Well I’ve been told by my dermatologist to not use soap like that make bubbles on my body cos like I think that can aggravate it and make it worse. So I use non-soap based products when I wash my body and wash my face and stuff. Hm I think concealer and foundation is fine as long as I don’t put loads on. I’m trying to think triggers. Well, it’s been said that like sunlight helps psoriasis quite a lot, but for me I always say my psoriasis is worse during the summer, so I don’t know whether that’s just me, but usually-. And when I’m ill or-, yeah, when I’m ill as well that can sometimes cos obviously like with my immune system working as well, if I’m ill then that can trigger it as well because it’s working and I don’t know how much of a correlation that has, but often when I’m ill my psoriasis is quite bad as well.

It’s difficult to know what triggers it. I know sometimes people say diet and things can trigger it. I’ve occasionally tried like over the years tried different ways to kind of like suppress it, so I’ve tried sort of a gluten-free approach and diary-free and those kind of things and thought that maybe that would help. Didn’t really make a difference. For me, the only thing that helps is medication, but it’s hard to know what the trigger is. It’s like a vicious cycle, when it’s bad you’re more stressed and it just continues to be bad. When medication makes it better I feel less stressed, so I feel like my stress and any kind of depression I’ve had because of my skin has been completely linked to the skin all the time, so whenever the skin’s better, I feel better, and whenever the skin’s bad, I feel bad. So it’s really hard to determine what’s a trigger, or what’s you know like a, like a factor or what’s a result of the skin, I just, it’s hard to know.

So triggers that we know can either cause a flare of psoriasis or initiate psoriasis. Particular types of infections. So in children and young adults, often streptococcal. So that can cause throat infections, it can also cause skin infections. So sometimes I do see children who have [throat cleared] a streptococcal infection in the genital area, or around the bottom, and that can also sort of trigger off psoriasis more generally. We know that also stressful events and stress can definitely exacerbate and trigger psoriasis. And we’re now kind of starting to understand a little bit more about the whole inflammatory pathways that stress causes. And, you know, clearly having psoriasis also makes you feel stressed, so it can be quite a difficult process to sort of work out what best to do about it. Which is why, you know, psychological support is so vital for people, particularly with psoriasis, and that, you know, coping mechanisms are also really important.

Really, funnily, in the leaflet that came with this cream that I’ve got now, which I’ve got somewhere if you want to see it. I don’t know where it is, I think it’s in here [looking in bag]. They gave me a little leaflet. I think I brought it with me, yeah. They gave me a little leaflet and in it, it says, if I can find ah, it’s talking about triggers and it says, Even though the exact cause is unknown, it appears that some people are more inclined to develop it than others. Many patients are able to think of someone else in the family who has psoriasis. So that was like my dad and I’m reading this and I’m like, check’ [gestures ticking]. But it’s thought that people with a family history of the disorder only get it themselves if another factor starts it off. So I was like, hm okay. And then I’m sat at the hospital like last week thinking back to it and then the next paragraph is, One of these factors could be a throat infection. And the time that I started with psoriasis, I was also a little bit unwell I had pericarditis, they think, and a possible throat infection. And so having read that, and I’d never really linked the two together, I thought they were kind of just happened at the same time and like, I don’t really know if they were linked together. I think that could have been the trigger. But then I’ve never really noticed anything, stress doesn’t tend to make it worse, like during my exams it was constant. In fact it got better at one point during exam time. Being overtired doesn’t really change it. I can’t really find something to, people are like, Oh, what you eat, da, da, da [shakes head] Nothing. I think for me it’s just the fact that I’ve got it and that it comes and goes. I don’t really know one thing that does set me off.

But the problem with me is that most of the time it’s not necessarily stress that makes my psoriasis worse but if it’s like when it the one time it basically went and then sort of it came back with, with a vengeance was, was sort of a two-week period when I was really-, well I was really stressed. But then once it’s sort of come back to a certain level, I found there’s not really much that causes it to-, especially the last six months when it’s sort of been spreading enough, I’ve been fine, it’s been difficult to pinpoint, pinpoint anything really that’s sort of caused it to do that.

So stress is a definite trigger for your psoriasis?

