Psoriasis

If you have been diagnosed with chronic plaque psoriasis (the most common type of psoriasis) by a doctor then you can request a prescription for treatment via this service.
Please be advised, as a written consultation service, our clinical criteria for issuing treatment is stricter than that which  may be used during a face-to-face consultation. 

Psoriasis is a long term (chronic) skin condition where there is inflammation of the skin. The skin produces new skin cells too quickly causing excess growth of scaly skin; patches (plaques) of skin that are red, dry, and covered in a silver scale. Once you develop this condition, it tends to follow a pattern of flaring and settling throughout life. 

What causes Psoriasis?

The cause of psoriasis is not completely understood. It is currently believed to be an autoimmune condition (a problem with how your immune system reacts to your skin cells).
It often runs in families and environmental changes are likely to play a role.
Psoriasis is not infectious or contagious.

Are there different types of psoriasis?

There are different types of psoriasis. Chronic plaque psoriasis is by far the most common, affecting 80-90% of those with psoriasis. It usually affects the elbows, knees and lower back but can affect anywhere on the body.
Other types of psoriasis include guttate, pustular, nail, palmoplantar and erythrodermic psoriasis. (Please be aware that we are only able to provide treatments for chronic plaque psoriasis via this service).

Are there other conditions associated with psoriasis?

People with psoriasis are at increased risk of developing inflammation of their joints (psoriatic arthritis). The fingers and toes are most commonly affected, but it can affect any joint.
You should seek medical review if you have a diagnosis of psoriasis and any joint pains or pain in your heels. 

There is also an increased risk of cardiovascular disease (heart disease and stroke) if you have psoriasis and you should speak with a doctor to assess your individual risk factors so that these can be optimally managed if necessary. 

Psychological difficulties are often associated with psoriasis and anxiety/ depression can develop. Some people will feel embarrassed about the appearance of their skin and this can prevent them from taking part in certain activities and cause relationship problems. If this is affecting you, please speak to one of our doctors via a video consultation or your local GP. There are things we can do to help.

Are there lifestyle changes I can make to help with psoriasis?

  • Having a balanced, healthy diet and taking regular exercise has been shown to improve psoriasis. 
  • Avoid known trigger: Some patients will have triggers that cause a flare of their symptoms. If identified, these should be avoided.
    • Smoking: Stopping smoking will help psoriasis and also decrease your risk of heart disease and stroke
    • Stress 
    • Being overweight/ obese
    • Excess alcohol
    • Certain Medications: If you are concerned about this, please speak with a doctor to arrange a medication review
    • Sunlight (natural or artificial): Injury to the skin or excess scratching can trigger psoriasis
    • Some Infections 
    • Hormones: Psoriasis can be worse during puberty and menopause. Often improves during pregnancy but can flare postnatally. 

What treatment options are available for mild- moderate chronic plaque psoriasis?

There is no cure for psoriasis but we can help you to manage this condition with the right treatment. The main aim of treatment is to clear the rash. Treatments will vary from person to person and are guided by the location, severity and frequency of the flares. 

  • Emollients 
    • These help to soften hard skin, remove scale and ease itch, and can make other treatments more effective.
    • If you are using another treatment, apply the moisturiser first, allow it to dry for 30 minutes and then apply the other treatment.
    • There are many moisturisers to choose from - the best one is the one that you like.
    • Regardless of what treatment you are using, it is essential that you keep your skin well moisturised by using liberal amounts of moisturiser regularly (3-4 times daily), even when your skin is in good condition.

CAUTION: When moisturisers dry on dressings, clothing, bedlinen or hair they can catch fire very easily if they come into contact with a naked flame. It is essential that extra care is taken around naked flames (e.g. candles, cigarettes) when using skin care or hair care products. It is advisable to wash clothing and bed linen regularly if it has been in contact with moisturisers.
Please note the moisturisers are not fire hazards when in their containers - it is only when they have dried out on these materials.  

  • The most commonly used treatments are listed below. For further information on these and other available treatments -please click here
    • Emollients
    • Vitamin D based treatments
    • Steroid creams/ ointments
    • Salicylic acid 

Combinations of these treatments are often used.

What treatments for chronic plaque psoriasis can we prescribe?

For additional information on these medicines, including potential side effects, please read the product information leaflets via the links. 

The prescriptions issued are for short term use only (up to 4 weeks). 

It is important to use regular moisturisers (3-4 times daily) with these treatments for best results. 

Scalp treatments: 

Body treatments:

Vitamin D derivatives slow the rate of new skin cell production, reducing scaly and flaky skin.

Steroids reduce the skin inflammation associated with psoriasis.

Salicylic acid softens and thins thick scaly skin (allowing the steroid treatment to penetrate more efficiently) 

What is the difference between ointments and gels?

Ointments are thicker and more moisturising, while gels are lighter and easier to absorb. 

How long does it take for treatment to work

You should start to see an improvement in your symptoms within 2 weeks of starting treatment. Treatment should not be used beyond 4 weeks without medical advice.
If you feel that things have not started to improve after 2 weeks or not settled after 4 weeks, please arrange a video consultation with one of our GPs or an appointment with your local GP for further assessment. 

You should continue to use the prescribed treatment until the skin feels smooth (it may still look pink). At this stage you can stop your treatment and continue with frequent application of moisturisers. 

Can I use this service if I am pregnant or breastfeeding

If you are pregnant (or suspect you might be pregnant) or breastfeeding, we would advise that you arrange a face to face consultation to discuss your symptoms and appropriate treatments in more detail than this service is able to offer.
Hormonal changes can trigger improvement or deterioration in your symptoms and there are some treatments that can be prescribed if needed. However, as with all things during this time, the individual risks and benefits need to be considered, and you need to be an integral part of that decision making process. 

For further information about psoriasis please click here

Who Is This Service For?

This service is suitable if you:

  • Have been diagnosed with plaque psoriasis by a healthcare professional 
  • Have mild- moderate plaque psoriasis
  • Are having a flare of your usual symptoms
  • Can upload 3 clear pictures of the affected areas 

This service is NOT suitable for you if:

  • You are under 18 years of age
  • You are pregnant (or suspect you could be pregnant) or breastfeeding 
  • More than 5% of your skin is affected by plaque psoriasis (5% is approximately the area covered by 5 of your hand prints)
  • You need treatment for psoriasis on your face, genitals or skin folds (groin, armpits, under the breasts)
  • You require treatment for nail changes associated with psoriasis 
  • You are feeling generally unwell (including fever/ high temperature) 
  • You are experiencing joint pain, swelling or stiffness
  • You have noticed unexplained weight loss (not planned, or no identified reason for this)
  • You have had problems regulating your calcium levels in the past (high levels or low levels)
  • You have significant kidney or liver disease 
  • You require a prescription for medications other than those listed
  • You are currently using specialised treatments such as methotrexate, ciclosporin, Acitretin, Biologics or phototherapy. 
  • You need treatment for a skin condition other than plaque psoriasis 

Please be aware we are not able to treat other types of psoriasis e.g. guttate, pustular, palmoplantar or erythrodermic, or other skin conditions via this service.

If you are unsure if this service is suitable for you, please send us an email to info@careoncall.ie and we can help to clarify. 

How Does It Work?

  • Online consultations with Irish based doctors
  • Our doctors issue a prescription if medically safe and suitable
  • Valid in any Irish pharmacy to buy your medication
  • Prescription sent to your chosen pharmacy via secure email (Healthmail) within minutes of approval.

The accuracy of the information you provide is very important for the safe prescribing of the most suitable type of medication. The information that you provide is treated with the same patient-doctor confidentiality as in a normal face-to-face consultation.