Carys

(Text only clips) Carys had plaque psoriasis when she was 22. It took a long time for her to be correctly diagnosed, by which time a lot of her body was affected. Having psoriasis had a big impact on Carys confidence and social life as well in her job as a hospital nurse.

Carys developed plaque psoriasis when she was 22. Her psoriasis was itchy, flaky and would sometimes crack open, especially when she was moving around a lot at work. Her first patch developed on her leg after nicking the skin whilst shaving. She became concerned when the mark wouldn’t heal and so went to her GP, who thought she might have ringworm and prescribed her antifungal creams. She continued going back to her GP as patches kept cropping up elsewhere on her body. Eventually Carys saw a dermatologist who instantly recognised it as psoriasis. At this stage, Carys had psoriasis on her scalp, face, neck, hands, stomach, back, legs and feet. Having psoriasis on her scalp meant that she sometimes caught the plaques when brushing her hair, which was painful and caused clumps of hair to fall out. Since completing a course of phototherapy treatment course several months ago, Carys hasn’t had any psoriasis return. She thinks that her psoriasis developed due to a combination of triggers: stress with starting a new job, having a cold and the shaving cut. She tries to avoid stress but finds it’s very hard to do so at work.

Getting a diagnosis of psoriasis was quite a frustrating process for Carys. She went back to her GP multiple times when it was thought that she had ringworm for stronger anti-fungal treatments. In contrast, her dermatologist instantly diagnosed her with having psoriasis on the first visit. Carys was upset that her psoriasis was too severe for other treatment options and that she would need phototherapy. Because of the long wait for the treatment, Carys ended up getting a quicker referral through Occupational Health at her work. In the meantime, she used emollients and was given a soap replacement for washing her hands as well as Oilatum bath oil. All the prescriptions, and water bill with daily baths with bath oil, were very costly. Using the creams helped but could be very time-consuming, uncomfortable (greasy) and got on her clothes and bedsheets, creating lots of laundry. Carys was worried about the increase in risks of skin cancer with phototherapy but felt that trying it was the right decision for her. Having pale skin meant that she couldn’t have phototherapy sessions in quick succession and she found that her skin would become quite red and uncomfortable afterwards. The dermatology department was very supportive and tried to fit appointments around her work shifts. She had phototherapy for a few weeks, alongside using the prescribed emollients and a shop-bought scrub to give some relief to the itchiness of her skin.

Having psoriasis really knocked Carys confidence. She says that it was very hard going out and socialising. She struggled to find outfits which covered up the psoriasis and being unable to shave made her feel less confident going out. Carys tended to stick with cotton leggings and floaty tops at home to avoid irritating the skin. She wore make-up at work to boost her confidence because it made her skin look less red but she says the dryness was still visible. Having psoriasis on her arms and hands was particularly hard for Carys because being a nurse means that she has to wash her hands frequently and she wouldn’t get a chance to use the moisturisers with such long shifts. Although her medically-trained colleagues understood about the condition, Carys found that some patients thought it might be contagious (spreading). She couldn’t wear the nurse uniform because the fabric irritated her skin and this made Carys feel like she didn’t look the part. Having broken skin on her arms was a concern because of infection risks to both herself and others. Carys found it hard to sleep when it was hot as her skin would become very itchy. She has pre-existing joint problems, which are unrelated to psoriasis, so she says that she’s used to being kept awake. Putting creams on her skin before bed could also be uncomfortable and she would sometimes scratch in her sleep, waking up to find spots of blood on the sheets. To reduce the damage to the skin, she took to wearing cotton gloves.

Carys encourages other young people with psoriasis to try and keep on top of the symptoms. She adds that if things aren’t improving, to push their doctors for more treatments to try. She says that talking to someone else about the emotional impact of psoriasis can help. Carys says that it helped talking to her family, especially her mum, and that her partner and best friend were both really supportive. She used social media to vent her feelings sometimes. Given her difficult experiences with getting diagnosed, Carys thinks it would be good for GPs to have more knowledge about skin conditions. She thinks that getting a diagnosis sooner could have prevented her psoriasis becoming so severe and requiring phototherapy. Her advice to dermatology professionals is to be more understanding of why people might try shop-bought products (in addition to prescribed treatments), since the itchiness and flaking of psoriasis can be very hard to cope with.

The impact of psoriasis on Carys’ confidence was hard on her parents.

Age at interview 23

Gender Female

Age at diagnosis 22

Carys found the bath oil/emollient made her skin feel greasy. She washed out the bath as it made the surface slippery.

Age at interview 23

Gender Female

Age at diagnosis 22

Carys’ phototherapy sessions were scheduled around her work shifts.

Age at interview 23

Gender Female

Age at diagnosis 22

Carys weighed up the risks and benefits before deciding to try phototherapy.

Age at interview 23

Gender Female

Age at diagnosis 22

Carys struggled to fit in using emollients with shift work as a nurse.

Age at interview 23

Gender Female

Age at diagnosis 22

Carys’ water bills were high when she used a bath oil/emollient daily.

Age at interview 23

Gender Female

Age at diagnosis 22

Carys saw her GP several times before seeing a dermatologist who quickly diagnosed it. She then had a wait before starting phototherapy treatment.

Age at interview 23

Gender Female

Age at diagnosis 22

Carys found it hardest to have psoriasis on her hands because her job as a nurse meant that she was using/washing them constantly and that they were an infection risk.

Age at interview 23

Gender Female

Age at diagnosis 22

Carys’ psoriasis was triggered by a combination of factors, including catching her skin while shaving.

Age at interview 23

Gender Female

Age at diagnosis 22

Occupational Health at Carys’ workplace helped her see a dermatologist quicker, as her psoriasis was impacting on her job as a nurse.

Age at interview 23

Gender Female

Age at diagnosis 22

Carys tried a body scrub to help reduce skin flaking and itchiness. The dermatology nurse she told about this was dismissive.

Age at interview 23

Gender Female

Age at diagnosis 22