Yeah. Yeah, definitely. I mean, last year when I was working as a teacher, it was my training and it was my NQT year, it’s called. And I found that very stressful, because there was a lot of planning, a lot of marking and then the actual teaching as well. It was very very full on. And so, my skin got worse during that. And a few years ago, my mam, my mam had meningitis and she was taken in suddenly. And, within days, like my skin got a lot worse. So I think stress massively, massively plays a part. But, it’s y’know it’s finding ways to deal with that stress. So I exercise regularly, which really helps my stress. Cos, I mean, at school I was awful at PE [laughs] I hated PE. But now I really do appreciate how important exercise is. And I’m not one of those people whose really interested in having a flat stomach or, you know, perfect beach body. But I do it for, for my mental health really, for, to stay calm and to deal with my stress, cos I find that cycling or running or any type of exercise really. Going to an aerobics class is really good. And just getting out the stress and calming yourself down. And then again, my boyfriend and my mam and dad are really good at just talking things through. And if I’m ever, I’m very lucky to have those really supportive relationships. And my brother and sister as well. Because if I am worried or stressed about anything, I can just talk to them about it and I know that they’ll be really nice and supportive. So that’s really good to have that.

I had my ears pierced, but because of my psoriasis I had to take them out cos my psoriasis would grow in them and then like go round the actual wiry bit, and then it would be like stuck, so I took them out. And like the holes are still there, but because there’s psoriasis in them, I can’t re-pierce them.

So, does that also affect like other things; like if you were planning on getting other parts pierced, or like tattoos and things in the future?

I can’t have tattoos because of the like ink bit. I’ve already been told that. Like I could if my psoriasis had completely gone; and I want to get my belly button pierced, but, and I asked the doctor, and the doctor said it was probably OK to do it, because I don’t have psoriasis round that area.

Mm mm and had you had psoriasis like on your ears before you got them pierced, or was that?

No, and then after I got them pierced it kind of just started.

So, do you think you will get your belly button pierced?

I don’t know. I keep like thinking about it, but I don’t wanna do it and then my psoriasis goes near it and then obviously I can’t have that anymore. So, I think I might just wait for a bit, and wait till I know where my psoriasis is under control even more.

There’s a good chance that because psoriasis can impact like really damaged skin, skin, so, is it Koebner phenomenon, Koebner? Something like that. So where you get like-, I’ve even got bits there, so sometimes when you get like a cut or whatever and that’s the same as like getting psoriasis on a tattoo so because of your damaged skin impacts like skin cycles and stuff. So that was sort of my original thought was that my cheeks obviously, a fair bit of my face obviously when I had acne as a teenager, obviously your skin takes quite a lot of just general wear and tear from that. And I think that could definitely be linked to then getting psoriasis in the same areas.

Were there any sort of other factors that you had to avoid to sort of minimise aggravating the skin at all?

Try-, sounds quite weird [laughs], try to touch things as little as possible. So I wouldn’t be able to sit like this [leaning back], I’d have to sit forward [demonstrates]. I’d wear really loose, loose clothing, to try and avoid touching things. I’d make sure that when I was working I wouldn’t sort of-, my elbows couldn’t touch the desk, and stuff like that, because that would aggravate it, effectively just touching anything or like rubbing against like a chair arm and things like that, that would be really sore. So I’d try and minimise that. So I would sort of put myself in like a sort of isolation bubble, where I’d try and-, I’d try and touch as little as possible to try and make sure that that didn’t happen. But obviously that’s not that easy, sort of day to day life, so you sort of try and strike a balance between touching as little as possible and actually being able to function. Because obviously you can’t wander round with a big bubble on you and not touching anything. So it was-, it took quite a lot of getting used to, but after a couple of-, sort of two, three weeks, I was much better at making sure that I could get about and sort of do the things that I wanted to do, to an extent, without aggravating it as much as possible.

Sunlight, yeah. Over the summer, I know it wasn’t the best summer we’ve ever had but I did notice and it is kind of a common fact that vitamin D is really good for psoriasis. And I found that if I got in the sun then it did do what happens when the su-, it has steroids put on it. So it’s like reducing, it’s not as- kind of the- they’re called plaques, they’re not like- it’s not as like inflamed or red. When psoriasis goes away is you get like loads of little scars, white scars kind of, and they’re not really scars it’s where the skins either inflamed or like flattened down in a way so it’s got to come back to its normal functioning level after being disturbed, oh I don’t know, being affected for so long. And I started to get those which for me is a signal it’s getting better. But then as the sun started to go away and as I came back to school and my stress of being back at sixth form came back, it kind of reversed, started happening and it wasn’t getting better anymore, it was getting worse.

Does weather make a difference at all to your psoriasis?

The cold

Does it make it worse?

It like cracks it and makes it all dry; and the sun’s really good for it, cos I got told, I remember getting told at the hospital that I should move to a hot country because the heat like softens it, but the cold cracks it and makes it worse, and like makes it all dry and then obviously it flakes more.

