Psoriasis is generally considered to be a skin disease. The word alone is practically synonymous with itchy, flaky skin. But it’s important to remember that psoriasis’s trademark symptoms are precisely that—symptoms. In his recent article “Effects of Psoriasis Not Confined to Skin,” Dr. Anthony L. Komaroff reminds us that, at its core, psoriasis is an immune system disease resulting in inflammation—and that inflammation can manifest in many forms, both externally and internally.

The real takeaway is that managing psoriasis requires a holistic approach. Of course, this often begins with treating the red or scaly patches that so often form on the skin, but it doesn’t end there. As Dr. Komaroff notes in his article, psoriasis’s constant inflammation can lead to further, more serious complications such as diabetes, heart disease, high blood pressure, and even cancer.

One all-too-common manifestation of psoriasis is psoriatic arthritis. In fact, nearly 1-in-3 psoriasis patients will find themselves adding swollen, painful joints to their list of symptoms. Like all forms of psoriasis, psoriatic arthritis has no cure, but it can be managed when properly treated.

Seemingly unrelated conditions like heart disease and arthritis serve to remind us of one important thing: while the skin-deep aspects of psoriasis get a lot of attention, you’re not just managing an itch—you’re managing your health. So regardless of where or how your psoriasis manifests itself, always maintain an honest, ongoing dialogue with your doctor. It’s the single best thing you can do to treat your psoriasis symptoms—those you can see, as well as those you can’t.