A Prisoner of Your Own Skin

Story by Talithia Taitano // Photos by Jon Bergman

Out of desperation, Dhillon gets her roommate's attention. Her roommate is shocked and frantic as she scrambles to search the Internet for ways to stop Dhillon's bleeding. Her pajama pants and towel now lay blood-soaked on the floor.

Dillon explains that she accidentally shaved off a patch of dry skin when she was shaving. Thinking her psoriasis was controlled enough to run a razor across her legs, she carved off an area of her skin affected by the condition.

Finally, after 15, frightening minutes, the bleeding stops on its own.

According to the National Institute of Health, as many as 7.5 million Americans have psoriasis. Dermatologist Dr. Bruce Bowden says it is a chronic, genetic, autoimmune disease that appears on various parts of the body. When a person has psoriasis, the immune system sends out faulty signals to the skin causing it to overreact to injury. When someone with psoriasis is injured and their skin excretes substances normally, their immune system attacks the area, which causes the growth cycle of their skin cells to speed up. As a result, red patches covered with a silvery, white buildup of dead skin cells form on the skin.

Bowden says the condition is generally worse on the knees, scalp and elbows since those parts of the body are especially prone to injury. He says most people with psoriasis do not know they have a genetic vulnerability to the condition and are astonished when patches of dry skin appear. However, two-thirds of people with psoriasis have a family history of the disease, he says.

Western senior Colby Mayberry says he first noticed the condition as a child. When he was 10 years old, his initial noticeable symptom was a red, flaky patch of skin the size of a CD on his leg. But as he got older, the psoriasis patches became smaller and spread all over his body, he says.

Although Mayberry says his peers never commented on his psoriasis, he felt singled out because he looked different. Eventually, he became more insecure about his condition and found it harder to change after swim class, even in the dimly lit locker room, he says.

"I became more and more self-conscious of [my psoriasis] probably around freshman year because you're starting to interact with the opposite sex," Mayberry says. "It didn't really bug me, but I always wondered if I was dating someone, what they would think about it."

Mayberry says the severity of his psoriasis changes throughout the year. His breakouts are worst between December and January when the weather is cold and dry in Washington, he says. If he does not keep his psoriasis under control during the winter, his skin will crack and appear blister-like.

Conversely, he says his dry skin patches usually disappear altogether during the summer. Still, he says he cannot get too much sunlight or the condition worsens. The right amount of sunlight can reduce the appearance of psoriasis by penetrating the skin and causing the immune system to calm down, Dr. Bowden says.

Mayberry says school related stress also plays a huge part in making his condition worse. On the other hand, eating healthy and exercising at least two to three hours a day help make his condition less noticeable.

Dr. Bowden says exercise does not directly affect psoriasis but helps people with their self-image. Being active and fit can decrease stress and depression for those with psoriasis. However, since stress can affect the immune system, if the body is under a lot of stress, it may assign stress to other organs, he says. As a result, stress can cause headaches, stomachaches or can even indirectly make a condition such as psoriasis worse.

No matter what state his condition is in, Mayberry gets frustrated with his psoriasis and resents the time his skin takes to treat. Just getting ready for school can be a time-consuming process for Mayberry. He has to set aside at least 10 minutes to apply his psoriasis medication cream, he says.

"At least for me, it adds more things to do when you wake up and don't want to get out of bed," Mayberry says. "I put my contacts on, brush my teeth and usually focus on one spot at a time."

Psoriasis victims often deal with insurance roadblocks because most insurance companies do not fully cover medication costs. Mayberry's health insurance only gives him $5 toward the $30 psoriasis creams he has to buy every four to five months.

Dr. Bowden says chronic diseases such as psoriasis cost a lot of money not only for individuals, but also for insurance companies. People with chronic diseases can bankrupt insurances companies, which often look for ways to cut costs.

"[Insurance companies] look at it from a cost containment issue," Dr. Bowden says. "They look for artificial rules to control how much they are going to pay. Insurance payment schemes are totally baffling."

For psoriasis victims without insurance, medication can be especially expensive. Raegan Price, a 22-year-old Moses Lake resident, says she spends $400 for a tube of cream that lasts about two months. If she had the money, she would get two doses of Humira shots for $1,600 a month. The shots work best at clearing up her skin, she says.

The Humira shots block pathways in the main immune system linked to psoriasis, Dr. Bowden says. As a result, the shot relaxes the immune system and controls the psoriasis. Unfortunately, because the Humira shots shut down parts of the immune system, it often makes those who use it, such as Price, sick.

Price says because she cannot always afford the shots, she often gets depressed when her psoriasis goes from being clear to covering her entire body.

As an alternative solution to the shots, people with psoriasis can purchase a foam called Olox, which costs $200 for 100 grams. Mayberry says the foam has the same level of concentration as the generic cream, but lasts longer. However, on a college student's budget, a $200 foam treatment is an unrealistic option, he says.

Dr. Emily Gibson, director of Western's Student Health Center, says she typically prescribes steroid creams for students with psoriasis. Dr. Bowden says steroids work by slowing down the immune system.

"I have to suck it up and do it [buy and apply the medication everyday]," Mayberry says. "At first, you kind of feel sorry for yourself, but it could be a lot worse."

Dr. Bowden says 10 percent of people with psoriasis contemplate suicide at one point in their lives. He says psoriasis victims often face discrimination because many people have the misconception that the condition is contagious.

Price has first-hand experience with psoriasis discrimination. Although she enjoys going to the beach or lake during the summer, she says she feels embarrassed and uncomfortable when people ask about her condition. Walking from one side of the beach to the other, she often catches others giving her odd looks.

While stretched out on a towel like any other person at the beach, children occasionally walk up and ask her what she has on her skin. Price says psoriasis is a difficult condition to explain to people, especially children, who sometimes mistake it for chicken pox. She is usually left at a loss for words.

"It's uncomfortable when people ask about it all the time," Price says. "People give weird looks and think it's contagious."

Although psoriasis is a life-long, incurable condition, the symptoms can be treated and maintained with regular treatments and medication. Psoriasis is still a mysterious condition to doctors and until a cure is found, people living with psoriasis must face their condition one spot at a time.