First published on Thursday 5th March 2020, LAST UPDATED on Friday 18th September 2020.
Information for people living with psoriasis and psoriatic arthritis, including those taking immunosuppressive medicines
For the most up-to-date advice on COVID-19 (Coronavirus), you should read the guidance on the NHS website.
- Video - Professor Chris Griffiths on COVID-19 and psoriasis
- Resource - Hints and tips for coping well with the COVID-19 pandemic from Professor Chris Bundy
- Am I at higher risk of catching COVID-19 if I have psoriasis?
- What about if I take immunosuppressant medication?
- How can I lower the risk of catching COVID-19?
- What is 'shielding' and does this apply to me?
- What if frequent handwashing irritates my psoriasis?
- Guidance on face coverings and avoiding irritation of psoriasis
- What research is taking place? Introducing PsoProtect & PsoProtectMe
- Resource - Preparing for a virtual consultation
- Resource - Eating well during this challenging time
- Reporting suspected side effects from medicines
- Useful resources
Video - Professor Chris Griffiths on COVID-19 and psoriasis
The current situation with COVID-19 (coronavirus) has created a significant amount of uncertainty for us all. Now more than ever, access to clear and accurate information is vital to help us to make informed decisions about our own health and wellbeing. With that in mind, we're honoured to bring you information from a world-leading psoriasis expert, Professor Chris Griffiths (Professor of Dermatology at the University of Manchester and Honorary Consultant Dermatologist at Salford Royal NHS Foundation Trust).
In the video below, our Chief Executive, Helen McAteer, puts some of your most frequently asked questions about psoriasis and COVID-19 to Professor Griffiths.
Please note that the information in this video is correct as of 30th March 2020.
Resource - Hints and tips for coping well with the COVID-19 pandemic
With the current Coronavirus outbreak dominating the headlines it is not surprising that people are feeling anxious and worried about what may happen next. For some people with psoriasis, stress can make the condition flare, so looking after your psychological wellbeing is as important as caring for your physical health.
With this in mind, we have teamed up with Professor Chris Bundy (Professor in Behavioural Medicine at Cardiff University) to create a resource for people living with psoriasis and psoriatic arthritis on how to manage their worry about their condition and its treatment, as well as their concerns about COVID-19.
The tips cover a range of topics including managing your worry, expressing worry and anxiety, coping with isolation and when to access help and support. There is also a daily schedule, to help people to structure their day and stay engaged and active whilst spending more time at home.
Click below to access the relevant documents;
Hints and tips for people with psoriasis and psoriatic arthritis
Am I at higher risk of catching COVID-19 if I have psoriasis?
There is currently no evidence to suggest that people with psoriasis are at any more or less risk of catching COVID-19 than the rest of the population. As such, you should follow the same precautions as issued by the NHS.
What about if I take an immunosuppressant medication?
As far as we are aware, if you take an immunosuppressant medication (e.g. methotrexate and ciclosporin) or biologics to treat your psoriasis or psoriatic arthritis, you may be at extra risk of complications from the virus if you are infected. The specific risk for each individual depends on a number of factors, including: which immunosuppressant medications you are taking; whether you are taking just one of these medications, or more than one; and whether you are also living with other medical issues. You can find out more in our 'shielding' section.
It is not necessary for you to stop taking your systemic/biologic medication unless specifically told to do so by your prescriber (e.g. dermatologist, rheumatologist, or biologics nurse), and actually to do so could cause a flare in your condition.
If you do have concerns about continuing your medication, you should speak to your prescriber about the risks and benefits before deciding whether or not to stop your treatment.
If you are taking an immunosuppressant medication for psoriasis and/or psoriatic arthritis, and you do develop the symptoms of an infection or virus (such as a high temperature, a new, continuous cough, or loss or change to your sense of smell or taste) you should follow the latest NHS advice and consult your prescriber on whether or not to continue taking your medication.
If at any stage you do need to seek treatment for the symptoms of COVID-19, it is a good idea to make a note of the different medicines you take and the different conditions that you have, and give this to the healthcare staff who are treating you.
The following guidelines from the National Institute for Health and Care Excellence (NICE) and the Scottish Government may be helpful for reference. They are based on the latest evidence and expert opinion, and have been verified as far as possible.
