Damini was diagnosed with psoriasis at the age of 4. She’s had two major episodes of her psoriasis flaring up, one during secondary school and once most recently during her university exams. These have been difficult experiences for Damini. She was bullied during secondary school for her psoriasis. Her latest flare up of psoriasis knocked her confidence a great deal and developed on her face, a part of her body which hadn’t been badly affected before. She finds that stress is a major trigger, although there is often a delayed reaction so that a flare up can occur later e.g. just after her exams. She has noticed that there can be a vicious cycle whereby lack of sleep, being anxious and worsening psoriasis all come together.

Damini has tried steroid creams and phototherapy for her psoriasis in addition to moisturisers. She has seen a dermatologist only once and prefers seeing her family GP as he is aware of her treatment history with psoriasis. Damini has also been to India to seek advice on treating her psoriasis with herbal remedies. This included dietary rules which she followed for 6-12 months. It seemed to help but she found that the restrictions on food became too much to cope with, but she still tries to maintain a healthy diet.

Psoriasis has a big impact on Damini psychologically and she finds it very difficult to socialise during a flare-up. She tries to cover up her skin as much as possible; for instance, even though her neck wasn’t affected by the latest episode of psoriasis, she often wore a scarf because it made her feel better to be covered up. Making eye contact was especially hard because she worried that people were looking at the psoriasis on her forehead and around her eyebrows. She wasn’t able to wear make-up during her most recent flare-up; she found other ways to cover up her face, such as by keeping her hair down, getting a fringe and wearing her glasses. As her psoriasis cleared, she started to gain confidence and, for example, wear short-sleeved tops around the house before going out in public in them.

Damini didn’t used to tell anyone how badly psoriasis was affecting her. She kept her feelings to herself because she felt ashamed and feared that other people wouldn’t understand. It was very reassuring for Damini when she found others online talking about the psychological impact of psoriasis in their lives. Before this, she hadn’t realised that others might feel the way that she did about her skin. She also finds it helpful to see people’s before and after’ photographs. Damini has become more open to talking about her psoriasis with family and friends now. She sometimes worries though about meeting new potential partners because, for her, psoriasis is a conversation that you don’t know how to bring up.

The financial costs associated with psoriasis for Damini include not just medical prescriptions but also shop-bought products such as bath salts, covering-up clothes, aloe vera gel and different brands of make-up to try out on her skin. She feels that she is constantly trying to find something that works and it can be disappointing when this is only temporary. Treating her psoriasis can also be very time-consuming as she has to wake up early to apply the creams and allow them to dry before getting dressed to go out.

Damini’s advice to other young people with psoriasis is to try not to let it affect them. She thinks that doctors should also talk to their patients more; she encourages doctors to listen, not just tell patients what to do, but instead to ask for an insight into what the person is feeling. Damini thinks it would be helpful too if doctors told patients about a full range of treatments available for psoriasis to give some options.