10 Ways to Navigate Psoriasis at Work

Anyone who has psoriasis is likely familiar with the physical symptoms like itchiness, soreness, or bleeding from cracked skin, all of which can make it difficult to work.

Lauren Winder, 32, experienced her first psoriasis flare when she was 6,000 miles away from home. Winder was studying abroad in Beijing, China, during her junior year at the University of California (UC) Berkeley when she noticed her skin had broken out in lesions.

At first, Winder thought the breakout may have been caused by the air pollution she was breathing in, so she waited a few weeks until she was back in the United States before seeking medical care. Eventually, a doctor at the UC Berkeley medical center examined her skin and immediately diagnosed her with psoriasis.

“It came as kind of a shock to me,” Winder says. As a cash-strapped college student, she couldn’t afford many of the products that the doctors recommended, and oftentimes, she was too busy with her studies to manage her psoriasis closely.

After graduation, Winder got her first job in southern California, where her psoriasis started to flare up yet again. “I started to notice breakouts on my legs,” she says. “And I was working in a typical office, so I decided to wear slacks that would cover my legs rather than a dress or skirt.”

To ease the itchiness and inflammation of her skin, Winder also applied coal tar products to her legs, then wrapped her legs in plastic wrap. “It was incredibly uncomfortable, especially during the summertime when it got hot,” she says. “I usually took it off halfway through the day.”

Psoriasis in the Workplace

According to a study published in the journal BJD in September 2020, people in the U.S. who have psoriasis lose more than 15 percent of their working hours per year to the condition — either because they have to take extra days off or because they’re experiencing “presenteeism,” meaning they have a hard time being productive because they are actively dealing with psoriasis symptoms.

Young adults especially can have a hard time managing their condition at work, according to a study published in the Journal of Dermatology Treatment. The researchers found that about 40 percent of participants with psoriasis, who were between the ages of 18 and 30, weren’t as productive at work as they could have been if they didn’t have a skin condition. About 21 percent of them had to take sick leave at least once over the past three months.

People with psoriasis are also more likely to miss work and go on short-term disability than those who don’t have it, according to a study published in July 2021 in the journal Clinical Rheumatology.

Additionally, there are emotional symptoms of the disease, such as self-consciousness, embarrassment, and even shame, according to research.

“If the psoriasis is on any visible skin surface, it can be very challenging,” says Adelaide Hebert, MD, a dermatologist with McGovern Medical School at UTHealth Houston. “There are social situations where you might be out at a company picnic, and you might be wearing clothes that might have short sleeves. If you have psoriatic plaques, others who don’t know what the disease is might find it disconcerting or even unsettling,” she says.

10 Ways to Manage Your Condition at Work

Here are 10 psoriasis-related challenges that you may encounter at work, and ways to deal with them.

Challenge 1: Your coworkers saw your breakout, and now they keep their distance.

Some people don’t realize that psoriasis isn’t contagious, says Dr. Hebert. And while that’s certainly frustrating, you may want to tell them you have a chronic condition — one that no one else can “catch.”

“Some people may find that reassuring,” says Hebert.

Challenge 2: You have to take yet another day off for a doctor’s visit.

Worried about what your boss may think? Just know that, under the Americans with Disabilities Act (ADA), employers are legally obligated to provide reasonable accommodations to people who have certain disabilities — and if your psoriasis (or psoriatic arthritis) is interfering with your ability to work, you may be protected under this rule.

That means you have every right to request time off to see a doctor or ask to work from home occasionally (or full-time) if you’re able to do your job that way.

Challenge 3: It’s hard to use certain equipment while your skin is flaring up.

If you can’t hold a particular tool or type on a computer, ask your boss if there are any devices you can use instead, suggests Jake Dickson, a personal trainer who has psoriasis.

Also good to remember: Under the ADA, your employer can’t withhold a promotion, raise, or other benefit from you based on your psoriasis diagnosis, according to the U.S. Department of Justice Civil Rights Division. If you think you are experiencing discrimination at work, reach out to your company’s human resources department.

Challenge 4: You have nail psoriasis, so you shy away from shaking people’s hands.

Nail psoriasis can cause the skin underneath the nail bed to look yellow, pink, or brown. Some people may also develop pits on the nails. In other cases, the nail can thin enough to pull away from the nail bed, says Hebert.

