Click here for COVID-19 (coronavirus) advice for people living with psoriasis and psoriatic arthritis.
21 July 2021
Coronavirus (COVID-19) Information
First published on Thursday 5th March 2020, LAST UPDATED on Wednesday 21st July 2021.
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.
Please use the menu to navigate our information:
- Resources for you
- COVID-19 vaccine and psoriasis
- 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?
- Shielding and advice for the clinically extremely vulnerable
- What if frequent handwashing irritates my psoriasis?
- Guidance on face coverings and avoiding irritation of psoriasis
- What research is taking place? Introducing PsoProtect & PsoProtectMe
- Reporting suspected side effects from medicines
- Useful links
To help you live well with psoriasis and psoriatic arthritis during the pandemic, we've put together the following resources:
- Preparing for a virtual consultation
- Hints and tips for coming out of isolation
- Hints and tips for coping well with the COVID-19 pandemic from Professor Chris Bundy
- Eating well during this challenging time
- Video - Professor Griffiths on COVID-19 and psoriasis (recorded on 30th March 2020)
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.
While going into isolation was worrying, coming out of isolation can also cause anxiety for many people. Everyone is different and some people need more support than others.
This is a troubling time for everyone and it is normal to worry about what lockdown and isolation means for you and your family. It only becomes a big problem when it stops you doing things you need to and has an impact on the rest of your life.
With the help of Professor Chris Bundy (Professor in Behavioural Medicine at Cardiff University), we've produced a resource with hints and tips designed to help you manage fear or worry and keep it in proportion so you can go about doing the things you need to do.
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;
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.
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.
The COVID-19 vaccine provides the best protection against coronavirus. Four vaccines for COVID-19 have currently been approved for use in the UK: the Pfizer/BioNTech vaccine; the Oxford/AstraZeneca vaccine; the Moderna vaccine; and the Janssen vaccine. The Pfizer/BioNTech, Oxford/AstraZeneca and Moderna vaccines are now being given to people at sites across the UK. The Janssen vaccine will be available in the UK later in 2021.
While this is certainly cause for optimism, it’s completely understandable that people who are taking immunosuppressive drugs for their psoriasis and/or psoriatic arthritis may have some concerns about whether or not it is safe for them to receive a COVID-19 vaccine.
We’ve put the following information together to try and address some of the concerns you may have. It’s important to note that we are learning more about both COVID-19 itself and the different vaccines that are being developed all the time. We will ensure that this section is updated regularly as further information is released.
Is the COVID-19 vaccine suitable for people with psoriasis and/or psoriatic arthritis?
Yes, current evidence suggests that the Pfizer/BioNTech, Oxford/AstraZeneca and Moderna vaccines are all suitable for people who are living with psoriasis and/or psoriatic arthritis. Therefore, having psoriasis and/or psoriatic arthritis, or taking prescribed medicines to treat your condition will not affect whether or not you can receive the COVID-19 vaccine, or which vaccine is best for you.
Is a COVID-19 vaccine likely to affect my psoriasis?
There is no evidence to suggest that vaccines are bad for psoriasis (or likely to make it worse, or flare), hence why people are encouraged to have the flu vaccine each year. At this stage, scientists are having to extrapolate data from other vaccines such as the flu vaccine and can see no reason why the COVID-19 vaccine would be any different in terms of flaring/causing psoriasis from, say, the flu vaccine. Systematic reviews have not found evidence that (non-live) vaccines are bad for psoriasis.
Is it safe for people who are taking immunosuppressant medication to receive a COVID-19 vaccine?
Yes, the Pfizer/BioNTech, Oxford/AstraZeneca and Moderna vaccines are all considered suitable for people who are living with psoriasis and/or psoriatic arthritis regardless of whether they are receiving drugs that affect the immune system (such as methotrexate and biologic injections, for example) or not.
People who are receiving drugs which affect the immune system are not able to receive live (also known as 'attenuated') vaccines, however the Pfizer/BioNTech, Oxford AstraZeneca and Moderna vaccines are not live vaccines. Non-live vaccines can generally be given safely to people receiving drugs that affect the immune system (such as methotrexate and biologic injections, for example), however further study is required to understand how well the vaccines work in the context of these medications.