From the National Institute for Health and Care Excellence (NICE):
COVID-19 rapid guideline: dermatological conditions treated with drugs affecting the immune response
COVID-19 rapid guideline: rheumatological autoimmune, inflammatory and metabolic bone disorders
COVID-19 rapid guideline: children and young people who are immunocompromised
From the Scottish Government:
Coronavirus (COVID-19) – Important advice for people with dermatological conditions (not cancerous)
Coronavirus (COVID-19) – Important advice for people with rheumatic conditions
How can I lower the risk of catching COVID-19?
For the most up-to-date advice on COVID-19 (Coronavirus), you should read the following guidance from:
- The NHS (UK)
- Public Health England (England)
- The Northern Ireland Executive (Northern Ireland)
- The Scottish Government (Scotland)
- The Welsh Government (Wales)
According to the latest NHS guidance, to stop the spread of coronavirus (COVID-19), you should avoid close contact with anyone you do not live with. This is called social distancing.
In England, if you live alone or you’re a single parent who lives with dependent children (i.e. if there is only one adult in your home), you can now have close contact with 1 other household (of any size) without social distancing. This is called a support bubble.
From Monday 14th September it became against the law in England
to meet people you do not live with in a group larger than 6, indoors or
outdoors, unless meeting as a support bubble. Information about exemptions
where groups can be larger than 6 people can be found here.
In Scotland, if you live alone, you're a single parent who lives with children under the age of 18 (i.e. if there is only one adult in your home), or you are in a relationship, but don't live with your partner, you may form an 'extended household' with the members of 1 other household (of any size).
From Monday 14th September the number of people who can gather together,
indoors or outdoors, changed to a maximum of six from two households in
Scotland. Children under 12 from within the two households are not be counted
in the new limit of six people.
In Northern Ireland, people who live alone are permitted to form a 'support bubble' with one other household (of any size) without social distancing.
In Wales, up to four households can now join together to form an 'extended household' without social distancing. All the occupants of these households will be part of the extended household, no matter how many people are in any of the individual households.
From Monday 14th September, meetings or gatherings indoors within your extended household must be limited to six people at any one time (not including any children aged under 11). This applies in places like pubs and restaurants as well as in people’s homes.
It's very important to do what you can to reduce the risk of you and other people getting ill with coronavirus. You can spread the virus even if you do not have symptoms.
To stop COVID-19 from spreading, you should:
- Try to stay at least 2 metres (3 steps) away from anyone you do not live with (or anyone not in your support bubble)
- Wash your hands with soap and water often (for at least 20 seconds)
- Use a sanitiser gel if soap and water are not available. Emollients can be applied following hand sanitiser use if necessary
- Wash your hands as soon as you get home
- Cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
- Put used tissues in the bin immediately and wash your hands afterwards
- Wear something that covers your nose and mouth when on public transport, in shops, and when you go to a hospital appointment, or to visit someone in hospital. If you can, also wear a face covering in other places when it's hard to stay away from people.
- Not touch your eyes, nose or mouth if your hands are not clean
For more detailed information about what you can and cannot do outside your home, please refer to the UK Government's full guidance on social distancing and Coronavirus outbreak FAQs: what you can and can't do.
There is separate advice about:
What to do if you're at high risk from coronavirus (clinically extremely vulnerable)
What is 'shielding' and does this apply to me?
'Shielding' is a measure which is intended to protect people who are deemed to be 'clinically extremely vulnerable' to severe illness and hospitalisation from COVID-19 by minimising their interaction with others. If you fall into this ‘clinically extremely vulnerable' category, you should have been contacted directly by the NHS and initially advised to stay at home for a period of at least 12 weeks (until 30th June 2020) and avoid any face-to-face contact with others.
What is the current shielding guidance?
The current guidance for the clinically extremely vulnerable in England is that, as of 1st August, shielding has been paused. From this date, the Government is advising you to adopt strict social distancing rather than full shielding measures. Strict social distancing means you may wish to go out to more places and see more people but you should take particular care to minimise contact with others outside your household or support bubble.
This means that people in England who have been shielding:
- No longer need to follow previous shielding advice
- Can go to work as long as the workplace is Covid-secure, but should carry on working from home wherever possible.
- Clinically extremely vulnerable children should attend education settings in line with the wider guidance on reopening of schools and guidance for full opening: special schools and other specialist settings. Where possible children should practice frequent hand washing and social distancing.
- Can go outside as much as you like (including to buy food, to places of worship and for exercise) while maintaining strict social distancing, but you should still try to keep your overall social interactions low.
- Can visit businesses, such as supermarkets, pubs and shops, while keeping 2 metres away from others wherever possible or 1 metre, plus other precautions
- Should continue to wash your hands carefully and more frequently than usual and ensure that you maintain thorough cleaning of frequently touched areas in your home and/or workspace
- Will no longer receive free food parcels, medicine deliveries and basic care from the National Shielding Service.
