Finding Happiness with Psoriasis


Published on LinkedIn July 31, 2018

I am not usually very open about this but I have had psoriasis for about 15 years. Initially it did not bother me as my skin problems were limited to insignificant small patches on my knees, but now, in my 30s, I’m quite vain about it. When it first came on, I was about 17 years old and lived in a southern state that is always ‘on my mind’, so sunlight was abundant and shorts were almost always in season. The sunlight provided effective suppression and where that failed some over the counter steroid creams really did the trick. I have been out of the south for 8 years now and my skin has gotten significantly worse. The over the counter steroid creams and hydrating lotions progressed to prescription strength steroid creams, then topical immune suppressors, and finally combination creams. When those were failing and becoming so cumbersome (who has time to apply all those creams twice a day?!), I started phototherapy. I thought this was going to be my saving grace. My skin looked flawless to me, though admittedly there was still some evidence, and I had the perfect year-round glowing tan! I got into a comfortable maintenance regimen until one particularly dry winter I finally sunburned during a session. We put phototherapy on hold and dialed back the intensity, yet the thought of UV therapy for the rest of my life implanted the fear of melanoma and I backed off for good. I made a few attempts at dietary modifications (vegan, meatless, diary-free, gluten-free, flavor-free) and saw no improvement.

I continued to use the prescription creams and over the counter remedies and suffered the gross side effects. The coal tar works really well but makes you smell like an ash tray. The steroid creams on my legs caused hair loss (temporary!) and discolored my skin. As I started getting more serious about dating, I grew concerned about… the other areas… that are affected by psoriasis. I felt gross, unworthy, and unattractive. I overcompensated by pushing myself at the gym for muscles and a waist line that would, at the very least, work synergistically with my charming personality in order to redeem myself when my awful skin was discovered or I had to turn down sexual advances.

I finally caved and decided the benefits of biologics (injectable immune modulating medications) would outweigh the miserable potential of life long singledom and revirgination. I saw a new dermatologist (shout out to Dr. Meera Sivendran at Mt. Sinai Dermatology) and we went through the years of medication trials and failures and the progressive scaly plaque spreading throughout my skin. Being someone who has seen the worst of medication side effects took a leap of faith and injected myself with the first dose. For the first 48 hours I had convinced myself that I was experiencing every kind of medication side effect from tuberculosis up to and including metastatic lymphoma. As I continued to wake up every morning not dead from the horrible effects, I realized I may have been overreacting and waited patiently for results. As the months passed and the subsequent doses arrived in the mail, my skin began to look healthier and healthier. Confidence reborn, I put myself back out there and landed an amazing and supportive guy. Occasionally some areas will flare up but they remain well suppressed with some basic steroid creams. My attitude has completely changed and psoriasis is no longer in control of me. I am in control if it! | @joethepanyc