living with adolescent psoriasis: 'don’t let it change' you
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jessica used to wear sweaters and pants all year round to cover her psoriasis out of fear how people would judge her.
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jessica mccormack doesn’t remember exactly when her psoriasis started because she was a young child. when she hit middle school, though, that’s when her memory began to put some pieces together of her experience with the inflammatory skin condition.
“i was most definitely insecure about it, but i don’t think many people knew what it was,” she said.
according to jessica, her ability to make friends and hang out with people in those formative years, where more significant friendships are made, was negatively impacted by living with psoriasis because she was “scared they would say something or even point it out, even the slightest.”
jessica isn’t alone. children, especially adolescents and teens, are significantly affected by living with psoriasis in often irreparable ways.
dr. sam hanna, medical director of dermatology on bloor in toronto, ontario, sees young people living with psoriasis all the time, so he knows firsthand how difficult it can be.
“there’s this sort of sense of being viewed by the world, being looked at by the world, not in a way that you’re inviting, in a way that you can’t help,” he said. “and we hear stories all the time, if you’re working in retail and you give somebody their change with psoriasis on your hands, this sort of withdrawal piece. you feel eyes on you.”
hiding away because of psoriasis
jessica, who has always loved being outside, spent much of her time hiding her skin when she was younger. winter became her favourite season because it was the only one in which she could wear baggy sweaters without being questioned about it, a practice she adopted to hide her skin lesions from her peers.
“i could wear the sweaters and long sleeves and pants, and then come summer, i would be also wearing sweaters and pants because i didn’t want to show them,” she said. “i would rather take being hot than showing my psoriasis.”
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she notes that school made her experience that much harder because she “could tell that it was just full of judgmental kids,” and being aware of that fact amplified her insecurity about her skin lesions to the point where she would walk down the hallway feeling as though every person was looking at her. it made her feel incredibly isolated as well.
“it definitely did have a huge effect in high school, more than anything,” she said.
high school is an amazing experience for some, and for others, not so much. but when dealing with psoriasis, even the good opportunities with friends become something that requires more thought, more self-consciousness and more explanations.
“i almost did not go to prom because i had a spaghetti strap dress and i didn’t want it to ruin my pictures, be in other people’s pictures. i didn’t want it posted anywhere, so i didn’t want to go to prom,” she said.
she did end up going to prom, but she spent most of her time hiding her skin lesions by resting her hands on her elbows. she also chose to attend her graduation beach party in wasaga beach at the end of her high school career. again, though, she felt she had to hide away.
“i was the only crazy person standing there in a wool sweater at the beach because of my psoriasis,” she said.
to deal with the questions, jessica brushed people off, told them she wasn’t hot, and cut conversations short so she didn’t have to field all the questions.
psoriasis in youth affects entire life trajectories
for adolescents living with psoriasis, hiding away is just one part of the puzzle they have to deal with. the condition itself can change the entire trajectory of their lives it affecting self-esteem, confidence, and their willingness to pursue things they truly want to do that would be great for their future.
according to dr. hanna, psoriasis creates “spirals” that affect their future career, relationships and self-image. because these pivotal years build people up for their potential, and when they’re grappling with what psoriasis brings, it can be difficult to really go for gold.
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kids may stay away from certain activities or may not be able to participate in them as they’d like, such as avoiding trying out for sports teams because they don’t want to be seen in the locker room, or feeling uncomfortable with themselves from a young age.
“all of these things … how i learned to socialize, who i see myself as in the eyes of the world, what i’m willing, comfortable doing, and the risks i’m willing to take, and the activity, all of those things can be altered by that,” said dr. hanna.
he notes that cumulative life course impairment, a concept he says was stolen from a cardiologist, finds that any disease that starts early in life and is left untreated can alter that life irrevocably.
“there’s a number of places that kind of add up where maybe you’re not as capable in romantic relationships. maybe you acquire maladaptive behaviours, like relying on alcohol, or focusing on anxiety … or even spiralling anxiety and depression,” he said. “so, educational goals are harder to meet, you don’t get the job that you would have liked, and it’s cumulative. where would you have been had it not been there?
he notes that children and adolescents are “all potential,” and when those cumulative effects of living with psoriasis add up, that potential can be severely hindered.
because psoriasis is an inflammatory disease, it can also affect adolescents’ physical health in the long-term.
“inflammation is bad for you,” said dr. hanna. “having that disease contributes to worse cardiac health, to metabolic dysfunction, obesity, alcoholism. and i don’t mean like, ‘i’m sad about my psoriasis, so i drink more.’ whatever the biological drivers for those things is there.”
he continues, “we can start to see self-injurious behaviour, bad coping mechanisms, using substances … we see greater discomfort.”
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with these connections to both physical disease and the mental health effects of psoriasis, treatment as early as possible is vital to ensure that life trajectories are protected as much as possible.
“where we are with psoriasis in general is worlds different from what we were 20 to 25 years ago,” said dr. hanna. “so, it’s really nice to have these effective things that aren’t steroids that are helpful in that population.”
today, jessica has treatments available, but when she was a kid, she “wasn’t really too keen on getting it looked at” because doctors and medical researchers weren’t looking into psoriasis as much, so her options were limited.
finding the right circle and treatment to be okay with your condition
for jessica, who still enjoys being outside and aspires to become a flight attendant so she can see the world, she has learned that being around the right people is a great help in making her feel comfortable in her own skin, whether she’s dealing with outbreaks or her treatment is keeping things under control.
she recalls having a “crazy breakout” just after high school, where it went everywhere, but the way she felt it was starkly different than when she was at school. she worked a job, and every person there became a friend to her.
“they would tell me, ‘it’s okay. you don’t have to feel this way about them. it doesn’t change how i’m looking at you as a person,’” she said. “it made me open my eyes to think like, i’m a lot stronger than i think, and there’s a lot more things that i can handle than what i’m putting myself through, and i feel like i learned to not think that people are going to judge me so quickly off of just something on the outside of me.”
today, jessica can happily say that she’s “really comfortable” with her psoriasis because the people around her have helped her get to that point. she even notes that one of her friends has turned to humour to help things feel normal and light.
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“as crazy as it sounds, there’s literally a person who makes jokes, but he doesn’t make them in a respectful way. he’ll make funny jokes about them,” she said.
as for jessica, she wants others to know that psoriasis, though it’s challenging, doesn’t have to have as much impact as it seems. she knows from personal experience.
“the main thing is, don’t let it bring you down. don’t let it change how you act, how you think, how you dress, how you look. don’t let it affect you in any type of way because i feel like an insecurity can definitely mess with your mental health a lot,” she said. “eventually, it’s going to get better, and it’s really not the end of the world as much as it feels like it might be.”
for kids who are diagnosed with psoriasis today, medications that continue to pop up are there to help them deal with the symptoms better than ever before. that, combined with jessica’s positive advice, can make living with psoriasis that much easier.
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