You will still be able to get:
- Local volunteer support by contacting your local authority.
- Prescriptions, essential items and food you buy delivered by NHS Volunteer Responders.
- Priority slots for supermarket deliveries (if you previously registered for free food parcels).
People in England who have been shielding should remain cautious as you are still at risk of severe illness if you catch Coronavirus. You could be advised to shield again if the situation changes and there is an increase in the transmission of COVID-19 in the community. Your name will be kept securely on the shielded patient list by NHS Digital. The Government will write to you if the advice changes.
If you’re clinically extremely vulnerable, you
are advised not to enter any area where shielding advice is in place. Information about what to do if you are clinically extremely vulnerable and the area in which you live becomes subject to a local lockdown can be found here.
In Wales, as of 16th August 2020, shielding has been paused. People in Wales who have previously followed shielding advice no longer need to do so, and can now follow the same rules as the rest of the population.
- You no longer need to stay 2 metres or 3 steps away from people you live with or who are part of your extended household.
- You can now go to work, if you cannot work from home, as long as the business is COVID secure (has taken reasonable measures to minimise risk to employees).
- Children who have been shielding can return to school when schools re-start.
- You can now go out for any reason, including going to shops to buy food, but you should stay 2 metres or 3 steps from other people.
As part of the support arrangements, food boxes will end, but priority supermarket slots will continue to be available and medicine deliveries will be available via the National Volunteer Prescription Delivery Scheme until the end of September.
The Welsh Government will keep a record of everyone on the shielding patients list in case they should need to ask anyone to shield again in future.
The current guidance in Northern Ireland is that, as of 31st July 2020, shielding has been paused.
This means that people in Northern Ireland who have been shielding no longer need to follow the previous shielding advice, but should continue to following strict social distancing rules.
Pausing, rather than stopping shielding is just a precaution and there are no plans for it to restart at the moment. The pause is indefinite, but it remains possible that shielding guidance will need to be reactivated if the risk increases in the future.
For information about support after the end of shielding in Northern Ireland, please click here.
In Scotland, as of 1st August 2020, shielding has been paused and most people who have been shielding can now follow the same advice as everyone else in Scotland. This advice applies to most people who have been asked to shield (including any children and young people who are still on the shielding list), but it does not apply to anyone living in a residential care or nursing home.
This means that most people in Scotland who have been shielding can:
People in Scotland who have been shielding should continue to strictly follow physical distancing and hygiene measures.
The Scottish Government will keep its shielding advice under constant review. If they see an increase in infection rates that gives them concern, they may ask you to take extra steps again to stay safe. If so, they’ll let you know by letter and through the SMS Shielding Service.
How do I know whether or not I should be shielding?
If you fall into the ‘clinically extremely vulnerable' category, you should have been contacted directly by the NHS and initially advised to stay at home for a period of at least 12 weeks (until 30th June 2020) and avoid any face-to-face contact with others.
If you are only taking a single medication that affects your immune system and have no other medical issues, it is unlikely that you will fall into the ‘clinically extremely vulnerable’ category requiring shielding, but very careful social distancing is advised.
We have put together the following information to help make it clearer for people who are living with psoriasis or psoriatic arthritis whether or not they fall into this ‘clinically extremely vulnerable’ category. If you think you fall into the 'clinically extremely vulnerable' category but you have not received a letter or been contacted by your GP, you should discuss your concerns with your GP or hospital clinician
In psoriasis and psoriatic arthritis, people who are 'clinically extremely vulnerable', at the highest clinical risk from COVID-19 and will definitely be advised to 'shield' include:
- People who have any of the medical conditions on this list from the UK Government (whether they also have psoriasis/psoriatic arthritis or not).
- People who are taking TWO or more immunosuppressive or biologic medicines (please see the list below) for their psoriasis and psoriatic arthritis (except a single biologic in combination with methotrexate, hydroxychloroquine or sulphasalazine).
- People who take either Infliximab originator (Remicade) or biosimilars (e.g. Flixabi, Inflectra, Remsima, Zessly), which are given by infusion.
- People who take ONE immunosuppressive or biologic medicine (or a biologic combined with methotrexate, hydroxychloroquine or sulphasalazine) who are ALSO 'clinically vulnerable' as defined by this list.
