Frequently Asked Questions
Q. Does suffering from psoriasis count as an underlying health issue that makes me more susceptible to coronavirus?
A. Psoriasis by itself does not increase the chances of acquiring COVID-19.
It is important to note that many patients living with psoriasis have associated diseases (co-morbidities) that may interfere with their immune response against the virus (such as diabetes, obesity, etc.).
If you are living with psoriasis, it is important to follow the recommendations from the Public Health Agency of Canada and your local public health authorities during this time, such as isolation and social distancing, washing hands frequently and other measures to avoid the potential spread of the virus.
Q. I am receiving phototherapy for my skin disease. Are dermatologists continuing to offer these treatments in their clinics?
A. The decision to continue delivering phototherapy will be up to the individual physician, so you would need to contact your treatment provider to learn about their approach.
The major difficulty in continuing delivery of phototherapy is keeping the environment safe and clean. Phototherapy machines are used many times per day. The machines are touched by many patients, as well as by the operators. The virus is very fragile to disinfectants such as diluted bleach, but it is very difficult to completely disinfect the entire machine after each treatment. The virus may be present up to 5 days on hard surfaces such as metal and plastic, making transmission a real possibility.
While there are many safety precautions that can be taken, including the operators wearing gloves and thorough cleaning after each treatment, this may not be feasible for some phototherapy clinics on the level needed to prevent the spread of the virus. Check with your own treatment provider to see if they will be continuing to offer phototherapy treatment during the COVID-19 outbreak.
Q. I am taking immunosuppressive medications - am I at higher risk for coronavirus? Should I stop taking them?
A. The Canadian Dermatology Association has provided specific guidance for skin patients who are taking medications that affect the immue system. The risks for patients depend on which medication they are taking. Specifically, they note that if you are taking one of the following, you may need to discuss their use during the COVID-19 pandemic with your dermatologist:
- Methotrexate (depending on the dose)
- TNF-alpha inhibitor: infliximab, adalimumab, etanercept or certolizumab
- IL-12/23 inhibitor: ustekinumab
Patients who have been prescribed medications that affect their immune system should have received information from their dermatologist about the risks of infection when taking these medications and what to do in the case of an infection.
However, there are also risks associated with stopping these medications, including triggering a flare and/or not recapturing the same success if the medication is restarted later on. At this time, the best information we have suggests that, in general, patients do not stop the medication unless they develop symptoms of an infection - any infection. If you are worried that this might be your situation, please contact your treating physician to discuss the best plan for you.
Ultimately, the best thing that people can do is protect themselves against becoming infected with COVID-19. Patients taking systemic immunosuppressant medication, including biologics, should be very vigilant in following the recommendations of the Public Health Agency of Canada, particularly regarding hand washing, avoiding touching your face, cleaning often-used surfaces, and avoiding public spaces with crowds and individuals with flu symptoms or recent travel history. Your provincial or territorial government will also have its own guidance and make specific resources available to you. It is also important that those living with people taking biologics are also vigilant to reduce the risk of becoming infected.
Dermatologists and other physicians are considering whether to start new patients on systemic immunosuppressant medications or modify treatment schedules. Please consult your dermatologist or other specialist for details about your care.
Q. I keep hearing advice about washing my hands but don't want to trigger my symptoms. What is the best way to keep my hands clean without exacerbating my condition or triggering a flare?
A. Regular handwashing is key to the prevention of contracting and spreading COVID-19. Proper handwashing means thoroughly washing with soap for at least 20 seconds, making sure to wash the palms and tops of the hands, wrists and between the fingers. There is no need to wash with hot water, which can aggravate skin conditions and offers no advantage in terms of controlling the spread of infection. After washing and rinsing your hands, pat them dry and use a good moisturizer. Moisturizing after washing is key for those with conditions like eczema, psoriasis and other dry and sensitive skin conditions.
In terms of which soap to use, it is not necessary to use an antibacterial soap and soap-free cleansers can be used. The Canadian Dermatology Association and the Eczema Society of Canada have recognized products that are more suitable for sensitive skin or patients with eczema.
If you cannot use soap, hand sanitizers (with at least 60% alcohol) are a good second choice to reduce the spread of infection. These may sting the skin of some patients, including people living with eczema. Consider looking for hand sanitizers with emollients and moisturizers to make using them more comfortable if hands are dry. If your skin disorder begins to flare, use an anti-inflammatory topical regularly.
Q. I don’t want to trigger a flare or worsen my symptoms. What are the best tips for managing the anxiety around the coronavirus?
A. Focus on what you can control. Try to seek comfort in routine — taking your medication and applying creams, etc. Try not to watch too much news or read too much online. You want to stay informed, but after a certain point, it will just exacerbate your stress. Focus on enjoying time with your loved ones at home, over FaceTime, or over the phone. Remember that there is only so much you can do, so focus on protecting yourself by staying home (other than when absolutely necessary) and practicing good hand hygiene.
Q. Because of my skin disorder, I have open wounds. Am I at greater risk of getting coronavirus?
A. An open wound is a potential portal of entry for any infection. While the best information and models of COVID-19 suggest that this virus does not spread through blood, it is wise to take a cautious approach if you are living with open wounds. To help keep yourself safe, make sure to properly dress and cover the wounds. Reach out to your wound care provider or dermatologist for more information on best practices for wound care. Consider using gloves when changing the dressings even if this was not part of your regular practice. It is important to keep in mind that the best tools we have to prevent the spread of COVID-19 are washing our hands and other frequently touched surfaces, avoiding touching our faces, and practising social distancing. Check out the video below from the World Health Organization on how to protect yourself.
World Health Organization
Rolling updates on COVID-19: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen
How to protect yourself against COVID-19 (video):
- Apply an effective therapy cream to decrease the symptoms
- Wear gloves, so no direct contact
- Consider using disposable ice packs