Having Psoriasis

“What is that?”
I casually unrolled my sleeves, smoothing over the wrinkles. “What is what?” I asked, feigning oblivion.
“Those things on your arm.” He was staring now, as if he could see through the white fabric to the pink dots scattered on my forearm.
I didn’t know what to say; the buzz of conversation in the classroom dimmed in my ears, as if someone had turned down a radio. I felt the color rush into my cheeks, partly from embarrassment, partly from anger – he didn’t even know me, so who was he to ask? “It’s none of your business,” I managed.
He stared a little longer, and then shrugged. “Whatever.”
I turned to face the front of the room again, my other hand protectively clenched over my sleeve, as if somebody might tear it off. This moment is one of many of the strongest memories I’ll have from high school. The dots were the symptoms of an autoimmune disease called psoriasis, which I had likely inherited from my mother. They first appeared in May 2018, just before my freshman year. My pediatrician had misdiagnosed them as a yeast infection, but the condition worsened over the course of a three-week trip out of town that summer despite applying what I thought was the right treatment. Eventually, nearly my entire body was covered with angry red spots of varying size. Finally, in July, my mother brought me to her dermatologist, who prescribed me with fluocinonide (a medication for psoriasis), to be applied daily to affected areas.
A quick breakdown of the condition: psoriasis is a common condition – 2-3% of the global population has it – though it is slightly more prevalent among women. It is a chronic autoimmune condition where the immune system mistakenly attacks healthy skin cells, causing it to go into overdrive to fight the “infection.” Mine, like most others, tends to go through cycles of flaring and remission. It is not contagious; however, there is no cure. My mother, my aunt, and my grandmother all had the condition at some stage in their lives (though it first appeared anywhere from childhood to after giving birth). We all have the most common type of psoriasis, which is plaque psoriasis; symptoms are dry, raised, red, itchy skin patches covered with dead skin. This is generally the most bearable version of the condition in terms of appearance and discomfort. Factors that cause the disease to flare are different for everyone, but for my mother and I and others, the number one thing that precedes a flare seems to be high stress levels and sleep deprivation.
As a freshman, I did not deal with psoriasis very well. Even in eighty degree weather, I started to wear long pants and sweatshirts, constantly aware of where every lesion on my skin was and whether it was at risk of slipping out into the open. The psoriasis spread to my scalp not long after, and I would sit still, my scalp burning, resisting the urge to scratch, hoping that no one would think that I had dandruff or lice.
Each night, I spent an hour rubbing coconut oil into my scalp, carefully massaging off the dead skin so I could soften the hard shell. I’d wake up early to wash the oil out, but still it clung to my hair, making my hair look oily and unhygienic; I worried endlessly that other people would notice. Eventually, I would cut off my long hair to my ears to make the process less painful, and I couldn’t help thinking thoughts that I know to be ridiculous now, such as: no one likes girls with short hair.
One day, I was talking to my friend from out-of-state when she mentioned off-handedly that she had psoriasis. I was sure I hadn’t heard correctly, and she repeated herself. I suddenly realized that I could see signs of her condition on her forearms, the same red splotches that I took so much time to cover up. At the same time, I realized that I had always seen them, but in years being her friend, I had never given them a second thought, because they had never registered as remotely important.
As we kept talking, she shared her story – diagnosed as a child, also got it from her mother, flared every 2-3 years. She showed me tips for treating it: don’t leave the coconut oil in overnight, it might irritate the skin; you also don’t have to do it every day; try spreading it on the rest of your body and combining it with other prescription treatments. But she also gave me mental tips; “It’s clinically linked to depression,” she said, “so I struggled a bit with that. But in the end, I think it’s a question of self-worth. You are more than your condition.”
I began to follow her advice, particularly those last words: “You are more than your condition.” While I combined coconut oil with prescription medicine, I started to wear shorts outside, the splotches on my skin absorbing the sunlight like my doctor had advised long ago. You are more than your condition. I explained to anyone who asked that I had an autoimmune disease, and that it was not contagious, and politely moved on with the conversation. You are more than your condition. I read empowering stories of people who had psoriasis, realizing that I was part of a much larger community of people, bonded by a shared experience. You are more than your condition.
My psoriasis didn’t significantly improve until the lockdown in March 2020. I started getting nine hours of sleep each night, my stress levels went down, and my psoriasis entered a recession that no medication or coconut oil had ever been able to induce before. In a way, the condition has forced me to manage my time better; I started college applications in July, not out of an abundance of enthusiasm for the process or out of diligence, but out of fear that a particularly stressful senior year would cause the condition to flare again. It seems to have worked; today, my psoriasis seems to have gone into near-total remission, with only light, non-textured patches on my kneecaps and elbows. The psoriasis on my scalp has disappeared. The condition has also brought me closer to my mom; through sharing our experiences and preferred methods of treating it, we get to spend time together over something we have in common.
At the end of the day, I think psoriasis has made me more grateful for what I have. For me, the true emotional burden of the condition lay in how it altered my physical appearance, but there are a world of conditions with much more difficult, long-lasting effects. It is hard to measure people’s pain, but on the critical metric of how much physical pain and discomfort diseases can cause people, plaque psoriasis is on the low end of the list. However, mental health is too often hidden and stigmatized, despite being essential to happiness and life satisfaction. Thus, here is a list of organizations and support groups for psoriasis; my personal favorite is Kopa. It has informational articles about psoriasis, posts from other people with psoriasis about their appointments, experiences, and questions, advice for doing daily activities with psoriasis, and a daily stress tracker to keep track of your mental health.
It’s important to know that you’re not alone, and that’s what my friend did for me; her frankness, her confidence, and her conviction that I should have that same confidence, helped me understand that we cannot possibly be defined by one aspect of our person, especially one that is out of our control. I began to see psoriasis as something unique, something that I had the opportunity to treat and experience; a part of me, yes; but I decided to what extent. I am more than my condition, and people are more than their struggles, their failures, and their flaws.