A list of the immunosuppressive and biologic medicines used for psoriasis and/or psoriatic arthritis:
- Immunosuppressive medications: Ciclosporin, Fumaric Acid Esters (FAE, Fumaderm and Skilarence – Dimethyl Fumarate), Leflunomide, Methotrexate. This does NOT include Acitretin or Sulphasalazine.
- Biologics: Any Adalimumab biosimilar (e.g. Amgevita, Hulio, Hyrimoz, Imraldi) or Adalimumab originator (Humira), Anakinra (Kineret), Cimzia (Certolizumab pegol), Cosentyx (Secukinumab), Etanercept originator (Enbrel) or Etanercept biosimilars (e.g. Benepali, Erelzi), Ilumetri (Tildrakizumab), Kyntheum (Brodalumab), Infliximab originator (Remicade) or Infliximab biosimilar (e.g. Flixabi, Inflectra, Remsima, Zessly), Simponi (Golimumab), Skyrizi (Risankizumab), Stelara (Ustekinumab), Taltz (Ixekizumab), Tremfya (Guselkumab)
- Small molecule immunosuppressants: Otezla (Apremilast), JAK inhibitors e.g. Xeljanz (Tofacitinib)
'Clinically vulnerable' - at a higher clinical risk from COVID-19 (but not the highest risk) - Very careful social distancing is advised - Advised to 'shield' only if there are other concerns, high-risk circumstances or comorbidities (to be decided by your clinician):
You will be asked to 'shield' if you meet any of the following criteria AND you are recommended to do so by your clinician:
- If your psoriasis or psoriatic arthritis is well controlled with minimal activity, you have none of the comorbidities listed here, and you are taking only ONE of the following: an immunosuppressive medication, a biologic, or a small molecule immunosuppressant (please see the list above for specific examples).
- If your psoriasis or psoriatic arthritis is well controlled with minimal activity, you have none of the comorbidities listed here, and you are taking ONE biologic (see list above) in combination with methotrexate.
- If your psoriasis or psoriatic arthritis is well controlled with minimal activity, you have none of the comorbidities listed here, and you are taking ONE immunosuppressive medication (see list above) plus Hydroxychloroquine or Sulphasalazine.
No need to 'shield' but should still follow social distancing measures:
There is no need to 'shield', but you must continue to follow the latest NHS advice, including social distancing measures, as per the rest of the UK population, if you are taking any of the following medications, either alone or in combination:
- Topical skin treatments (creams, gels etc.)
The British Association of Dermatologists have put together a useful FAQ section here that includes the following examples:
Examples of the type of patient who would NOT be advised to self-isolate are:
- A person with hidradenitis on Humira (adalimumab) who is 45 and has none of the described comorbidities.
- A person who is 50, on methotrexate up to 25 mg per week, and Humira (adalimumab).
- A person who is 57, on hydroxychloroquine and mycophenolate mofetil and has no other comorbidities.
Examples of the type of patient who WOULD be advised to self-isolate
- A person on any single agent biologic - e.g. you are only using one biologic such as Humira (Adalimumab) or Cosentyx (Secukinumab) at a standard dose, who is more than 70 years old.
- A person on any single agent biologic at a standard dose, who is on medication for hypertension or diabetes or asthma or Ischaemic Heart Disease, or who is pregnant.
- A person on a single agent biologic at a standard dose, with renal (kidney) impairment.
- A person on a single agent biologic at a standard dose, and up to 25mg weekly of methotrexate, who develops any medical problems described in the above three points.
Guy's and St Thomas' NHS Foundation Trust have also put together some Dermatology and coronavirus frequently asked questions. These include a number of FAQs specifically about immunosuppressant medications, social distancing, shielding, and a handy self-assessment risk calculator. Please note, while this resource contains really useful information for everyone, please only contact Guy's and St Thomas' if you are already one of their patients.
If you have psoriatic arthritis, you may also find this risk stratification guide from the British Society for Rheumatology useful if you are taking an immunosuppressant medication and you are unsure whether or not you fall into the 'extremely vulnerable' category requiring 'shielding'.
The Arthritis and Musculoskeletal Alliance (ARMA) has produced a handy resource on 'making decisions about shielding'. While this resource has a particular focus on the previous shielding guidance (from 6th July 2020) in England, much of the information may still be helpful even after shielding was paused on 1st August 2020.
Finally, full guidance on shielding to protect 'extremely vulnerable' people can be found here:
- Public Health England guidance (England)
- Northern Ireland Executive guidance (Northern Ireland)
- Scottish Government guidance (Scotland)
- Welsh Government guidance (Wales)
What if frequent handwashing irritates my psoriasis?