For further reassurance on this point, please refer to the British Society for Immunology statement on COVID-19 vaccines for patients who are immunocompromised or immunosuppressed.
Will a COVID-19 vaccine be effective in people who are taking immunosuppressant medication?
It is not yet known whether taking an immunosuppressant (such as methotrexate) or biologic medication reduces the effectiveness of COVID-19 vaccines. Trials to date have not included people taking drugs that affect the immune system and thus vaccine efficacy in this specific population will need to be established.
However, even a reduced response to the vaccine is better than none, so you are still advised to get vaccinated even if you are taking an immunosuppressant medication.
In July 2021, results of a study which investigated the immune response to the first dose of the Pfizer COVID-19 vaccine in people taking immunosuppressant drugs for psoriasis were published. You can find out more here.
I have been offered one of the COVID-19 vaccines - should I stop or delay my immunosuppressant or biologic medication?
The British Association of Dermatologists currently does not usually advise stopping or delaying immunosuppressant or biologic treatment before receiving the COVID-19 vaccine.
There may be situations where your doctor advises reducing or stopping your treatment - for example, if your risk of COVID-19 is high and your psoriasis or psoriatic arthritis is well-controlled and unlikely to flare up. This should be discussed with your doctor on an individual basis. Do not stop any of your treatments without first discussing with your doctor.
I am about to start taking an immunosuppressant or biologic medication for the first time - can I receive the COVID-19 vaccine?
Yes. Your doctor may offer you the COVID-19 vaccination before you start your treatment to give your immune system enough time to respond to the vaccine.
Ideally, the time between receiving your vaccine and starting treatment is at least 2 weeks. Where possible, it is also preferable for the two-dose schedule to be completed before starting treatment, which may mean that the second dose of the vaccine needs to be given at the recommended dosing interval for that particular vaccine (3-4 weeks after the first dose). However, this may not be possible depending on the severity of your psoriasis and the type of immunosuppressant or biologic medication you are about to start taking. Your doctor will discuss this with you.
When will I be offered the COVID-19 vaccine?
The UK has now entered phase 2 of the COVID-19 vaccination programme. The Joint Committee on Vaccination and Immunisation (JCVI) has published advice that people should be offered the vaccine in age order starting with the oldest adults first. More information about this can be found here.
As of 28th June 2021, ALL ADULTS (aged 18 or over) in England, Northern Ireland, Wales and Scotland are now eligible to book their COVID-19 vaccine appointment.
During phase 1 of the programme the NHS offered the COVID-19 vaccine to people most at risk from coronavirus. If you are in one of the priority groups for COVID-19 vaccination outlined during phase 1 of the programme and have not yet received your first vaccine you can book online with the NHS.
I am in the 'clinically extremely vulnerable' group, should I continue to take extra precautions after I have received the COVID-19 vaccine?
No vaccine is 100% effective and therefore even if you have had both doses, there is still no absolute guarantee that you will not become ill from COVID-19. As such, you are advised to continue to take the extra precautions set out in the specific guidance for people who are clinically extremely vulnerable. There is individual guidance for England, Northern Ireland, Scotland and Wales.
Will data be collected on the effect of the COVID-19 vaccines on people with psoriasis?
Registry data such as that from the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR) and PsoProtect should be collected to inform whether the COVID-19 vaccines either positively or negatively affect psoriasis outcomes. In addition, if you have psoriasis yourself, you can self-report to the PsoProtectMe study (whether you have had COVID-19 or not). If you do experience COVID-19 infection then you can also ask your healthcare professional to report this to the PsoProtect registry.
Finally, if you have received the vaccine, you can report any suspected side effect using the Coronavirus Yellow Card safety scheme.
Information from the British Society for Immunology about the different types of vaccines for COVID-19 and how they work can be found here.
The British Association of Dermatologists has also issued an FAQs document addressing COVID-19 vaccination for immunosuppressed patients, which can be found here.
Specific information on COVID-19 vaccination in England, Northern Ireland, Scotland and Wales can be found by following the relevant link below:
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 guidance that is in place for everyone - see guidance for England, Northern Ireland, Scotland, and Wales.