“When people are out shaking hands and making business affiliations, unattractive nails can be very problematic in the business or service realms,” she says.

If your job allows it, you may be able to wear nail polish, which can hide some of the symptoms of nail psoriasis, she says. You can also gently buff the nails, which helps hide the pits or discoloration, and wear gloves when you’re washing dishes to avoid drying out the nails or the surrounding skin, according to the Cleveland Clinic.

Challenge 5: You work indoors all day.

Haven’t seen the sun in days? You could be running low in vitamin D, a vitamin that’s used to treat psoriasis and is found in certain psoriasis prescription medications, according to the National Psoriasis Foundation (NPF).

The problem is, people who have psoriasis are much more likely to be deficient in vitamin D — aka, the “sunshine vitamin,” since your body produces it when you’re exposed to sunlight — than people who don’t have the skin condition, according to a study published in October 2022 in the journal BMC Nutrition. Your doctor can do a blood test to determine if you need more vitamin D.

Joanna Briggs, RN, a medical consultant at Jugo Feed, says it was difficult to manage psoriasis while working 12-hour shifts at a hospital. Now that she works from home, she tries to go outside to soak up some sun. The NPF says that you can get vitamin D from 10 minutes of sun exposure.

Challenge 6: Dry air dries out your skin.

Whether you’re working in an air-conditioned building or a room in your home during the fall or winter, a dry environment can make your skin feel parched. Briggs uses a humidifier in her workspace to help combat the dry air that can worsen psoriasis.

When the itching gets too intense, Briggs says, she uses “a lukewarm washcloth to pat the area, and then I apply a topical ointment.”

Challenge 7: You have scalp psoriasis, which is visible to your coworkers.

Even if you work from home, chances are you may have to be on video calls every now and then. And if that’s the case, you may worry that your scalp psoriasis is visible on screen to coworkers. “People who don’t understand the disease may think the person doesn’t wash their hair as often as they should,” says Hebert.

Winder finds herself battling persistent scalp psoriasis. To combat the plaques that appear on her head, she only washes her hair once or twice per week and uses a scalp moisturizer right after she finishes showering.

If you have scalp psoriasis, try to be gentle when you use shampoo because rubbing and scratching the skin can make your symptoms worse. You may also want to use a scale softener that contains salicylic acid, which helps soften the patches and allows certain psoriasis medications to work on the skin more effectively, according to the American Academy of Dermatology.

Challenge 8: It’s hard to stay hydrated when you’re always on the go.

Some people — including Briggs and Winder — notice that when they don’t drink enough water, their skin feels drier, too. Winder combats dehydration by drinking a large bottle of water every day.

“I bought a gallon-size jug of water and started filling it up and taking it with me,” she says. “If I didn’t want to bring it into the office, I’d get a 20-ounce water bottle and drink a minimum of three of them per day.”

Challenge 9: Work is stressful, which can cause a psoriasis flare.

You can’t always avoid a high-pressure sales meeting or a down-to-the-wire deadline, but finding ways to de-stress outside of work can help lower your overall anxiety levels. It worked for Winder, who started feeling more relaxed after doing acupuncture and deep-tissue massage.

Other ways tame the tension: practice meditation, mindfulness, or deep breathing. Need a little help getting started? Try downloading an app like Calm or Headspace, which offer guided meditation and relaxation sessions.

Challenge 10: You’ve tried everything, but you can’t work anymore.

Sometimes, psoriasis can severely limit a person’s ability to work as it can interfere with their ability to walk, stand, or use their hands.

If that’s the case, you may qualify for disability benefits, either through Social Security Income or Social Security Disability Insurance, according to the NPF. At times, navigating the system can be difficult, so you may want to seek legal help.

These days, Winder is now the founder and editor-in-chief of Coffee Hex. She has a much easier time managing psoriasis at work — something she credits to lifestyle changes such as staying hydrated, de-stressing regularly, and moisturizing her scalp with lotion.

“It’s really more of a lifestyle of self-discipline that keeps away the small outbreaks and makes the lesions manageable,” she says. “I’ve come a long way since my Saran-wrapped coal-tar days.”