By Amber McKnight, told to Shishira Sreenivas
The first time I started noticing white scaly patches it almost burned a little on the back of my ear. It was March 2019 and I was 24 at the time. I worked at Disney World and had to wear a hairnet and a fun hat. I figured it must have been the sweat and chafing of wearing them because the hat and the netting were sitting there. I just thought they were rubbing me the wrong way.
I went to the ER and showed them. I was hoping for a cream or ointment to put on it. They gave me topical steroids and told me it should go away in a while. I thought, “great!” I had eczema for a while so thought it might be a flare up. But I decided to keep an eye on it.
The steroid cream helped. The patches are gone.
In 2020 I started physical therapy school in Atlanta, GA. By the end of the year, eczema-like patches started appearing all over my body: stomach, back, breasts, arms and legs, especially in the crook of my elbows and on the back of my knees. However, the patches on my neck were the most severe – the crown of my head, behind my ears and the back of my neck.
But every time I showed it to a doctor, they kept ruling it out. They said, “oh it’s just eczema.”
Psoriasis can affect your quality of life
I looked like a scaly lizard. And I was both embarrassed and frustrated. Basically, you could see everything, so I had to cover everything. The summer heat in Atlanta didn’t help the situation either.
For school, especially during physical therapy labs, I had to do my hair and wear a mask. This meant that everyone could see my flaking and tormented skin. They could see huge chunks of white stuff falling off my skin. In fact, some people came to tell me that I had rice in my hair.
The PT school required a lot of touch and therapy. For the lab, you would have to undress. I just couldn’t. It was so uncomfortable for me. So I wore long leggings and a sweatshirt in the middle of summer. Additionally, the patches were flaking, itchy, or painful. I started skipping some of my labs.
I’ve had a ton of skin issues in the past, but these patches felt different and new to me. It looked like the patches I had in 2019. It just couldn’t be eczema. These patches had a different texture, widely connected, were very flaky and peeled a lot. It was horrible.
At this point, I decided to see a dermatologist.
Getting a psoriasis diagnosis can be tricky
I went to see a number of doctors – GPs and dermatologists. They all said it didn’t look good or it was just eczema. One even sent me to a wound care specialist. And they said they couldn’t fix it. Some of the spots were starting to get infected with staph infections.
At this point, I was going on two dates a week for a month. I tried a few medications, but nothing helped.
A dermatologist decided to do an allergy test to see if I was reacting to anything. When I returned to have my results read, it was a different dermatologist than I usually see. It turns out that she was replacing the other doctor.
She took a look at my scalp and said, “It’s 100% psoriasis. I don’t know why nobody told you that.
They biopsied a few different places. Some were eczema, but others, it turns out, were psoriasis. The type I had was called guttate psoriasis.
It can happen after strep throat. And I often have strep throat and staph infections. This is what has apparently caused the confusion about differentiating eczema from true psoriasis. The spots on my scalp, however, were plaque psoriasis.
I finally got a diagnosis in January 2022.
Finding Ways to Control Stress and Manage Psoriasis
After I was diagnosed with Psoriasis, they put me on injections of medication, which helped me a lot. All the doctors said it was important to manage stress.
I didn’t realize I was stressed. I mean, I was working at Disney World when it all started. I thought it was the happiest place on Earth. But I took some steps to change some things in my lifestyle.
The big thing I did that helped was I stopped using any lotion or cream that had petroleum jelly in it. I believe that caused some of the irritation. I switched to cleaner products and that made all the difference.
I regularly palpate my scalp or elbows for psoriatic patches. If I feel plaques starting to form, I immediately increase my sleep, drink more water, and figure out what might be stressing me out. I basically stopped being constantly on the go. Now I like to take long walks in nature. It helps me stay calm.
I also think I tend to scratch my arms more when I’m stressed. I think it’s my body’s subconscious reaction to distract me from whatever is stressing me out. But scratching makes psoriasis worse. So, I do whatever it takes to stop myself from scratching. I wear long sleeves or a jacket. Sometimes I’ll just sit on my hands and remind myself to stop.
But overall, once I started treatment and changed my lifestyle, my skin remained relatively calm. If I notice the plaques getting worse, I will see a doctor.
Find a good support system
Dealing with an autoimmune disease like psoriasis in your twenties can be difficult. If I could talk to my younger self, I’d say, “It’s okay. It will be fine. Stop scratching, stop staring, and stop obsessing.
Obviously, this is difficult to manage, but it is important to stay calm, take a step back and reassess the situation.
It is important to find a good person or a good support system. I was lucky to have a very good friend with me in Atlanta when all of this happened. She always let me vent.
It helps to have someone to go to the doctor with you, as it can be intimidating. I had times when I lost hope. It’s always good to have someone who knows what’s going on or who can just be there for you if you start to shut down or go in circles.
And keep defending yourself. Ultimately, you know your body better than anyone.