Unfortunately it is likely that increased handwashing will have an impact on people with psoriasis on their hands. In order to minimise this impact, we have compiled the advice below:
Wash hands with soap and water, then re-wash with an emollient soap substitute.
You should follow government guidance and wash your hands regularly with soap and water for 20 seconds. You may find it helpful to wash them a second time with an emollient soap substitute to help moisturise the skin and prevent it from drying and cracking. A list of soap substitutes or emollient cleaners can be obtained from the Psoriasis Association.
Dry hands gently, and moisturise them afterwards.
Keep tubes of moisturiser by the sink at home, as well as in your handbag or pocket.
Wear cotton gloves with moisturiser at night
Cotton gloves can help moisturiser to penetrate the skin and work more effectively, so consider purchasing a pair and wearing at night, or whilst at home.
Use gloves when washing up
Use plastic or rubber gloves with cotton linings when doing the washing up or hand washing clothes, this will help to prevent unnecessary drying resulting from activities other than washing your hands.
Wear gloves during cold weather
Wear warm gloves when you go out in cold weather, as the cold can be particularly drying to the skin.
Wearing rings, watches and other jewellery may aggravate your skin if your psoriasis is already sore from handwashing. Try removing your jewellery for a few days, and see what effect (if any) this has.
Handwashing instructions from the NHS can be found here.
Guidance on face coverings and avoiding irritation of psoriasis
As part of the gradual changes in restrictions, people across the UK are now being asked to wear a face covering (something which safely covers the nose and mouth) in certain circumstances. However, the specific guidance varies in different parts of the UK.
In England, you must now wear a face covering by law in the following settings:
- On public transport (e.g. aeroplanes, trains, trams and buses)
- Transport hubs (airports, rail and tram stations and terminals, maritime ports and terminals, bus and coach stations and terminals)
- In shops and supermarkets (places which offer goods or services for retail sale or hire)
- Shopping centres
- Auction houses
- Premises providing professional, legal or financial services (post offices, banks, building societies, high-street solicitors and accountants, credit unions, short-term loan providers, savings clubs and money service businesses)
- Premises providing personal care and beauty treatments (hair salons, barbers, nail salons, massage centres, tattoo and piercing parlours)
- Premises providing veterinary services
- Visitor attractions and entertainment venues (museums, galleries, cinemas, theatres, concert halls, cultural and heritage sites, aquariums, indoor zoos and visitor farms, bingo halls, amusement arcades, adventure activity centres, indoor sports stadiums, funfairs, theme parks, casinos, skating rinks, bowling alleys, indoor play areas including soft-play areas)
- Libraries and public reading rooms
- Places of worship
- Funeral service providers (funeral homes, crematoria and burial ground chapels)
- Community centres, youth centres and social clubs
- Exhibition halls and conference centres
- Public areas in hotels and hostels
- Storage and distribution facilities
- In NHS settings, including hospitals and primary or community care settings, such as GP surgeries
You are expected to wear a face covering immediately before entering any of these settings and must keep it on until you leave unless there is a reasonable excuse for removing it.
You are also strongly encouraged to wear a face covering in other indoor places where social distancing may be difficult and where you come into contact with people you do not normally meet. They are advised to be worn in care homes. Individual settings may have their own policies and require you to take other measures.
You are not required to wear a face covering in restaurants with table service, bars, and pubs.
From 1st September, new advice will apply to the use of face coverings by staff and pupils in some schools, and to learners in further education. This guidance is for schools and other education institutions that teach people in years 7 and above.
More specific information about circumstances in which the law does not apply or where you can remove your face covering, and legitimate reasons not to wear a face covering can be found here. You do not need to wear a face covering if you are under the age of 11.
Exemption card templates are available for people who may feel more comfortable showing something that says they do not have to wear a face covering.
The Scottish Government is supporting the use of face coverings in enclosed spaces, where physical distancing is more difficult and where there is a risk of close contact with multiple people who are not members of your household.
In Scotland, you must now wear a face covering by law in the following settings:
- Any premises which open to members of the public and used for the retail sale or hire of goods or services, such as shops, takeaway restaurants, estate agents, beauty parlours. This includes hospitality premises such as bars, pubs, cafes and restaurants except when an exemption applies.
