Psoriasis has a profound impact on quality of life (QOL) among affected individuals, influencing various aspects of their physical, emotional, and social well-being. Overall, data suggest that biologic therapies, including newer IL-17 and IL-23 inhibitors, are associated with improved QOL outcomes for patients with psoriasis.

Although it is not the most common inflammatory skin condition, psoriasis has redefined how we think about inflammatory skin diseases, given that its effects are far beyond skin deep. Psoriasis can have an impact on every organ system and can have connections to every discipline of medicine, and this, in turn, can impact patient QOL. It can limit someone’s ability to be successful and to engage with their environment and community.

In general, having a skin disease that is visible adds an extra level of burden. Individuals may look at someone with psoriasis and assume that the condition is infectious or contagious, or that this person may be unclean. That stigma of having psoriasis exists, in addition to the physical discomfort of psoriasis; the condition can be itchy and painful—and that is just the skin. Up to one-half of patients with psoriasis will experience stiffness that may ultimately evolve into joint pain associated with psoriatic arthritis. The physicality and visibility of psoriasis can cause increased psychological distress and can have a significant psychosocial impact. Patients may be unable to participate in work or social activities because they are uncomfortable wearing short sleeves or shorts. Their ability to play sports may be limited due to friction occurring at affected skin sites that could worsen their disease. The impact of how this visible disease could influence someone’s ability to perform routine tasks or duties certainly needs to be considered.

There are multiple validated research tools that we can use to assess the impact of psoriasis on patient QOL. In the real world, however, we rarely have time to use such tools. Still, it is of the utmost importance that we, as providers, document metrics that signal how a patient with psoriasis is doing in the real world over time. Helpful indicators include questions about their social life, sleep, and work.

It is also important for patients to understand that psoriasis is a sign of a bigger issue that can cause other medical problems, so comprehensive management is important. Getting patients to that mindset may lead to better adherence to systemic therapies. The targeted therapies work from the inside out, and many patients with psoriasis will demonstrate some benefit from an IL-17 or IL-23 inhibitor. There are certainly patients who may fail one agent and do well on another, but we have options. Just letting patients know that there are many treatments to choose from can have a positive impact on psychosocial well-being, as they understand that we are going to keep trying these treatments because we know they work.

We have a significant amount of QOL data for both IL-17 and IL-23 inhibitors. There was a period previously when the impact of skin disease on QOL metrics was not talked about enough. Now we have a wealth of data for all the currently available drugs, not only on long-term safety and efficacy but also on the meaningful QOL improvements that occur with successful treatment. We know that these drugs change lives; however, there are still too many people who do not use systemic options for psoriasis. I think that these data are useful for us to know that we are not just changing a patient’s disease—we are changing their entire life and are making each day better for them.