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):
From the Scottish Government:
For the most up-to-date advice on COVID-19 (Coronavirus), you should read the following guidance from:
- The NHS (UK)
- The UK Government (UK)
- The Northern Ireland Executive (Northern Ireland)
- The Scottish Government (Scotland)
- The Welsh Government (Wales)
- Social distancing: You no longer need to stay 2 metres apart from people you do not live with. There are also no longer limits on the number of people you can meet. However, in order to minimise risk at a time of high prevalence, you should limit the close contact you have with those you do not usually live with, and increase close contact gradually. This includes minimising the number, proximity and duration of social contacts. You should still meet outdoors where possible and let fresh air into homes or other enclosed spaces.
- Working from home: The Government is no longer instructing people to work from home if they can. However, the Government expects and recommends a gradual return to workplaces outside of the home over the summer.
- Face coverings: The requirement to wear face coverings in law has been lifted in England. However, the Government expects and recommends that people wear face coverings in crowded areas such as on public transport.
England moved to Step 4 of the Government's roadmap on Monday 19th July 2021.
Most legal restrictions to control the spread of COVID-19 in England have now been lifted. You can find details of the remaining rules and restrictions here.
Key changes to restrictions from Monday 19th July onwards:
- Meeting indoors: Up to 8 people from up to 4 households can meet indoors in private homes without physical distancing, and stay overnight (children aged 12 and under are not counted towards the total).
- Indoor public spaces: Up to 10 people from up to 4 households can meet in a public indoor space (a pub or restaurant for example).
- Meeting outdoors: Up to 15 people from up to 15 households can meet outdoors without physical distancing - whether in a private garden or public place (children aged 12 and under are not counted towards the total).
- Physical distancing: In both indoor and outdoor public spaces you should maintain at least a 1 metre distance (rather than 2 metres) from anyone not in your permitted group.
- Face coverings: The mandatory wearing of face coverings in shops and on public transport, as well as in bars and restaurants when not seated is still in place in Scotland.
- Working from home: You should continue to work from home where possible.
- Meeting indoors: Up to 6 people from no more than 2 households can meet in a private home and stay overnight. Children aged 12 and under are not counted in the total. A household of 6 or more can mix with 1 other household (maximum of 10 people in total).
- Meeting in private gardens: Up to 15 people (including children) from no more than 5 households can meet up outdoors in a private garden, but you should maintain social distancing.
- Work from home if you can: You may still go out to work if you cannot reasonably work from home.
- Meeting indoors: Up to 10 people from no more than 3 households will be able to meet in a private home and stay overnight. If a single household has 10 members, the maximum is increased to 15 people from no more than 3 households
- Meeting in private gardens: Up to 15 people from any number of households will be able to meet up outdoors in a private garden. Children aged 12 and under are not counted in the total.
- Household bubbles: Households bubbles will end on Monday 26th July 2021
- Social distancing: The legal requirement for social distancing will be reduced, where relevant, to a minimum of one metre indoors, and removed for all outdoor activities and public transport.
- Meeting outdoors: There are no longer any legal restrictions on the number of people you can gather with anywhere outdoors including in private gardens, public parks and beaches, outdoor areas of regulated premises or for outdoor activities and events.
- Meeting indoors: Up to 6 people can meet indoors in private homes and holiday accommodation.
- Face coverings: Wear a face covering (if you are able to) in all indoor public places.
- Social distancing: You should follow social distancing rules with people you don’t live with or who are not in your extended household.
- Extended households: You can form an extended household with no more than 2 other households and they should stay the same.
- Work: You should work from home if you can.
- Meeting indoors: From Saturday 7th August 2021, there will be no legal limits on the number of people who can meet others indoors, including in private homes.
- Physical distancing: Remaining restrictions will be removed and replaced with the ongoing requirement for all organisations and businesses to carry out COVID-19 risk assessments.
- Get vaccinated - everyone aged 18 or over in the UK can book COVID-19 vaccination appointments now
- Meet people outside if possible
- Open doors and windows to let fresh air in if meeting people inside
- Limit the number of people you meet and avoid crowded places
- 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 a face covering when it's hard to stay away from other people - particularly indoors or in crowded places.
- Not touch your eyes, nose or mouth if your hands are not clean
In Scotland, a system of different COVID protection levels is currently in place. There are 5 COVID-19 protection levels, from 0-4. The rules you have to follow depend on the level for your area. You can find out more here.