- Aquariums, indoor zoos or visitor farms, and any other indoor tourist, heritage or cultural site
- Banks, building societies and credit unions
- Community centres
- Crematoriums and funeral directors premises
- Libraries and public reading rooms
- Museums and galleries
- Places of worship
- Post offices
- Storage and distribution facilities, including collection and drop off points
- Bingo halls
- Bowling Alleys
- Amusement arcades and other leisure facilities (such as snooker and pool halls)
- Indoor funfairs
- Indoor fitness studios, gyms, swimming pools or other indoor leisure centres
- Indoor skating rinks
- On public transport (including travel by train, subway, bus, tram, ferry and airline services as well as when using taxis and private hire vehicles) and in public transport premises (including railway and bus stations, airports. and open-air railway platforms), but NOT bus stops
The use of a face coverings in public and customer toilets is advised as they are often crowded and less ventilated spaces.
Exemptions to this guidance in Scotland include children under 5 years of age, and people with a reasonable excuse, examples of which can be found here.
In Northern Ireland, it is now mandatory to wear a face covering in the following settings:
- Any indoor place where goods or services are available to buy or rent (e.g. shops, shopping centres, bookmakers, food takeaways, dry cleaners).
- On public transport, including on buses, coaches and train services, indoor areas of ferries (and outdoor areas where it's not possible to keep 2 metres apart), and in public transport stations. This law does not apply to tour coaches and taxis or private hire vehicles but some operators may have their own rules you should follow.
It is not mandatory to wear a face covering in a business that is able to maintain social distancing by using a system of ticketing or appointments. This might include, for example, a cinema, a hairdresser or a solicitor. You do not have to wear a face covering in a bank or a business that operates like a bank, or in a gym or other place where the purpose of your attendance is aerobic exercise.
Exemptions to the face coverings guidance in Northern Ireland include children under 13 years of age, and people with a reasonable excuse, examples of which can be found here.
In Wales it is now mandatory to wear face coverings in all indoor public places, this includes both customers and staff working in those indoor public areas. This includes a wide variety of settings such as:
- Shops and shopping centres
- Places of worship
- Hairdressers and salons
- Cinemas and museums
- Gyms and leisure centres
- Anywhere that is open to members of the public. This includes any public areas within buildings that are otherwise closed to the public – for example a reception area of an office building.
It is recommended that people use a three layer face covering. The only indoor public areas where face coverings will not be required are where you are inside a place to eat or drink, for example, cafés, restaurants and pubs. But where food and drink is only being served for consumption in part of the premises – for example, a café which also offers take away services – you will need to wear a face covering in the parts of the premises where people are not eating or drinking.
Exemptions to the face covering guidance in Wales includes children under the age of 11 and people who have a reasonable excuse, examples of which can be found here.
It is now compulsory to wear a face covering on public transport in Wales. This requirement applies to all enclosed public transport vehicles including buses, coaches, trains, trams, ferries and aircraft (where they take off or land in Wales). It also applies to taxis and to tourist services, such as mountain railways and excursion buses.
Face coverings should be worn for the duration of the journey on public transport, however there is no legal requirement to wear a face covering while waiting for transport to arrive.
Exemptions to this guidance in Wales include children under the age of 11 and people who have a reasonable excuse, examples of which can be found here.
The Welsh Government is advising passengers to carry information if possible which demonstrates why they have a reasonable excuse (for example a prescription or evidence such as a hospital appointment letter relating to a medical condition), while some transport operators provide the facility for those who have a reasonable excuse to download and print a card from their website.
Why are we being advised to wear a face covering?
While evidence suggests that face coverings will not protect you against COVID-19, when used correctly they may reduce the spread of coronavirus droplets in certain circumstances, helping to protect others if you are infected but do not know it. Please note that face coverings do not replace social distancing and if you have symptoms of COVID-19 your whole household must stay at home.
Young children or individuals who find it difficult to wear face coverings, such as people with breathing difficulties or primary school children who cannot use a covering without help, are not advised to wear them.
Wearing a face covering
A face covering is something which safely covers the nose and mouth. You can buy reusable or single-use face coverings. You may also use a scarf, bandana, religious garment or hand-made cloth covering but these must securely fit round the side of the face. The government has provided advice on how to wear and make your own face covering, which can be found here.
When applying a face covering, it is important that you wash your hands first and avoid touching your face. After each use, you should wash or sanitise your hands before removing the covering, using only the straps or ear pieces, and put it in a plastic bag for washing or safe disposal. You should then wash or sanitise your hands again. If you plan to re-use the face covering, it should be washed in soap or detergent first, at the highest temperature appropriate for the fabric.
You can find more detailed instructions on how to wear and remove a face covering here.
