Psoriasis is a non-contagious skin condition that causes scaly, red patches to appear anywhere on the body. It can make you self-conscious about your appearance. Read on for advice from experts and patients on treating psoriasis and how to cope with the disorder...
What is psoriasis? And what causes it to flare?
Psoriasis isn’t fatal like cancer, but it has no cure. About 7.5 million Americans are affected by the disfiguring skin condition, which causes red welts on skin. It usually first appears between 15-35 years old and may be hereditary.
Psoriasis symptoms may be confined to small areas of the body – an elbow, for example. They can also cover the entire torso or, even worse, your face. Because of the lesions, many sufferers feel like lepers, untouchable and alone.
But you don’t have to lock yourself in your bedroom. Read on as doctors, patients and experts explain what triggers the disorder and share how to feel beautiful when your skin is acting up.
When the Immune System Turns Against Itself
Experts believe psoriasis is an autoimmune disease. A popular theory is that the immune system triggers skin cells to grow faster than your body can shed them.
Skin cells normally take 28-30 days to mature and fall off the body. With psoriasis, they grow in 3-4 days. And instead of shedding, they gather and form red, rough or silver-hued lesions.
Certain people may have a genetic predisposition toward the disorder, experts say. It’s usually triggered by stress, trauma or injury to the skin, or medications such as lithium, antimalarials and indomethacin, an anti-inflammatory drug for arthritis.
In some people, the inflammatory process also attacks the joints, causing psoriatic arthritis.
Coping with Emotional Scars
As distressing as the lesions are, the emotional pain of psoriasis is often more upsetting than the disease itself.
Many women with psoriasis symptoms experience embarrassment and unkind reactions from people around them.
It’s like grief, says Jonathan Weiss, M.D., a dermatologist in Atlanta and an assistant clinical professor of dermatology at Emory University.
Many psoriasis sufferers go through the same emotions as someone who has lost a loved one, he says: Denial, depression, anger and acceptance.
They’re mourning the loss of control over their health and well-being, often in the prime of their lives.
“There’s a lot of stigma around skin that doesn’t look healthy,” agrees Portland, Ore., psychologist Julie Nelligan, who works with the National Psoriasis Foundation. “People wrongly assume that it’s contagious.”
The social shunning can be excruciatingly hurtful, as it was for Allyson DeLorenzo, 29, a graduate student in New York City. She was 18 and in college when diagnosed with psoriasis.
DeLorenzo remembers several painful encounters. Once at a pool during spring break, a mom asked what disease she had because she worried her child would get it.
Another time, a manicurist insisted on wearing rubber gloves during a pedicure.
“On one hand, I could understand completely,” she says. “On the other, it made me feel crappy that someone didn’t want to touch me.”
Keeping Emotions in Check
It’s important to manage your sadness, frustration and embarrassment because stress and anxiety can trigger and make psoriasis symptoms worse, says Ted Grossbart, Ph.D., a psychologist in Boston and author of Skin Deep: A Mind/Body Program for Healthy Skin (Health Press).
Here’s how to cope with the condition:
1. Learn about the disease.
The more you know about psoriasis, the quicker you’ll become comfortable with it, Weiss says.
“You’ll come to a level of understanding that you don’t always have control over it and will learn to control what you can,” he adds.
To learn more about psoriasis, check out the National Institutes of Health, American Academy of Family Physicians and National Psoriasis Foundation.
2. Educate others.
When people ask questions about your “skin problem,” turn it into an opportunity to teach them about psoriasis. Explain that it’s a medical condition you can’t control and that it isn’t contagious.
The more comfortable you feel about your disease, the more capable you’ll be about discussing it.
“I realized it didn’t have to define who I am,” DeLorenzo says. “I was able to incorporate it and say, ‘I’m Allyson, and I have psoriasis.’”
3. Tackle stress head-on.
Having psoriasis is like having a built-in stress meter. When your anxiety level goes up, psoriasis spreads.
So it’s important to know what triggers anxiety or anger – whether it’s your mother-in-law or the morning commute – and find ways to lessen it, Grossbart says.
Consider engaging in yoga, meditation and regular exercise, all activities that can reduce your stress level.
