Psoriasis is an autoimmune disorder that causes itchy, inflamed lesions on the skin. Most people who have psoriasis need to see healthcare providers on a regular basis. Ideally, they see providers who specialize in treating skin conditions. Unfortunately, access to care can be challenging for some people with psoriasis.

This article discusses barriers to treatment for people with psoriasis and how to overcome them.

Access to Care and Psoriasis

Access to care means having the ability to see the kind of provider you need, when you need to see them. It also means getting effective, affordable treatment for your health condition.

According to the U.S. Department of Health and Human Services' Agency for Research Health and Quality, factors affecting access to care include:

• Insurance coverage
• Access to a healthcare facility
• Ability to get a timely appointment
• Treatment by qualified healthcare providers

People with psoriasis usually need regular health care to address their symptoms, keep the condition from worsening, or prevent it from affecting the joints. Though it can be mild, psoriasis can also be severe and is sometimes a complicated disease to treat, so the ability to access care is vital.

Specialists who treat psoriasis include dermatologists and rheumatologists, who are skilled in addressing psoriasis symptoms, including:

• Thickened, raised rashes
• Scaly, itchy skin
• Pain
• Joint inflammation

People with severe psoriasis are also at a higher risk of developing heart disease or other serious health conditions, so they need to be monitored for co-occurring conditions as well.

Access to Care Issues for Psoriasis Patients

Some people with psoriasis come across barriers to access to the kind of specialized care they need. There are several reasons why it may be difficult, including:

• Insurance: If you are uninsured or have limited coverage, your insurance provider may deny or not cover some effective but expensive treatments like biologics.
• Out-of-pocket costs: Charges paid directly by psoriasis patients account for about 55% of the total cost of treatment.
• Dermatologist shortage: Many people in the U.S. live in areas where there are not enough dermatologists. That can translate into long wait times to see a provider.
• Rheumatologist shortage: There is a similar shortage of rheumatologists in the U.S.

According to research among people who did not see a provider for their psoriasis for more than two years, the main reasons they cited were abandoning treatment altogether and high costs.

Improving Access to Care

Changes in healthcare delivery have made access to a provider and financial aid easier for some patients. Some of these improvements include:

• Free or low-cost dermatology clinics for Medicaid participants or people without insurance
• Telehealth and teledermatology for those on Medicaid, or for people living in areas where there are not enough dermatologists
• More primary care providers receiving additional training in dermatology
  
• Help to cover costs, including co-pay cards, patient assistance programs, free health centers, and nonprofits
• Pharmacy cards that can help you find the lowest prices for prescription medication

Some longer-term solutions that are being examined to improve access to care include:

• Direct access to specialists, so that you don't have to have a referral to see a dermatologist
• Increasing the number of practicing dermatologists and rheumatologists

Ask your healthcare provider or visit the official federal website, USA.gov, for more information on paying for medical care.

Summary

People with psoriasis can experience challenges with access to care. This can include the inability to see a qualified provider in a timely manner, and getting appropriate, affordable treatment. Lack of insurance or inadequate coverage, high costs, and a shortage in the number of specialists contribute to the problem.

Telehealth visits, free or low-cost dermatology clinics, financial aid, and healthcare providers who have received additional training in treating psoriasis can help address these access to care issues so people with psoriasis can get the help they need.

A Word From Verywell

Psoriasis symptoms and pain can be difficult to live with, but fortunately, there have been big strides in treatment in recent years. Many people with psoriasis respond to these new medications or even achieve remission. If you are having trouble finding treatment or affording the cost, look into the resources covered in this article to help you manage your psoriasis.