The impact of psoriasis on confidence and self-esteem

Psoriasis can make people feel self-conscious and negatively impact their confidence. Some thought psoriasis added more worries about body image and identity on top of other pressures faced by teenagers. Ella thinks this is especially difficult for young women. Some people who had psoriasis since childhood, like Damini (diagnosed age 4) and Megan (diagnosed age 7), said it didn’t really affect them psychologically until they were teenagers. Others, like Abbie and Sofia, were teased at an early age. Carys and Lucy thought the impact on self-esteem could also be hard on families, especially parents, of young people with psoriasis.
The effect of psoriasis on confidence can affect all aspects of young people’s lives, from: As Adam explained, “how my skin is just really kind of like impacts on everything that I do”. Jack described having psoriasis on his face as something he’s always conscious of “at the back of your mind”. Others felt that their confidence was not too badly affected or that they had found ways to manage many of their feelings about it.
Some remembered when other people had done or said things which made them self-conscious about their skin. Jack says this tends to be people “noticing and pointing it out to me”, but others had experienced bullying with nasty comments and physical injuries. Zara remembers when other children at primary school stamped on her feet, where she has psoriasis. Abbie moved schools because of bullying. Megan sometimes didn’t want to go to school because of name-calling and says she lost a lot of friends. She was clear that the problem wasn’t having psoriasis, it was other people’s responses and behaviour that upset her most. Sometimes the things others did or said weren’t meant to be hurtful, but often were out of ignorance. Ella and Lola don’t mind explaining about psoriasis but don’t like it when people are “rude”, “awkward” or “mean”.
Negative feelings about psoriasis can be ‘internalised’ (when the person thinks nasty things about themselves, even if nobody else believes or suggests these things). Adam overheard his colleagues making nasty comments about a customer with psoriasis once, unaware that he also had the condition.

People had different strategies for managing times when they felt less confident about psoriasis. Often this involved hiding psoriasis with clothing, make-up or hair styles, though this is difficult with skin flaking and for very visible parts such as the face and hands. Carys found make-up “took the redness” away, even though the dryness of the skin was still there. Louie found wearing long-sleeved tops sometimes drew more attention and questions about his skin. Some people cancelled plans when they felt bad about their psoriasis. Damini says she would “hide away” in her room at university, “make excuses” to avoid socialising and stopped posting on social media. Hannah found she was “pushing everyone away” at low points. Others, like Louis and Steven, said they refused to let feeling embarrassment about psoriasis stop them from doing things.
Growing in confidence

Some people said they had become more accepting and confident with time. Often they thought that getting a bit older helped. Simon feels he’s “accepted” psoriasis as only one “part of me” rather than something “to be defined by”.

Many felt strongly that psoriasis is not something to be embarrassed about. This can be difficult to put into practice though. Steven and Damini said it can be nerve-wracking going out in summer in shorts that showed their psoriasis or scarring. For some, feeling self-conscious about psoriasis was also linked to wider pressures on appearance and body image which they thought could make people feel bad about themselves.
A few people said there had been some good things from having psoriasis – such as becoming a kinder and more understanding person. Many wanted to help others going through the same experiences, such as by starting blogs. Megan is “passionate” in educating others about psoriasis, including her school teachers, and Lucy volunteers for a skin conditions charity. Talking to supportive others (including those who have psoriasis themselves as well as family, friends and partners), was usually seen as a good thing. Damini says she was “bottling” her feelings up for a long time but feels “a lot happier within myself” since she started talking more about her psoriasis.


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