Psoriasis - when to ask for referral

[FloofPaws]

Just wanting advice, I've had psoriasis for 40 years, it started on my scalp in 2 patches as early teen, spread to whole scalp. It remained mostly scalp til I was around 40 ish. It's mainly plaques 4-6cm approx on arms, back, tummy. I get bigger plaques too. I also get inverted psoriasis under breasts, groin, and sometimes tiny perhaps guttate psoriasis on legs, around back/tummy. I've got a small patch on eye lid (near brow) and a small patch which I'm hoping has gone on my eyelid on lash area (tiny but can see it)
I've always just gone to the GP and nobody has ever referred me to a dermatologist. Creams kinda work for a bit so I use when a bigger flare to help calm down but some patches have been there years.
What do other psoriasis sufferers do? I'm feeling 😓 because the smaller guttate type patches - perhaps small
Plaques (not sure which) have suddenly escalated
Also being investigated for PsArthritis as got inflammation and troubles with some joints - random flare ups
Any advice welcome

Ask your gp for a referral. My db has it and arthritis too and has had lots of differnt treatments but currently has injections he self administers.

Hello @FloofPaws Do ask for a referral. It's miserable. The only thing that helped me was hospital light treatment (UVB). That gave me a glorious six months of clear skin and short sleeves. However, ten years later and I'm waiting the results of a biopsy for skin cancer, which may or may not be related to that. So all the treatments come with risks.

Please do get referred. I have had psoriasis all my life - severely as a child and young adult (several inpatient stays in hospital required). I had PUVA in my mid twenties which completely cleared the psoriasis on my body and that has never returned (mid 50's now). However my scalp psoriasis remains and is pretty grim just now so I am considering asking to be referred to a dermatologist (haven't seen one for nearly 30 years)
Do push for a referral - it's a bloody miserable disease but there are more options these days

I have it on my scalp also and had it for about 20 years before I asked GP for a referral, I just kind of lived with it and didn't realise I could ask for help. It took the best part of 2 years to even get an initial appointment.

I was advised not to try the UV treatment as it commonly does not work on the scalp and I couldn't manage the twice weekly light therapy sessions really. I was given a medication that was supposed to suppress my immune system, but required me to have twice weekly blood tests and appointments at first to check my liver as it can damage it, which was tricky to manage with work and single parenting - but easier to pop into local clinic for tests than the longer UV sessions at a major hospital over 50 mins away! I took it for about 5-6 months and indeed caught every cold and covid and flu going, despite having all vaccines, so it obviously did suppress my immunity but did absolutely nothing for the psoriasis.

Eventually I stopped taking it because the hospital kept cancelling my appts with my consultant and nobody else could prescribe it 🙄 I then had to go back on the waiting list to be seen again - and still waiting! So yes do ask GP but please don't get your hopes too high. I was pinning everything on it but no improvement here. However the consultants and specialist dermatology staff may well have cream/applications your GP hasn't considered, mine did suggest new things but sadly nothing helped, but may well be worth it for you.

You've possibly got PsA. Now - to rheumatology (added bonus = usually greater capacity, shorter waiting lists and have wider range of treatments they can prescribe/order as well as still working with dermatology.

Thanks all - 'good' to know it's not just me - I always worry it's because don't regularly take the creams. It worry that they actually damage the skin themselves - I'll ask for a referral this weekend as GP has an online system that works quite well - good luck to you guys with the bloody horrible AI disease and hope you get positive results soon