunity to advise you on your overall health including advice on healthy living or stop smoking.
What happens at the end of the consultation?
At the end of the consultation, you will receive a notification which will summarise the outcome. It will also advise if any referrals were made to your GP, along with any other advice that was given to you by the clinician.
If a GP referral letter was issued, you will be able to view a copy of this in the ‘My Documents’ section of your dashboard.
If you were prescribed a treatment plan, it will now be available in your shopping cart. When you go to your shopping cart, you will be able to checkout and make payment. Once the checkout is complete, your prescription order will be sent to our regulated online pharmacy for processing.
What if the prescriber does not prescribe what I want?
We operate a safe and effective service. This means that our prescribing clinicians always exercise their clinical judgment when prescribing. Unfortunately, we do not operate a service where you can demand a certain medication. If you are not prescribed anything, then you will not be charged.
Will I get status updates for my order?
Yes. When you place an order with NowPatient, we will keep you fully updated with the status of your order. Every time the status of your order changes, you will be notified immediately. These notifications will appear in your ‘My Notifications’ section on your dashboard. You can click the notification and it will take you to your active orders screen which will give you a timeline overview of the progress of your order. This can also be accessed using the ‘My Orders’ quick action widget which is on your dashboard. Here, you can access active and past orders.
How will my order be delivered?
All orders are shipped in discreet and unmarked packaging. This means it is suitable for delivery wherever you require (home, work, or a neighbour). For thermo-sensitive orders (e.g. Insulin or weight loss injections) we use cold chain-validated packaging. Your parcel will normally receive an estimated delivery window from the courier on the day of delivery.
For your protection and safety, your first order can only be delivered to the address that is registered with NowPatient. Future orders can be delivered to any other address, for example, your workplace.
Do you ship cold-chain or temperature sensitive products?
Yes. We use a specialist courier service for all thermo-sensitive deliveries. This is to ensure that cold chain integrity is always maintained and thus the product quality, safety and efficacy.
Learn more about how we handle the delivery of temperature sensitive products.
Where do you deliver?
We currently deliver to all postcodes/zipcodes worldwide. Some postcodes in rural areas may have a slightly longer delivery time.
When will my order arrive?
- UK – Royal Mail Tracked 24 & Signed for Delivery – Next day delivery
- Europe – Royal Mail Tracked – Typical delivery of 3-5 working days
- Worldwide – Royal Mail – Typical delivery of 5-7 working days. If a tracked option is available for your country via Royal Mail, this service will be applied.
What should I do if my order has not arrived?
Delivery is normally made promptly after your dispatch notification is received. You can check the tracking details of your order in the ‘My Notifications’ section of your dashboard, at any point after dispatch.
Unfortunately, packages can sometimes get lost in the delivery system, if after 10 days you have not received your delivery, please contact us and we will do all we can to resolve the problem.
Can you prescribe GLP-1 weight loss injections?
Yes. However, with GLP-1 weight loss medications, the license requires that there are support resources put in place as part of the plan including coaching for a healthy lifestyle, exercise, and diet. Our clinicians will discuss this with you, if you are prescribed this type of treatment.
You can learn more on our Weight Loss Programs feature page.
About Telehealth
Everything you need to know about video consultations
Are remote video consultations right for me?
How do I know if the remote video consultation service is safe?
Do I need to verify my identity during the remote video consultation?
Can I have a chaperone (carer, friend, family member) join a remote video consultation?
How can I be sure that you are handling and protecting my data securely?
How is my data stored?
Are my consultations confidential?
Can I select which clinician I have my consultation with?
Will my doctor be informed of any consultations I have through the app?
Do remote video consultations save money for health systems?
Are remote video consultations safer than online questionnaires?
What quality of care can I expect to receive from a remote video consultation?
Why am I being asked to provide my Blood Pressure reading?
If I don’t have a Blood Pressure monitor, how can I provide my readings?
Is the remote blood pressure monitor safe and medically accurate?
How does the remote blood pressure monitor actually work?
When and how is my remote blood pressure reading taken?
What devices does the remote Blood Pressure monitor work on?
Why do my results keep failing when using the remote blood pressure monitor service?
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In the UK, we are located at:
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Alternatively, if you need to speak to us, you can reach us on the following numbers:
UK telephone number – 020 388 51 500
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Who owns NowPatient?
NowPatient is owned and operated by Infohealth Ltd, a licensed online pharmacy with services spanning the UK, US and Rest of the World. Infohealth Ltd is registered in England and Wales under company number 04004930 and our registered office is at Lynwood House, 373 – 375 Station Road, Harrow, England, HA1 2AW.
Our website is www.nowpatient.com. Our App is called “NowPatient” and can be downloaded from the App Store (for Apple devices) or Google Play (for Android devices).
Can you tell me more about your NHS online pharmacy?
NowPatient’s Pharmaceutical services in the UK are provided by Infohealth Limited trading as ‘Infohealth Pharmacy’.
Our dispensing pharmacy is regulated and authorized for internet sales by the General Pharmaceutical Council (GPhC), registration number 1036487. You can view our license credentials on the General Pharmaceutical Council website. Our superintendent pharmacist who is responsible for the safe and effective oversight of medicines supplies is Mr Amish Patel (Registration Number 2042705).
Medicines are not ordinary items of commerce. All medicines or healthcare product sales are made under the supervision of a registered pharmacist who is licensed by the GPhC. At all times, we endeavour to provide a professional and transparent service whose primary goal is to ensure that the best interests of the patient are served.
How do I make a complaint?
From time to time, we accept that our service levels may not be up to your expectations. NowPatient welcomes concerns, compliments and complaints as valuable feedback that will help us learn from your experiences and make improvements. Feedback can be provided via our clear and transparent Complaints Procedures.
Can you tell me more about NowPatient’s prescribing services for treatments offered?
Our prescribing services are regulated by the General Pharmaceutical Council (GPhC). We provide the following regulated activity:
• treatment of disease, disorder, or injury
• transport services, triage, and medical advice are provided remotely
• caring for adults over 65 years old
• caring for adults under 65 years old
NowPatient prescribing services are run by Infohealth Limited. The Clinical Safety Officer and nominated individual is Mr Navin Khosla.
Can you tell me more about NowPatient’s US services?
Our head of US services is Dr. Jamie Winn.
You can lower the cost of your prescription medications using our various savings programs which include drug coupons, savings card and manufacturer-sponsored patient assistance programs.
We do not provide any prescribing services or dispensing services in the United States.
Is NowPatient legit and can I trust information from NowPatient?
Yes. NowPatient provides trustworthy and accessible clinical, health education and prescription services. We are also trusted by the NHS to deliver clinical and NHS repeat prescription dispensing across the whole of England. In the United States, we work with over 65,000 pharmacies to deliver considerable costs savings for our users.
NowPatient is operated by experienced licensed medical professionals in the United Kingdom and United States. Our Medical Team can be found here.
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What are NowPatient’s opening hours?
Our office hours are:
UK – Monday-Friday 9am-6pm GMT
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Please note that we are closed at weekends.
In the event of a medical life-threatening emergency please call:
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US – 911
In the event of a medical emergency which is not life-threatening please call:
UK – 111