Which Doctors Treat Psoriatic Arthritis?

Your healthcare team in psoriatic arthritis care

Psoriatic arthritis (PsA) is a chronic and complicated inflammatory autoimmune disease. Choosing the right doctor to treat PsA is important, but most people aren’t sure which doctors should be treating this debilitating condition.

What Is PsA?

PsA is a type of inflammatory arthritis affecting many people with psoriasis, an inflammatory skin condition causing skin to grow to quickly and form red patches with silvery scales. Many people with PsA develop psoriasis first, but it is possible for joint symptoms to occur before skin problems show up.

The main symptoms of PsA are joint pain, swelling, and stiffness. These can affect any joint in the body, including the spine and fingers. Both PsA and psoriasis will have periods of flares, where the disease is active, and periods of remission, where symptoms calm down. 

There are no cures for PsA or psoriasis. Treatment is focused on managing symptoms and preventing joint damage. Without treatment, PsA can cause severe complications, joint damage, and disability. 

The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) recommends people with PsA see both a dermatologist and a rheumatologist. And considering how complex both psoriasis and PsA are, it makes sense to have both a dermatologist and a rheumatologist, along with a primary care doctor and others as part of your treatment team.

Rheumatologists

Rheumatologists treat diseases of the bones, joints, and muscles. This includes autoimmune arthritis (i.e. rheumatoid arthritis and PsA) and various forms of arthritis, including osteoarthritis. For treating PsA, a rheumatologist would come up with a plan to reduce inflammation to avoid complications, joint damage, and disability.

As for the skin symptoms related to PsA, rheumatologists work to treat the inflammation responsible for skin lesions. This is different than a dermatologist, who treats skin symptoms at the surface. 

Treatments often prescribed by rheumatologists include drugs to target inflammation and halt the disease, so the body stops attacking its own healthy tissues. This includes disease-modifying antirheumatic drugs (DMARDs), biologics, corticosteroids, and nonsteroidal anti-inflammatory drugs (NSAIDs).

What to Expect From Your First Visit With a Rheumatologist

Dermatologists

Dermatologists treat conditions affecting the skin, hair, and nails. Dermatologists may treat up to 3,000 different conditions including psoriasis, this according to the American Academy of Dermatology.

Most people with PsA have had psoriasis for years and are already seeing a dermatologist when they are diagnosed for PsA. A dermatologist may ask about joint pain and stiffness at medical visits to look for possible indications of PsA. 

In treating skin symptoms of PsA, a dermatologist may prescribe topical ointments to reduce pain, redness, and itchiness. Light therapy treatments can also be done at dermatology visits.

Light therapy exposes a person’s skin to ultraviolet (UV) light. The UV light is believed to kill immune cells in the skin responsible for psoriasis. The light may also disrupt faulty signals between immune cells and skin cells that cause skin to grow too quickly and cause lesions.

Primary Care Doctors

Just because someone is seeing a rheumatologist and a dermatologist for PsA doesn’t mean they should cut their primary care primary care provider (PCP) out. The PCP is the one person who gets to see the entire picture of a person’s health. For example, people with PsA have a higher risk of heart disease and stroke, and these are not things rheumatologists or dermatologists check for routinely. PCPs are also generally aware of a person’s other risk factors.

Pain Management Doctors

Pain management doctors get involved when PsA pain is not managed despite attempts to reduce inflammation. Their goal is to diagnose and treat pain. Treatment will vary depending on the cause of pain. Moreover, some treatments reduce pain while others help patients to manage it. 

Treatment for managing PsA pain may include nerve blocks, medications, injections, physical therapy, or surgery. Pain management doctors may also use complementary methods, such as meditation, acupuncture, and biofeedback to help manage PsA pain symptoms.

A Word From Verywell

Regular treatment is important to managing PsA. It prevents inflammation that would eventually lead to joint damage. But simply following a treatment plan isn’t enough if the right person isn’t treating PsA. Therefore, it makes sense to see both a rheumatologist and a dermatologist. Moreover, a person’s primary care provider can help them manage their overall health picture while pain management doctors treat PsA pain.

The relationships with your entire medical team are important. These should be partnerships and involve honest communication. It is also important all doctors have each other’s treatment information so that their treatments balance each other out.

Treatment Recommendations for Psoriatic Arthritis
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