As of Monday 19th July 2021, all of Scotland is at level 0.
Key changes to restrictions from Monday 19th July 2021 onwards:
Key restrictions remaining in place after Monday 19th July 2021 include:
It is hoped that all remaining major restrictions can be removed on Monday 9th August 2021.
The current rules and restrictions in Northern Ireland can be found here.
A summary guide can be found here.
Current key restrictions include:
Each household is still currently permitted to form a 'bubble' with one other household of any size. However, indoor meetings between households in the bubble are limited to a maximum of 10 people, including children, at any one time.
An indicative date of Monday 26th July 2021 has been set for the following changes to restrictions:
The indicative date for the easing of restrictions in Northern Ireland is subject to a review on Thursday 22nd July 2021.
The current rules and restrictions in Wales can be found here.
As of Saturday 17th July 2021, all of Wales is at alert level 1.
Current key restrictions:
Further anticipated changes on Saturday 7th August 2021 when it is expected that Wales will move to alert level 0:
Please note that face coverings will continue to be required by law in Wales in most indoor public places and on public transport at alert level zero from Monday 7th August 2021, with the exception of hospitality settings.
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:
There is separate advice about:
There is specific advice 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. Most people who fall into this ‘clinically extremely vulnerable' category will previously have been contacted directly by the NHS or their GP to advise them of this.
In February 2021, more people in England were added to the 'clinically extremely vulnerable' list after being identified by the QCovid risk prediction model. QCovid estimates a person’s risk of catching COVID-19 and becoming seriously unwell, based on multiple risk factors, including age, sex registered at birth, ethnicity, body mass index (BMI), specific health conditions and treatments.
If you have been added to the 'clinically extremely vulnerable' list by QCovid, you should have received a letter or email explaining why. You should also have been invited to receive the COVID-19 vaccine as a matter of priority. Your invitation letter or email should have arrived separately.
What is the current guidance for people who are 'clinically extremely vulnerable'?
Shielding in England was paused on Thursday 1st April 2021. There is still advisory guidance in place for people who are clinically extremely vulnerable, which can be found here. You can find links to individual sections of this guidance below:
- What has changed
- Socialising inside and outside the home
- School, college and other educational settings
- Going to shops and pharmacies
- If you require additional care and support
Everyone on the Shielded Patient List should already have been offered a COVID-19 vaccine in line with the priority ordering set by the Joint Committee on Vaccination and Immunisation (JCVI). If you have not yet received your first dose, please contact your GP or book your vaccination online here. If you have received your first dose, you should still ensure you take up your second dose of the vaccine when it is offered to you. Having two doses should further increase your level of protection. For some people who are immunosuppressed it may only be with your second dose that a significant immune response is triggered.
No vaccine is 100% effective and therefore even if you have had both doses, there is still no absolute guarantee that you will not become ill from COVID-19. As such, you should continue to follow the guidance that is in place for everyone.
The NHS Volunteer Responders programme remains available to help support those who need it. Volunteers can collect and deliver shopping, medication and other essential supplies, help with a regular, friendly phone call, and provide transport to and from medical appointments. Call 0808 196 3646 between 8am and 8pm, 7 days a week to self-refer or visit www.nhsvolunteerresponders.org.uk for further information.
- How to protect yourself
- COVID-19 vaccine
- SMS (text) and email alerts
- If you develop symptoms of coronavirus (COVID-19)
- Mental health and wellbeing
- Work and employment
- Children and young people
- Care and support
- Shopping and medicines
- Hospital and GP appointments
- Keeping safe
- Care support
- Mental health support
- Loneliness and isolation
- Highest risk group
- Health and wellbeing
- Workplace safety advice
- Financial support
- SMS shielding service
- Medical appointments or advice
- Letters to the highest risk group
- Research about shielding
- 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'.
- 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)
- If your psoriasis or psoriatic arthritis is well controlled with minimal activity, you do not have a health condition which makes you 'clinically vulnerable', 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 do not have a health condition which makes you 'clinically vulnerable', 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 do not have a health condition which makes you 'clinically vulnerable', and you are taking ONE immunosuppressive medication (see list above) plus Hydroxychloroquine or Sulphasalazine.
- Topical skin treatments (creams, gels etc.)
