Friendships, relationships and psoriasis
Some people were comfortable being open with friends and partners about their psoriasis, others preferred to keep it to themselves. Sometimes people said their friends, partners or housemates didn’t ask about psoriasis much and so they didn’t often talk about it. For those who wanted to tell others, they were often unsure about how to go about it. Damini thinks telling a partner is “a conversation that you don’t know how to bring up”. Adam says he doesn’t tend to tell people he has psoriasis “unless I really kind of trust someone or unless I know that someone has like similar kind of [body image] vulnerability”. The symptoms of psoriasis, especially on visible body parts, can make it difficult to keep private. One of Steven’s friends was the first to notice skin flaking from the scalp, which prompted him to see a doctor and get a diagnosis. Zara had to wear trainers in gymnastics at school to protect her feet, which made her stand out from everyone else as they were bare foot. Sometimes people didn’t want to tell others because they felt embarrassed and worried about what they would say. Other times, people didn’t mention their psoriasis because they didn’t see it as relevant. Russell says it wasn’t a big deal when he told his friends and thinks that now they’ve “probably forgotten because it’s not something that I view as particularly serious”.
Most people who told their friends and partners about their psoriasis said it was a relief that they knew. They often found it wasn’t as big an issue as they expected and they received more support. Lucy explained, “Once it’s out in the open, it’s easier”. Lisa has had psoriasis since she was little and says her friends “were pretty fine with it, cos they’d always known”. Zara has kept the same group of friends as she’s grown up. She says because of this “it wasn’t a big new thing to them and so we never had a deep conversation”. Some people lost friends and were bullied at school. Others had not experienced any bullying. Many felt that other people don’t tend to know much about the condition and they had dealt with questions like ‘is it contagious?’, teasing and being avoided. Some tried to educate others about psoriasis but found it difficult to get the information across. Meeting and spending time with other people
Having psoriasis can have physical and emotional impacts on spending time with others. Physical aspects include when activities with friends and partners might trigger a flare-up or be too uncomfortable because of symptoms. Some people had side effects from treatment that made socialising difficult, such as nausea when taking cyclosporine and methotrexate. Feeling self-conscious about psoriasis can be a huge barrier to socialising with friends and partners.
There were lots of activities with friends and partners mentioned as being affected by psoriasis. Staying over at other people’s houses was a concern for some because of skin flaking (see also about sleep).
Some people thought their experiences with psoriasis brought their friendships and relationships closer. Lola says her girlfriend is supportive, offers reassurance and is happy for her when the psoriasis improves. Lots of people felt ‘good’ friends and partners would accept the person, regardless of them having psoriasis. Louie says his friends were “really understanding”, “respected me for telling them” and have since “helped me through some of the tougher times”. Sometimes having psoriasis wasn’t seen as a ‘problem’ the person had, but as something that made them ‘unique’. Meeting new people can be especially nerve-wracking, including those they were romantically interested in. Louie says he used to be confident but became “drawn back” because of psoriasis. He says it’s becoming less of an issue now and thinks his peers will be less judgemental as they get older. Hannah and Jack were unsure if their psoriasis affected their romantic relationships but thought it may have played a part in pushing people away or avoiding commitment. Sofia found it hard to make new friends because her psoriasis affects her confidence and makes her anxious in social situations. Sex and intimacy were talked about by some people. Contraceptives should be used to avoid pregnancy whilst taking some psoriasis treatments, such as systemic non-biologicals. A few said their romantic relationships were affected by having psoriasis in visible or intimate body areas. This was often talked about for new relationships or casual sex and many said it became less of an issue in longer term relationships. Adam sometimes plans ahead with using his psoriasis treatments to try and get his skin in good condition for dates. Others were unfazed by this. Carys was glad she had been with her husband for several years when she was diagnosed with psoriasis because she felt it would have been hard to be dating. A few people talked about joking and humour related to their psoriasis. Sometimes people were okay with the jokes others made and found it funny too, but other times it was upsetting. Louis says he got ‘stick’ from friends who joked that his psoriasis was a sexually transmitted disease (STD). He says he “quickly got used to a bit of joking about it and I didn’t mind”. Lola talked to her friends who have made jokes to help them understand why it wasn’t appropriate. Louie says people sometimes “make a little dig or little joke by accident, not really knowing what it is”.
Some people had experience of living with housemates. Louis says his housemates got used to the things he did to help his skin, such as take long cold showers to soothe the psoriasis, and helped him with applying topical treatments. Damini says her housemate “understood what I was going through” so they could talk about psoriasis, “but still, you still hide away, naturally. It was just, you don’t want people to see it”. Lots of people said they disliked having their photograph taken and seeing them on social media (see also about on photographs in the section on socialising and hobbies). Sometimes they wanted to see the photo straight away and, if they didn’t like it, would ask for it to be deleted. Nobody mentioned their partners having psoriasis, but some had friends with it (see also section on support). This gave them opportunities to talk about the condition and treatments (like steroids creams and phototherapy, as well as alternative therapies) with others.