In a world where perfection is glorified, it can be hard to accept flaws or things that make us appear less than ideal.
Psoriasis is one of those things. It's often seen as ugly, scary, or gives the impression there’s something wrong with you. It can be uncomfortable, even embarrassing, to go out in public. The looks you get and comments you hear can be almost unbearable.
There is hope. Today we’re going to uncover what psoriasis really is, how it affects people on a physical and mental level, and ways to break the stigma.
Understanding Psoriasis
What is psoriasis? Similar to eczema, it’s a skin condition that results in the appearance of rough, scaly patches. It’s actually very common, affecting more than 7.5 million Americans (1).
It’s believed to be an immune-mediated disease caused by multi-systemic inflammation. There are several types (2) of psoriasis:
- Chronic plaque psoriasis: The most common type, plaque psoriasis causes rashes of dry, raised patches of skin. They're usually covered with silver or grey scales
- Guttate psoriasis: More common in children and young adults, this type of psoriasis often emerges after a bacterial infection. Rashes typically resolve after treatment.
- Scalp psoriasis: While dandruff is a fungal issue of the scalp, psoriasis can cause red, patchy areas on the forehead and scalp that are itchy and flaky. Scratching may cause bleeding.
- Nail psoriasis: Psoriasis can also affect your nails, leading to discoloration, abnormal growth, and separation. In some cases, it can lead to nail crumbling.
- Inverse psoriasis: Instead of the typical rough, scaly look, this type of psoriasis showcases a smooth but inflamed rash. This is typically found under the breast, buttocks or groin area.
- Erythrodermic psoriasis: The least common form, erythrodermic psoriasis covers the entire body. Flare-ups can be triggered by episodes of severe sunburn, medication use.
- Pustular psoriasis: This rare form can bring about pus-filled sores in areas of a flare-up. The sores will spring up hours after an infection or flare-up and take days to subside. These often reoccur unless the underlying cause is addressed.
Typically it’s diagnosed by a physical exam. Lab tests or imaging is rarely needed. Once you have an official diagnosis, you and your doctor can work together to create a plan that gives you the best quality of life possible.
How Psoriasis Affects Mental Health
At this time in research and development, there is no cure for psoriasis. Because of this, you may experience negative feelings (3), including shame, guilt, helplessness or embarrassment. Painful lesions can also make it difficult to enjoy sleep, sex, or wearing certain clothes. This can sometimes lead to low self-esteem, depression, and isolation.
Stress can also trigger flare-ups by producing more cytokines (4). These cells are responsible for increasing inflammation. This can exacerbate the situation further.
Treatments
Psoriasis affects the whole person, so it’s important to approach treatments holistically.
Adopting positive ways to manage stress is one way to reduce psoriasis flare-ups. Some ways include eating foods rich in magnesium, practicing gratitude/meditation, and exercising.
As far as treating the skin rashes themselves, you have a few options. The goal of most conventional psoriasis treatments is to reduce the amount of cells that build upon themselves. Some current treatment options include:
- Topical creams and ointment: Creams, lotions, gels, and shampoos can help relieve itching wherever psoriasis flare-ups develop. Some of the most popular ingredients are hydrocortisone, Vitamin D, coal tar, and salicylic acid (6).
- Light therapy: The use of artificial ultraviolet light therapy (UVA and UVB) can help reduce the severity of plaques. It's a second-line treatment when topical applications don’t help (5). In-hospital treatments are available under the supervision and administration of certified dermatologists.
- Systemic medication: In severe cases, the best option may be taking an oral medication or receiving injections. These keep scales from forming. Keep in mind, some of the oral options have negative side effects - like liver damage, fertility and reproductive damage, fetal damage, and more (7). Talk with your healthcare provider to determine the best course of action for you.
How to Break the Stigma Around Psoriasis
If you know someone who’s been diagnosed with psoriasis, they're probably going through a lot.
You can help break the stigma (8) by addressing these core areas:
- Know the facts: Take time to educate yourself and others about psoriasis and how it affects people.
- Be aware: You’ll probably notice different feelings and thoughts. Acknowledging these feelings can help you choose the next step.
- Choose your words carefully: Whoever words don’t hurt was not being truthful. They do hurt, which is why it’s best to think twice before making a comment that might come across as hurtful.
- Focus on the positive: If patches of scaly skin get you down, try to shift your focus on how well your vision is, or how well you can run. Or, your qualities that are not so visible, like your kindness, ingenuity, or bravery.
- Support others: If your friend or loved one is struggling, offering an encouraging word, quote, or Scripture can help pull them out of a funk.
- Include everyone: When making plans to go out or have friends over, remember your friend with psoriasis. They may not accept your invitation, but knowing you thought of them can help boost their sense of self-worth. This can help them overcome hard times.
The bottom line is, your “flaws” can be flawsome, and are part of who you are!
Summary
Psoriasis is an issue that’s more than skin deep. Not only is it a multi-system disease, the impact affects people on a physical and emotional level.
Some of the ramifications of psoriasis can include depression, isolation, and low self-esteem. And while there is no known cure, treatments are available.
Creams and ointments help for some, while light therapy seems to be the best choice for others. Whichever path you choose, know that you’re not alone in your struggle.
And what is seen as a flaw can turn out to be a unique trait that drives you forward. Life will always have challenges. You can help reduce the stigma by educating, supporting, and including each other. Together, we can help others overcome those challenges and come out stronger on the other side.
Who do you know would benefit from reading this? Be sure to share this with them today!
References & Disclaimers
1.https://pubmed.ncbi.nlm.nih.gov/18423260/
3.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3890931/
4.https://www.verywellhealth.com/stress-psoriasis-5208785
6.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5518573/
7.https://www.nhs.uk/conditions/psoriasis/treatment/
8.https://www.camh.ca/en/driving-change/addressing-stigma
✝✝This noted statement is based on independent research and is not necessarily the opinion of the author