Shielding in Wales was paused on Thursday 1st April 2021. There is still advice in place for people who are clinically extremely vulnerable, which can be found here. You can find links to individual sections of this guidance below:
Everyone on the Shielding Patient List (aged 16 years and over) has already been invited to receive the COVID-19 vaccine. If you have recently been added to the Shielding Patient List you will be prioritised for vaccination. Please allow approximately a week from the date of your letter to be invited, while systems are updated.
Even if you have had both doses of the vaccine, you are advised to continue to follow social distancing and hand and surface hygiene advice strictly. The people you live with should continue to follow the public health rules and guidance as long as they are in place, including if you have received the vaccine and also if they have received the vaccine.
Clinically extremely vulnerable people can now go to work, if they cannot work from home, as long as the business is COVID-secure.
You can go to the shops yourself, however if you do not feel comfortable doing so, you should ask friends, relatives, neighbours or volunteers to go shopping for you. Priority supermarket delivery slots are also available to you online. If you need further support and you do not have family, friends or neighbours to help you, you can find information about getting food and essential supplies here.
The Welsh Government will continue to keep a record of everyone on the shielding patients list in case they should need to ask anyone to undertake shielding measures again in future.
Since 12th April 2021, people in Northern Ireland who are clinically extremely vulnerable have been able to return to the workplace if they are unable to work from home. This is provided their employer has taken the proper measures to ensure social distancing in their place of work, and they can travel to work in a way which allows for social distancing.
You can find the full guidance for clinically extremely vulnerable people here, and links to specific sections of the guidance below:
Scotland currently has a system of local COVID protection levels (tiers) in place. There are 5 different levels, from 0 to 4. The lowest level is 0 and the highest level is 4. If you are on the shielding list, you should follow the general advice for your local protection level.
Please note that, as of Monday 19th July 2021, all of Scotland is at level 0.
You can find the full guidance for clinically extremely vulnerable people in Scotland here, and links to specific sections of the guidance below:
This advice does not apply to anyone living in a residential care or nursing home. Care homes are following the separate guidance for care home settings.
How do I know whether or not I am in the 'clinically extremely vulnerable' category?
If you fall into the ‘clinically extremely vulnerable' category, you should have been contacted directly by the NHS or your GP to advise you of this.
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 (highest risk), but you may still be 'clinically vulnerable' (higher risk).
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 this 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', and at the highest clinical risk from COVID-19 include:
'Clinically vulnerable' - at a higher clinical risk from COVID-19 (but not the highest risk):
You will be moved up to the 'clinically extremely vulnerable' list ONLY if you meet any of the following criteria AND you are recommended to do so by your clinician:
At no higher risk but should still follow social distancing measures:
You are not in either of the 'clinically extremely vulnerable' or the 'clinically vulnerable' categories, 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:
The British Association of Dermatologists has put together a useful risk stratification grid, which can be found here.
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 'clinically extremely vulnerable' category.
Finally, full guidance on shielding and protecting people who are 'clinically extremely vulnerable' from COVID-19 can be found here:
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.
Currently, people across the UK are being asked to wear a face covering (something which safely covers the nose and mouth) in certain places where social distancing is very difficult or not possible. However, the specific guidance varies in different parts of the UK. You can find links to the specific guidance for England, Northern Ireland, Scotland and Wales below. Each nation's guidance covers instances in which face coverings must be worn, as well as any exemptions.
- England (Please note that the legal requirement to wear a face covering in shops, on public transport and in other enclosed public spaces in England ended on Monday 19th July 2021 and was replaced with government guidance recommending that people continue to wear face coverings in crowded areas such as on public transport.)
- Northern Ireland
- Scotland (Please note that the wearing of face coverings in shops and on public transport, as well as in bars and restaurants when not seated remains mandatory in Scotland.)
- Wales (Please note that face coverings will continue to be required by law in Wales in most indoor public places and on public transport beyond the move to alert level zero on Monday 7th August 2021, with the exception of hospitality settings.)
- 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.
Exemption card templates are available for people who have an age, health or disability reason for not wearing a face covering and may feel more comfortable showing something that states this. However, this is a personal choice and is not necessary in law.
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. Because face coverings are mainly intended to protect others, not the wearer, they are not a replacement for social distancing and regular hand washing. If you have symptoms of COVID-19, you and your household must isolate at home: wearing a face covering does not change this.