Face coverings and psoriasis
If you feel that your face covering is irritating your psoriasis, you could try the following:
- Make sure that the covering is made of a breathable fabric that your skin can tolerate. As with many aspects of psoriasis, this may be a process of trial and error.
- Whilst the covering needs to be secure, make sure that it is not rubbing or causing injury to the skin as this could trigger psoriasis through Koebner’s phenomenon.
- Finding the right face covering to lessen irritation may be a process of trial and error. Some people may find wearing a scarf more comfortable if it is for short periods. Or, if you have psoriasis behind your ears it may help to use an extender or adapter to relieve the pressure and attach the covering behind the head. Alternatively, a face covering which ties around the back of the head may be helpful.
- Keep your skin clean and well moisturised
- Wash the covering after each use with a detergent that doesn’t irritate your skin.
- Try to take regular breaks from wearing the face covering.
- Try to avoid wearing make up in the area under the face covering.
- If your psoriasis worsens speak to your doctor about your treatment options.
For further information and advice on scalp or facial psoriasis, please do get in contact with us.
What research is taking place? Introducing PsoProtect and PsoProtectMe
In the video below, psoriasis experts, Professor Catherine Smith and Dr Satveer Mahil of St John’s Institute of Dermatology in London introduce PsoProtectMe – a new survey to support vital research into COVID-19 and psoriasis.
Questions answered in this video include:
- What is PsoProtectMe, and why is it important? (0:20)
- Who should take part in PsoProtectMe? (1:25)
- How can people take part and what will they need to do? (2:17)
- Can patients revisit the survey if they catch COVID-19 after completing it initially? (4:12)
- How will participants’ data be stored and can they withdraw it if they change their mind at a later date? (5:02)
The Psoriasis Association is honoured to be collaborating once more with world leading experts on psoriasis at the St John’s Institute of Dermatology, Guy’s and St Thomas’ NHS Foundation Trust, London and the University of Manchester on a vital piece of research regarding psoriasis and COVID-19 (coronavirus).
PsoProtectMe is an online survey for people with psoriasis to complete, irrespective of whether you have symptoms of COVID-19 or not.
We are asking everyone with psoriasis to complete this important online survey, or to ask a friend or family member to complete it on your behalf. The online PsoProtectMe survey takes only 5-10 minutes to complete and asks about your symptoms, psoriasis treatments and any underlying health conditions you may have. If you have suffered from COVID-19, you will be asked how this has affected you and your psoriasis. If in the future you develop COVID-19 we would ask that you revisit the survey (you will be provided with a unique reference number at the end) and let us know of your experience.
Please do complete the survey irrespective of the type or severity of psoriasis you have, whether you are currently treating your psoriasis or not. We need all ages to complete the survey in order to build an accurate picture.
Your information will help us understand how the COVID-19 pandemic is affecting people with psoriasis, and whether the treatments used for psoriasis increase or decrease the risk of severe COVID-19 infection. This will help healthcare professionals make important decisions about the clinical care of people with psoriasis during the pandemic. Which is why, even if you are well and have not had any symptoms of COVID-19 we really need you to answer this survey call. It could be that your treatment is beneficial in helping protect people from COVID-19 or it could be that one type, or severity of psoriasis affects the body’s response to this virus.
Your contribution will benefit everyone – please help by completing the PsoProtectMe survey today.
Helen McAteer, Chief Executive of the Psoriasis Association commented, “Whilst the COVID-19 pandemic has been a worrying time for us all, it has again shown the strength of the psoriasis community that registries such as PsoProtect and now PsoProtectMe have been established so quickly to help further our understanding and treat people with psoriasis and COVID-19. The commitment of the teams at the St John’s Institute of Dermatology and the University of Manchester, with support from the Psoriasis Association is essential to the understanding not just of psoriasis, but all health events that may affect people living with the condition. Please do give 5-10 minutes to complete the survey – your information really is important.”
The Psoriasis Association is pleased to announce its support for PsoProtect, an international registry where health care professionals can report outcomes of COVID-19 infection in people with psoriasis.
PsoProtect has been set up by world-leading psoriasis researchers at Guy’s and St Thomas’ NHS Foundation Trust, King’s College London, and the University of Manchester to capture de-identified information about the outcomes and experiences of individuals with psoriasis who have had COVID-19. This will provide real world information for clinicians to help them assess risk in people with psoriasis. The registry will also help researchers to investigate whether different medicines or co-morbidities of psoriasis affect the outcome of COVID-19 infection.
