Which Doctors Can Treat Psoriatic Arthritis? Tips for Building Your Treatment Team

If you have psoriatic arthritis, you might already be working with a rheumatologist or dermatologist. But the inflammation from the condition can cause problems in the eyes, bowel, and heart. And all of these need expert care. Psoriatic arthritis can also take a toll on your mental health and ability to do everyday things.

That means people with psoriatic arthritis might need to see a few different types of doctors or specialists to be their healthiest. Below, we introduce possible members of your care team and explain their roles.

What kind of doctors diagnose and treat psoriatic arthritis?

Most people with psoriatic arthritis have at least a few different doctors and healthcare professionals on their team. 

The most common team members include:

• Rheumatologist: Typically the point person for psoriatic arthritis, rheumatologists are doctors who specialize in joint and autoimmune conditions. They will likely prescribe your medications, and monitor your symptoms and treatment over time. 

• Dermatologist: A dermatologist is also a top member of the team, though some people will only have a rheumatologist. Dermatologists can help diagnose the condition, and treat psoriatic arthritis symptoms that affect the skin.

• Primary care provider: A primary care provider, another top team member, will be the point person for everything else. They will also help monitor how your psoriatic arthritis treatment affects your overall health and medical conditions.

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Other health conditions — like heart disease, eye disease, or inflammatory bowel disease — can be related to psoriatic arthritis. If you have these conditions, you might need these members on your team, too:

• Cardiologist, a heart specialist

• Ophthalmologist, an eye specialist

• Gastroenterologist, a gut specialist

When you have psoriatic arthritis, it can be hard to move around or hold things. And when it’s hard to physically get through the day, it can be mentally tough, as well. If your physical function or mental health is affected, you might need the following members on your team, too:

• Mental health professionals, such as a therapist

• Physical therapists, the experts in mobility and strength

• Occupational therapists, who are trained in helping you perform everyday activities

Rheumatologist for psoriatic arthritis

A rheumatologist specializes in autoimmune diseases and the musculoskeletal system (joints, bones, tendons). Psoriatic arthritis is an autoimmune disease that affects the skin, joints, and, sometimes, other organs. So, it makes sense that your rheumatologist is the leader of your care. 

You and your rheumatologist will work together to find the right treatment for your symptoms. The goal is to clear your skin, improve joint pain, and stop the immune-system attack on your body. Rheumatologists are experts in the immunosuppressive medications that are needed to get psoriatic arthritis under control.

You’ll typically see your rheumatologist every 3 months — and perhaps more frequently at first. At your visits, you’ll chat about your symptoms, and your rheumatologist will take a good look at your skin and joints. They’ll adjust your medications if they aren’t working well.

EXPERT PICKS: WHAT TO READ NEXT

• Symptoms: Psoriatic arthritis can affect more than just your skin and joints. Here are the most common symptoms.

• Diagnosis: A diagnosis of psoriatic arthritis is mainly based on your symptoms and physical exam. But some tests can help.

• Treatment: A rheumatologist explains the different treatment options for psoriatic arthritis, and how they choose the best treatment for each person.

Since psoriatic arthritis is a lifelong condition, you’re going to be seeing your rheumatologist for a long time. 

In many cases, you’ll need a referral from your primary care provider to see a rheumatologist. But not always. It depends on your insurance coverage and/or the rheumatologist. It’s also important to make sure you find a rheumatologist whom you feel comfortable with. 

Dermatologist for psoriatic arthritis

A dermatologist specializes in skin diseases like psoriasis. About 25% of people with psoriasis will one day develop psoriatic arthritis, so dermatologists are often the first to diagnose the condition. Dermatologists are in charge of prescribing creams or light therapy for your rashes. They work with your rheumatologist to pick the best immunosuppressive medication.

Your dermatologist might use a screening test called the PEST (psoriasis epidemiology screening tool) to check for symptoms of psoriatic arthritis. If your score is three or higher, you should be referred to a rheumatologist for a possible diagnosis. Since dermatologists aren’t joint specialists, you’ll need a rheumatologist on your team if you are diagnosed. 

Primary care provider for psoriatic arthritis

A primary care provider should be on everybody’s healthcare team. But when it comes to psoriatic arthritis, they are extra important. 

One reason is because psoriatic arthritis increases the risk of heart disease due to uncontrolled inflammation in the body. A primary care provider can keep an eye on a few things to decrease your risk of heart disease. These include your:

• Blood pressure

• Weight

• Cholesterol (lipid test)

• Blood sugar (hemoglobin A1c test)

If you’re young, it’s important to remind your primary care provider that psoriatic arthritis increases your risk of heart disease. Cholesterol and blood sugar tests aren’t typically recommended for younger people without risk factors. But reminding your primary care team that you are at higher risk due to your conditions helps ensure you get the right tests.

Physical and occupational therapists for psoriatic arthritis

Psoriatic arthritis can make daily life a lot more challenging, especially when it’s not well controlled. If your joint pain is making it hard to do things, a physical and/or occupational therapist could be great short-term additions to your team. Physical therapists work with you to improve strength and mobility. Occupational therapists help find ways to make everyday tasks easier to do.

Other specialists for psoriatic arthritis

If you have other health conditions related to psoriatic arthritis, you might need the help of a few other specialists. If you don’t have these conditions, you can leave them off the roster. Preemptive screening visits (“just in case”) aren’t needed, either.

You may need the expertise of a cardiologist. While a primary care provider can manage blood pressure and other risk factors for heart disease, a cardiologist is needed if you have multiple risk factors or severe heart disease.

Seeing an ophthalmologist is important if your condition causes eye inflammation (uveitis or conjunctivitis). Eye inflammation is an uncommon complication of psoriatic arthritis. Symptoms include eye pain, redness, and vision changes. 

A gastroenterologist may also be a member of your care team if you have inflammatory bowel disease (IBD). Psoriatic arthritis can increase the risk of inflammation in the gut. Symptoms of IBD include chronic abdominal pain, diarrhea, and bloody stools.

Mental health professionals for psoriatic arthritis

A mental health professional — usually a therapist — can be helpful for many reasons. Psoriatic arthritis increases the risk of depression. And dealing with the painful joints and itchy rashes can increase stress. In turn, stress can trigger flare-ups and worsen symptoms. This can be a vicious cycle. So, addressing both your mental health and psoriatic arthritis at the same time can be a win-win.

Is it beneficial to see more than one doctor for psoriatic arthritis?

Since psoriatic arthritis can affect different parts of the body, having different specialists on your team may be the most effective way to keep it in check. Studies show that combined dermatology-rheumatology clinics can lead to better results for people with the condition. With different players on the team, things are less likely to fall through the cracks.

This being said, many team members can mean more appointments and higher costs. If you have to pick and choose, focus on seeing a rheumatologist and primary care provider for your psoriatic arthritis. 

If you don’t have health insurance, you could look at programs that could help you gain access to a primary care provider, and possibly a specialist. You or the primary care provider might be able to get some guidance from a specialist via telehealth (virtual medical visits). Sometimes, patient assistance programs can help cover the cost of expensive psoriatic arthritis medicines, too. 

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Written by:

Samantha C. Shapiro, MD

Samantha Shapiro, MD, is a board-certified rheumatologist and internist with expertise in autoimmune and inflammatory conditions. She founded the division of rheumatology at Dell Medical School at The University of Texas at Austin.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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