Choosing the right type of doctor is essential in the treatment of psoriatic arthritis (PsA). However, the selection process can be tricky because of the nature of the condition itself. PsA starts as psoriasis, so your first instinct might be to seek care from a dermatologist. But PsA is also characterized by inflammatory arthritis, which is treatable by a rheumatologist.
Considering the complexity of PsA, you’ll likely consider both types of medical doctors when seeking treatment. Learn more about the differences between a dermatologist and rheumatologist, and how both doctors affect your PsA management.
What is a dermatologist?
A dermatologist is a doctor who primarily treats conditions related to the skin. This also includes conditions that affect the nails and hair. According to the American Academy of Dermatology (AAD), dermatologists work with more than 3,000 related diseases, including psoriasis.
Dermatologists are often the first points of contact for those with PsA. This is especially the case for those who have psoriasis, but haven’t yet received a diagnosis for the arthritis component. A dermatologist treating a someone with psoriasis might ask about joint pain or stiffness, as these are common indicators of possible PsA.
In treating PsA, a dermatologist may prescribe topical ointments to minimize itchiness and pain as well as prescription medication. Light therapy might also be used in the dermatologist’s office.
What is a rheumatologist?
A rheumatologist is a doctor who treats conditions related to the bones, joints, and muscles. These often include autoimmune diseases such as gout, lupus, and various forms of arthritis.
Though the precise underlying causes of autoimmune diseases aren’t fully understood, they are thought to be related to the body attacking its own healthy tissues. Over time, untreated autoimmune diseases can also damage your organs, eyes, and nervous system. The goal of a rheumatologist is to come up with a treatment plan to reduce the damaging inflammation caused by related autoimmune diseases.
It’s important to note that while autoimmune diseases, like arthritis, can cause symptoms of the skin, rheumatologists work to treat the underlying inflammation that causes them. This differs from a dermatologist, who can treat the skin problems at the surface level. Rheumatologists use drugs that target inflammation so the body stops attacking healthy tissues. These come in the form of biologics, corticosteroids, and nonsteroidal anti-inflammatory drugs (NSAIDs).
Choosing the right doctors
PsA treatment often requires regular care by both a dermatologist and a rheumatologist. Still, finding the right doctors can be overwhelming to start. Aside from seeing which providers are in-network with your insurance carrier, you can also ask your primary doctor for some recommendations.
As a rule of thumb, you should also select doctors that are board-certified. You can also check out the AAD website for certified dermatologists, as well as the American College of Rheumatologists website for a rheumatologist.
In addition to undergraduate school and medical school education, dermatologists must undergo extensive internships and at least three years’ worth of residency training. To become board certified, a dermatologist must pass an exam for proper certification. A certified dermatologist usually displays their credentials somewhere in their office.
Like dermatologists, rheumatologists undergo significant schooling and training. The estimated timeline for education and training is the same, and they must also complete certification exams before practicing rheumatology. You may need a referral from your primary doctor to make an appointment.
Once you’ve found a dermatologist and rheumatologist, ask about their experiences in treating PsA. Because both types of doctors treat a variety of conditions, some might be more experienced in PsA than others.
Staying on top of your treatment plan
Consistent treatment plays a large role in PsA symptom management. Plus, treating PsA can prevent the inflammation that leads to potential permanent joint damage. To get the right psoriasis care, you’ll need skin expertise delivered by a dermatologist. However, you’ll also need to see a rheumatologist to treat the underlying causes of the inflammation that lead to joint pain and skin swelling.
Still, simply following your PsA treatment plan may not be enough to ward off the effects of the disease, particularly if you aren’t seeing the right doctor. For PsA, it’s often best to work with both a dermatologist and a rheumatologist. You also want to make sure that both doctors have treatment information from each other so you can ensure that they complement one another. Keep your own records and make copies when necessary so you can share the right information as appropriate.
At the same time, modifying your treatment plan with the correct medical doctor is essential. If your skin condition worsens, you might follow up with your dermatologist. On the other hand, a rheumatologist follow-up may be in order if you notice worsening redness and inflammation in your joints.Read more in Moderate to Severe Psoriatic Arthritis Pain Resources
Exploring care for psoriatic arthritis: Bridging dermatology and rheumatology. (n.d.). Retrieved from http://www.clevelandclinicmeded.com/online/monograph/psoriatic-arthritis/Psoriatic-Monograph.pdf
Psoriatic arthritis. (n.d.). Retrieved from http://www.arthritis.org/about-arthritis/types/psoriatic-arthritis/
Tips for finding the right doctor. (2016). Retrieved from https://www.psoriasis.org/health-care-providers/find-the-right-doc
What is a rheumatologist? (2015). Retrieved from http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Health-Care-Team/What-is-a-Rheumatologist
Why see a dermatologist? (2016). Retrieved from https://www.aad.org/public/diseases/why-see-a-dermatologist