This registry will provide a vital clinical and research resource to help in our collective fight against COVID-19 but please note that the registry is for clinicians to submit de-identified data, not patients. However, if you or a family member with psoriasis have had, or get Coronavirus, please do ask your clinician to submit your data to PsoProtect.
PsoProtect will publish regular summaries and insights from the registry, however, they are unable to provide information on request. The latest data can be found here.
Resource - Preparing for a virtual consultation
Due to the COVID-19 pandemic, we know that more people than ever are having their healthcare appointments held by telephone or video. For many, this is a completely new experience and it can be a little disconcerting having to rely on technology when you’re used to seeing your doctor or nurse face-to-face. While many aspects of a virtual appointment will be the same as in-person, others (including the technology itself) will be different, which is why we’ve put this resource together.
The tips have been divided into two sections: those to bear in mind in advance of your appointment; and those to consider during the appointment itself. We hope they will be helpful, whether your next appointment is with a GP, nurse, dermatologist or rheumatologist. If you have any tips of your own that you think we should add to the resource, please do get in touch and let us know.
Click here to view the top tips resource
Resource - Eating well during this challenging time
In this challenging time, it is understandable that people with psoriasis and psoriatic arthritis may be concerned about their diet or have questions about nutritional issues. If you are stressed or outside of your usual routine then your diet can suffer, but it's important to try and maintain a healthy, balanced diet for your general health and wellbeing if possible.
Using information from the British Dietetic Association, we've put together a handy resource to help you continue to eat well. The tips included range from supporting your immune system to planning your food shops, and considering how you store and use your food.
Download the resource here
Reporting suspected side effects from medicines
Due to the COVID-19 outbreak, patients are currently being asked to submit all suspected side effects of their medicines using the Yellow Card scheme electronically instead of paper. This is because all Medicines and Healthcare products Regulatory Agency (MHRA) staff are working remotely and no longer have access to the MHRA building (since 23rd March) due to the pandemic.
Please note that once the MHRA regains access to its building, it will process any paper suspected side effects reported to the Yellow Card scheme. If you have sent a side effect Yellow Card after 17th March 2020, and you haven’t received an acknowledgement of your report, you may wish to resubmit your suspected side effect electronically.
You can report suspected side effects electronically via:
- The Yellow Card website
- The free Yellow Card app (downloadable from the Apple and Google Play stores)
- Or by calling 0800 731 6789 for free on Monday to Friday between 10am and 2pm (you can leave a message outside of these hours and a member of the MHRA team will get back to you.
From the NHS:
From Public Health England:
From the British Association of Dermatologists:
- Dermatology advice regarding self-isolation and immunosuppressed patients
- Statement on dry skin and frequent handwashing to reduce COVID-19 risk
From Guy's and St Thomas' NHS Foundation Trust
- Dermatology and coronavirus: frequently asked questions - includes a number of FAQs specifically about immunosuppressant medications, social distancing, shielding, and a handy self-assessment risk calculator. Please note, while this resource contains really useful information for everyone, please only contact Guy's and St Thomas' if you are already one of their patients.
From the British Society for Rheumatology:
- A risk stratification guide which may be useful if you have psoriatic arthritis, are taking an immunosuppressant medication and you are unsure whether or not you fall into the 'extremely vulnerable' category requiring 'shielding'.
From the Arthritis and Musculoskeletal Alliance (ARMA):
- A handy resource on 'making decisions about shielding'. While this resource has a particular focus on the previous shielding guidance (from 6th July 2020) in England, much of the information may still be helpful even after shielding was paused on 1st August 2020.
From UK healthcare experts in psoriasis:
- A series of videos produced by the pharmaceutical company, Janssen, which include information on how COVID-19 spreads, how to manage your condition and treatments, and how to look after your wellbeing in this challenging time, from UK healthcare experts who specialise in psoriasis.
Someone to talk to:
- Samaritans - Confidential support for people experiencing feelings of distress or despair. Phone: 116 123 (free to call service 24 hours a day, 365 days a year), website: www.samaritans.org
- CALM - CALM is the Campaign Against Living Miserably, for men aged 15 to 35. Phone: 0800 58 58 58, webchat also available (5pm-midnight, 365 days a year). Calls free from landlines, pay phones and all mobiles. Website: www.thecalmzone.net
From Acas, the Advisory, Conciliation and Arbitration Service:
Please note that this information is correct as of 28th August 2020. For up to date information, or if you think you may have the symptoms of COVID-19, please follow the latest NHS advice.