So, do you have to do different treatments in winter or?

We did the same treatment, it was just I had to like wrap up warmer. And I couldn’t play out in the snow if it snowed that much because my skin would get too cold really quickly. Cos my skin was so sensitive.

Deodorant affected me really badly, so I had psoriasis on my underarms so I was, and like all the stuff, that are kind of aluminium based deodorants like just wreaked havoc and made the situation so much worse. I mean if I wore deodorant, a normal deodorant, the next day I would visible see that my psoriasis was about ten times worse under my underarms and red and kind of hurting. So I eventually had to give up all together with normal deodorants and try to use some natural ones which I feel like probably aren’t industrials strengths, so don’t really work in the same way. But I found coconut oil really, really effective with, like as a deodorant and it’s kind of stopped me sweating as much, it stopped like any smell. And it’s really, really worked for me. That, sometimes coconut oil mixed with baking powder, which is something that I read online, so these, there are all of these kind of natural things online that people talk about and some things won’t work for you and then some things really will and you’ll, you’ll wonder how you survived without them. So now like I use coconut oil all the time on my underarms and it’s really helped. And then like I’ll use sometimes natural deodorants as well that I’ve found like there’s salt based one’s that use like salt to-, kind of like a rock of salt and you rub that and you have to like kind of wet your underarms first. There are other ones that have like tea tree in them and other things to kind of like sooth, but also like to completely give it a better smell. But obviously nothing that’s like antiperspirant because the idea of an antiperspirant in itself is like not a good thing to kind of stop yourself from perspiring that can of, that-, anything that has that in it can affect your skin badly I think if it’s sensitive or if you have psoriasis.

The only main thing that I’ve always been told is like stress, and because when I was at high school, my first high school I went to, I didn’t really enjoy it which was why I had the IBS as well from the anxiety which then, they put that down to why it got worse as well, just being stressed out. And then when I saw the consultant this year they mentioned -, cos everyone’s really said about stress and she mentioned again, “What’s work like; how is it?” and I said, “look what I do is busy,” so they did mention the stress. And then she also mentioned about different foods that can be triggers, so she give me so many to eliminate – so I don’t eat beef, don’t eat tomatoes, don’t eat dairy and I don’t eat oranges. And although when I’ve cut -, I cut them out pretty much completely for the first month and a half or so, because I was doing phototherapy I didn’t really see much of a difference, whereas now because obviously I have my food all cooked for me, I still eliminate it but every now and then I will have naughty days, and I will eat some of those foods and I’ll go have a burger, I’ll go drink proper milk, cos I drink goat’s milk.

And see, but I haven’t seen any effect that these, what I’m eating every now and then, it’s flaring up my skin so I’m just every now and then I eat it in smaller doses just in case.

But also being a male student, beer as well is a big contribution of yeast and once I’d sort of spoken to him and had this conversation it made a lot of sense and I did start to see a difference and there’d be times last year if, perhaps I, I don’t go out sort of every night I’m not one of those people but I do like to go out occasionally and stuff. And of a week perhaps where you go out once or twice, I went out twice and our sort of my staple drink was, would be kind of beer. I could see it over the next couple of day’s I’d wake up and I could see like the beginnings of a patch and maybe it was because I was more sensitive to it in terms of I was watching more what I ate. Because previously I’ve had quite a fast metabolism, I do quite a lot of sport and I’m quite active so I don’t, I’ve never really watched what I ate and my weights never really fluctuated I think I’ve been the same weight for about five or six years and I’ve never really paid much attention to it so it could just be the fact that I was now slightly more sensitive to what I was putting into my system but I’m convinced now if I have a couple of nights out in a row or a couple of late nights in a row with maybe a night out with drinking interspersed in that, I can see it in my hands. just either in the beginnings of kind of a dry spot or something and so again it’s a little bit of a kick to drink some more water, have a few nights off, get some early nights, try and eat some good food over the next few days and to start moisturising again. And invariably that kind of keeps it at bay. the only thing that doesn’t at that point is sort of stress is the only other input that I can’t really have too much, well I can but at the same time I can’t, have too much of an influence on because there just seems to be so much going on all the time.

So how ever early a night, however well you eat and whatnot there’s only so much it can do cos I’m one of those people that can’t really say no to doing stuff so I still run around like an idiot, trying to do everything that I can but I wouldn’t have it any other way I’d take a little bit of dry skin to kind of enjoy my university experience a bit more.