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 while allowing you to breathe comfortably. It should fit securely to the side of the face and be secured to the head with ties or ear loops. It should be made of a material that you find to be comfortable and breathable, such as cotton, and ideally include at least 2 layers of fabric.
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 (or use hand sanitiser) and avoid touching your face. Once applied, you should avoid wearing it on your neck or forehead and avoid touching the part of the face covering in contact with your mouth and nose, as it could be contaminated with the virus.
After each use, you should wash or sanitise your hands before removing the covering, using only the straps, ties or ear loops, 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:
For further information and advice on scalp or facial psoriasis, please do get in contact with us.
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.”
In December 2020, the first publication using PsoProtectMe data revealed new findings on shielding behaviour during the COVID-19 pandemic. You can find out more here.
In April 2021, two video updates were published with the latest news from PsoProtect and PsoProtectMe. You can watch these video updates here.
In June 2021, further findings from PsoProtectMe were published, describing the burden of the COVID-19 pandemic in people with psoriasis. You can find out more here.
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.
In October 2020, the first findings from PsoProtect were published. You can find out more here.
In April 2021, two video updates were published with the latest news from PsoProtect and PsoProtectMe. You can watch these video updates here.
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 on 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 2020) 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.
Please note there is a separate Coronavirus Yellow Card reporting site to report suspected side effects from medicines and vaccines or medical device and diagnostic adverse incidents used in coronavirus treatment.
From the NHS:
- Coronavirus (COVID-19) vaccine
- COVID-19 advice for everyone
- Advice for people at higher risk
- What to do if you or someone you live with has symptoms of coronavirus
- How to wash your hands
- NHS fitness studio: exercises you can do at home
- Every Mind Matters
- Coronavirus (COVID-19) guidance
- Coronavirus restrictions
- Roadmap out of lockdown
- Vaccine priority groups (phase 1)
- Vaccine rollout (phase 2)
- Guidance on shielding and protecting people who are clinically extremely vulnerable from COVID-19
- Staying safe outside your home - Face coverings
- Coronavirus (COVID-19) information
- Coronavirus (COVID-19) regulations guidance: what the restrictions mean for you
- Guidance for 'clinically extremely vulnerable' and 'vulnerable' people
- Coronavirus (COVID-19): Face coverings
- Coronavirus in Scotland
- Coronavirus (COVID-19): local protection levels
- Coronavirus (COVID-19) – Important advice for people with dermatological conditions (not cancerous)
- Coronavirus (COVID-19) – Important advice for people with rheumatic conditions
- Coronavirus (COVID-19): public use of face coverings
- Coronavirus (COVID-19): shielding advice and support
- Coronavirus (COVID-19) information
- Current restrictions
- COVID-19 alert levels
- Guidance on shielding and protecting people defined on medical grounds as extremely vulnerable from coronavirus (COVID-19)
- Face coverings: guidance for public
- 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
- FAQs on COVID-19 vaccination for immunosuppressed patients
- Dermatology advice regarding self-isolation and immunosuppressed patients
- Risk stratification grid
- Statement on dry skin and frequent handwashing to reduce COVID-19 risk
- If you have psoriatic arthritis, you may also find this risk stratification guide useful if you are taking an immunosuppressant medication and you are unsure whether or not you fall into the 'clinically extremely vulnerable' category.
- Types of vaccines for COVID-19
- A statement on COVID-19 vaccines for patients who are immunocompromised or immunosuppressed
- 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
- Silver Line - Free, 24 hour confidential helpline for people aged 55 and over. Phone: 0800 4 70 80 90, website: https://www.thesilverline.org.uk
- 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
- Coronavirus and your wellbeing
- Coronavirus advice for employers and employees
From the UK Government:
From the Northern Ireland Executive:
From the Scottish Government:
The Welsh Government:
From the National Institute for Health and Care Excellence (NICE):
From the British Association of Dermatologists:
From the British Society for Rheumatology:
From the British Society for Immunology:
Someone to talk to:
From Acas, the Advisory, Conciliation and Arbitration Service:
Please note that this information is correct as of 21st July 2021. For up to date information, or if you think you may have the symptoms of COVID-19, please follow the latest NHS advice.