Psoriasis

Psoriasis and different areas of skin: where on the body?

Psoriasis can affect skin anywhere on the body. Some people we talked to had psoriasis only in one area, such as the feet for Zara. Others had psoriasis on lots of different parts of their body at various times. This includes the subtypes of nail psoriasis and scalp psoriasis.
People often had particular concerns based on where their psoriasis was located. Concerns about the practical difficulties of managing their psoriasis, like applying topical steroids to the back or scalp, were common. There are also emotional aspects and having psoriasis on visible parts of the body made some people self-conscious. Jack says the psoriasis on his face is his main concern and other body parts affected are “secondary”. 

Psoriasis on the scalp 

Many people we talked to had first developed a patch of psoriasis on their scalp (see also about psoriasis types). Skin flaking meant that they often thought it was dandruff to begin with. Louie found it annoying when people assumed he had dandruff, Abbie remembers being teased at school about this and Sofia’s peers also thought she had head lice (“nits”).
Having psoriasis on the scalp can have an effect on hair-care, cuts, styling and dyeing. Lucy’s scalp gets itchy if she doesn’t wash it every day but says it’s a “faff” with long hair. Steven gels his hair up to reduce skin flakes dropping from his scalp. Jack finds getting his hair cut “awkward” and Lola’s mum cuts her hair as she’s too embarrassed to go to a hairdresser. Simon thought he shouldn’t ever dye his hair again, even if the psoriasis on his scalp cleared up. Others continued to dye their hair – Abbie found it stings her skin though and Megan buys special hair dyeing products which contain fewer chemicals. 

Psoriasis on the face/neck

Psoriasis on the face and neck can be difficult because it’s so visible. Lola said having patches on her face was the first time she realised how big an impact psoriasis can have emotionally. Adam remembers being “mortified” at school when a teacher made a comment about him having something on his face without realising it was psoriasis. Damini found it uncomfortable socialising and making eye contact with others when she had psoriasis around her eyebrows. Jack said it was tough having psoriasis on his face whilst at university because he was constantly meeting new people.

Some people used make-up and hair styling to cover psoriasis on their faces and necks. Adam sometimes used concealer for nights out. Ella said skin flaking makes psoriasis difficult to cover and make-up can make it “more obvious”. Damini used to wear her hair down a lot to cover up the psoriasis on the back of her ears. She also wore glasses and a scarf because she “felt better the more covered up I was”. Lucy, Damini and Ella said having a fringe can help cover psoriasis on the face. 

For those who shaved their faces, having psoriasis could make this more difficult. However, Simon found his psoriasis skin was less prone to bleeding.
Psoriasis on the ‘trunk’ (e.g. torso, shoulders, chest, back), arms and legs

Although easier for most people to cover on a daily basis, psoriasis on the ‘trunk’, arms and legs can be tricky. It can restrict movement and flexibility, as it did for Carys who had plaques on her stomach which cracked when she moved at work. Megan’s psoriasis on her arms and knees sometimes made it painful to bend and walk. Some clothing and fabric could irritate the skin and make it itchier. Megan and Lucy found wearing tights a problem. Lola struggled to stop herself picking at her psoriasis when she could see it on her arms. A few people had psoriasis on their armpits, which deodorant sometimes irritated.
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Psoriasis on the trunk, arms and legs made some people feel self-conscious. Hannah sometimes used make-up to disguise patches on her arms and legs. Both men and women talked about having restricted clothing choices because they didn’t want others to see their psoriasis. This was especially a concern during the summer, swimming and dressing up for nights out or special occasions.
Some people felt strongly that they shouldn’t have to cover up their psoriasis (and that fresh air/sun might help), but also they didn’t want others to make comments or ask questions. Steven described this as “a balancing act”. It could be nerve-wracking wearing clothes which showed psoriasis. Lucy remembers being asked about her skin by a stranger on a bus when she was wearing a halter neck top. Simon used to wear a jacket all the time, including in hot weather. Abbie was “fed up” with wearing trousers and tights to cover the psoriasis up on her legs but didn’t feel she had other options. A few people thought their clothing choices made them ‘stand out’ more. Carys remembers an outfit for a party which she liked but thinks “it was obvious that there was something that I was hiding”.
Body hair removal was talked about by some of the young women. Some said there were times when they didn’t shave because it was too uncomfortable. Abbie found cuts from shaving on her legs would scab and become new patches of psoriasis. Damini prefers waxing.
Psoriasis on the hands and feet

The hands and feet are often visible and in constant use. Hannah and Simon also had nail psoriasis and Zara’s toe nails fell off when she was little.

For some with psoriasis on their feet, finding comfortable shoes can be difficult. Russell said he had to a buy “an emergency pair of flip flops” when he had a big flare-up. Zara sometimes feels self-conscious taking her shoes off because they’re prone to infections which make them weep and smell. It’s painful for Zara when doctors spread her toes apart to examine the psoriasis.

Applying treatments like steroid cream to the hands and feet can be impractical. Russell finds it time-consuming having to wait for the creams to absorb. Some people found wearing socks helped topical treatments stay on their feet and Zara had some silk ones which helped reduce the friction on her skin.
Psoriasis in ‘intimate areas’

A few people talked about psoriasis in ‘intimate’ body parts, including those affected by genital psoriasis on the vulva, penis or bottom. Lucy was nervous talking to a doctor about developing psoriasis on her breasts. Abbie had some psoriasis on her bottom, which she said “obviously that wasn’t the nicest”. Some stressed it’s important to tell your doctor if you do develop it and take care with using treatments (e.g. steroids) on sensitive parts.

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