If you live with psoriasis, having a great dermatologist on your side is key. If your condition is under control, you might only need to see your specialist at your annual checkup or at a scheduled review of your medications. But like with all chronic skin disorders, psoriasis can often throw a wrench in the works at any time. If your condition is changing, worsening, or not responding to treatment, it’s a good idea to get your dermatologist’s advice as soon as possible.

Here are six signs you should get in touch with your dermatologist about your psoriasis.

Sign #1: You’re having a particularly bad outbreak.

“Psoriasis can have flare-ups that cause itching, discomfort, scaling, and flaking of skin, along with other symptoms like scalp involvement, nail abnormalities, or even joint pain and swelling,” says Tanya Nino, M.D., a dermatologist at Providence St. Joseph Hospital in Orange County, California.