Or spend time gardening and hiking or vegging on the beach. That’s what finally helped Dawn Swidorski, a San Francisco outreach specialist with the condition.
Those activities relaxed her and, for the first time since she was diagnosed, she let go of her anxiety over psoriasis symptoms.
“I didn’t care about it as much,” she says. “As soon as I wasn’t obsessing about it, it went away.”
4. Develop social support.
Connect with others who have psoriasis, so you don’t feel like the lone “leper.”
“I find that if people feel supported, their depression and anxiety lessens,” says Nelligan, the Portland psychologist. Not only will that ease flare-ups, but sharing information about the disease will also help erase the stigma, she adds.
Which is what happened to DeLorenzo. She got over her feelings of shame when she was able to diagnose a friend and met another woman with psoriasis.
“By that point, I realized I wasn’t alone,” she says. “I started wearing short sleeves and shorts and I became more comfortable discussing it.”
DeLorenzo also joined the board of the National Psoriasis Foundation and took part in a fund-raising walk.
“Not only was I doing something to help myself and others with psoriasis, I also was able to connect with others who have it,” she says.
5. Dress appropriately.
Living with red lesions all over your body can shake the self-esteem of even the most confident person.
If you’re embarrassed by your psoriasis, dress in ways that conceal the lesions. Wear 3/4-length or long sleeve shirts and slacks instead of dresses or shorts.
Dress in light-colored clothes, so flakes are less visible. And choose items you really like, so you’ll feel better about your appearance.
The color and texture of the fabrics you wear make a difference in how you look and feel too, says Chad Hayduk, a makeup artist who has psoriasis and co-founder of Three Custom Color Specialists in New York City.
“Psoriasis can be irritated by rough, scratchy fabrics so avoid wools,” he says. “Wear softer, more free-flowing fabrics to let the skin breathe and prevent abrasion.”
Sometimes a simple change in clothing can help lessen the frequency of outbreaks. Swidorski’s psoriasis improved when she moved from Michigan to California in 1990 and was forced to dress in lighter clothing because of the state’s year-round warmer climate.
Because psoriasis’ lesions can be red or pinkish, “you should avoid wearing fabrics and makeup in those shades,” Hayduk says. They’ll make flaky patches stand out.
6. Cover up.
Certain cosmetics can help conceal patches. But be careful, because some can exacerbate the condition. Ask your dermatologist to find out which products might work best for you.
Wear fragrance-free makeup because perfumes can irritate the skin.
Also look for moisturizing foundations, “which will help hydrate, condition and calm the flaking,” Hayduk says. “A liquid or oil-based product will be easier to apply.”
But it isn’t just dry skin, so don’t try treating psoriasis or get rid of the flakes with moisturizer. Again, consult a dermatologist for recommendations.
Avoid matte, oil-fighting and oil-free formulations too – and “anything that’s too waxy because they can be irritating,” he says.
For a more natural finish, apply concealer and foundation with a clean, synthetic brush.
“You can control the amount of coverage on flaky areas and it will look less heavy-handed than application with fingers,” Hayduk says. “A brush can also feather out the edges, giving you a seamless appearance.”
If you’re using concealer on the body - where heavier application might be necessary - look for water-resistant makeup or one that won’t stick to clothing and will last longer.
For color, Hayduk suggests trying to match the skin tone as closely as possible. Also buy products with a touch of yellow to help minimize redness.
7. Consider therapy.
After she was diagnosed, DeLorenzo became so depressed, she said, that she’d cry every day. She told no one about her psoriasis except her closest friends.
If anyone asked about her disease, she would dodge the question.
“At that point, I was so uncomfortable with it,” she says. “And maybe part of it was denial too. I didn’t want to accept that I had a lifelong sentence of psoriasis.”
Mild cases of depression and anxiety often can be managed with a balanced lifestyle. But if the blues don’t let up, see a mental health professional, who can provide proper treatment and counseling.
Or find a doctor who will help you not only with medical treatment, but also counsel you through the emotional havoc that psoriasis symptoms can cause, Weiss says.
The best way to find a good doctor and support groups? Check out the National Psoriasis Foundation website, Weiss advises.
For more expert advice and information, visit our Psoriasis Health Center.
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