Speak Clearly: Perspectives on psoriasis

I still remember being diagnosed with psoriasis at 21 years old. At the time, I did not know the true impact this disease would have, which I’ve learned over time and through talking with others living with chronic skin conditions. Although, at first, only a few parts of my body were affected by plaques, my first reaction was to hide my skin. In the following months, my psoriasis spread even more, which heightened my impulse to hide.

A few months later, just after my skin began to clear, my joints began to hurt. After discussing with my physician, it became apparent that I was not only affected by psoriasis, but also by psoriatic arthritis. It was a confusing time for me because I didn’t know anyone who had a similar experience and I had just wrapped my head around living with psoriasis. Even though I was now more knowledgeable about psoriasis in general, the diagnosis from the doctor still felt devastating.

Psoriatic arthritis is an inflammatory disease in which the body’s immune system mistakenly attacks healthy tissue in the joints and the skin.¹ About 30 percent of people with psoriasis also develop psoriatic arthritis, experiencing common signs and symptoms which include joint pain, fatigue, nail pitting, stiffness and swelling.^1,2,3,4 Inflammation associated with psoriatic arthritis can lead to permanent join and tissue damage if not controlled.⁴  A diagnosis of psoriatic arthritis can feel overwhelming, but there are people who can help. Psoriatic arthritis can be managed with guidance from both a dermatologist and a rheumatologist.⁵

Because it can cause irreversible damage, my doctor and I decided relatively quickly that I would have to find the right management plan, which we did. People with psoriasis do not always develop psoriatic arthritis, so it is important to talk to your doctor right away if you are experiencing joint pain or any other signs of psoriatic arthritis.

Life with Psoriasis

Even now that my skin has cleared, I will always remember how psoriasis held me back. As a passionate soccer player (unfortunately, I didn't quite make it to the pros), I was scared to use the shared showers in the locker room or get undressed in front of my team. And to make matters worse, the psoriasis had left my skin sensitive – I don't have to tell anyone what this means in soccer – a contact sport.

But the physical impacts were only part of my journey – psoriasis also affected me psychologically. I began to live in a constant state of worry: what should I wear, should I really go swimming today, what do others think about my skin? These were just a few of the questions I would ask myself every day. When you’re 21, you want to enjoy life, not worry constantly about your plaques.

Life in the Clear

After working closely with my doctor, we were able to come up with a management plan together that allowed me to take control of my disease. It took roughly 15 months, but in that time, I did my own research, had open communication with my doctor and connected with others living with psoriasis. When my symptoms finally started to fade, I felt liberated. Thankfully, I’ve been living symptom-free of psoriasis most of the time (with minor flare-ups). Now that I’ve had time to reflect on my journey, I realize how much I took being healthy for granted and how free and unencumbered life without psoriasis really was.

For me, being free from psoriasis means a relaxed attitude to life. I feel like I have more choices. I no longer dread getting dressed in the morning. I no longer must debate or worry when I have to take a shower. I am free from the fear of society judging how I look; even though that never actually happened, on bad days, it can feel like everyone is staring. I am free of the fear of constantly having to overcome my own anxieties, whether that’s wearing short-sleeved clothing or going swimming. Living life in the clear has truly freed me.

Plus, an unexpected bonus: as I've learned more over the years, my skin care routine now only takes a few minutes. More time for soccer!

Want to take the first step in feeling free but not sure how? Here are some resources to talk to your doctor or read advice from others living with psoriasis.

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References:

1. Diseases & Conditions: Psoriatic Arthritis. 2019. American College of Rheumatology. Available at: https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Psoriatic-Arthritis. Accessed on April 13, 2020.
2. Psoriatic Arthritis: Symptoms & Causes. 2019. Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/symptoms-causes/syc-20354076. Accessed on April 13, 2020.
3. Arthritis: Signs and Symptoms. American Academy of Dermatology. 2019. Available at: https://www.aad.org/public/diseases/painful-skin-joints/psoriatic-arthritis#symptoms. Accessed on April 13, 2020.
4. Eder, L., et al. The Development of Psoriatic Arthritis in Patients With Psoriasis Is Preceded by a Period of Nonspeci‑c Musculoskeletal Symptoms: A Prospective Cohort Study. Arthritis Rheumatol. 2017 Mar;69(3):622-629. doi: 10.1002/art.39973.
5. Boehncke, WH., et al. Association between clinical specialty setting and disease management in patients with psoriatic arthritis: results from LOOP, a cross-sectional, multi-country, observational study. J Eur Acad Dermatol Venereol. 2020 Jan 30. doi: 10.1111/jdv.16251.

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