Ella

Ella has had psoriasis since she was 3. Although Ella is more confident now that her psoriasis is well-controlled with creams, she highlights that it can be another layer of worry for body confidence for young women in particular.

Ella has had psoriasis since the age of 3. Her first memory of having psoriasis was being kept in hospital for about a week after a bad reaction to a tar-based cream. Ella’s psoriasis tends to be on her elbows, upper chest, around the edges of her face and on/in her ears. Having psoriasis around her hairline and ears is difficult because Ella has to put her hair up in a ponytail for her part-time job and she worries that everyone can see it. Ella thinks that her psoriasis looks a bit like a rash, as it’s usually raised red skin with skin flaking but can vary depending on where it is on the body. Around the age of 13/14, Ella would get quite severe psoriasis in her ear canals. The skin flakes would block her ears, making it very painful and she was unable to hear. She tried ear drops and the doctors used water to try and flush out the blockage (ear irrigation), but this made the problem worse. One treatment which worked well was microsuction, in which a tube is used to suck out the blockage. Ella would go for this treatment at the hospital every couple of months alongside using the ear drops and it would almost instantly return her hearing to normal.

Most of Ella’s psoriasis treatments have been steroid creams, moisturisers and Protopic from her GP and dermatologist. One downside is that the creams are greasy and this can be a problem for controlling some teenage acne on her face. Ella says it’s a balance looking after her skin to manage both the psoriasis and the acne. Another thing Ella uses for her psoriasis are non-soap based showering products which she says smell nice. Ella was offered light therapy treatment but turned it down as she has always found that her psoriasis becomes more severe in the summer. Ella thinks that she will soon be attending dermatology appointments without her parents, so that she can talk more directly with her dermatologist about her concerns rather than only listening. This is related to the fact that, as she got older, Ella and her parents realised that they hadn’t ever talked much about what psoriasis is or what the creams do because she had it since such a young age.

As Ella started to get older and was at secondary school, she felt self-conscious about people looking at her psoriasis. Some pupils in secondary school made nasty comments about her psoriasis; Ella confidently spoke back and challenged what they were saying. She’s often surprised that people assume psoriasis is contagious. Ella says that she doesn’t mind explaining psoriasis to someone, unless they have been rude or mean. Ella sometimes struggles to concentrate because she will fixate on the psoriasis. For example, she will sometimes sit in classes in a way which tries to casually cover the psoriasis around her face and this distracts her from engaging fully. Ella describes having psoriasis as yet another layer of worry for body confidence to struggle with, especially for girls and young women. She doesn’t want any photographs of her on social media to show any patches, partly because she doesn’t want psoriasis to be what I’m known for and overshadow her whole personality. Ella tries to cover up her psoriasis when possible, such as by wearing her hair down or with a side-parting and wearing clothes with long sleeves or high necklines. Ella has also looked online for ways to cover up her psoriasis with make-up, but didn’t find anything really suitable for her skin.

Ella has a strict routine of applying her creams at night and thinks that this is why her psoriasis is so well controlled at the moment. She says that doctors would prefer her to apply the creams twice a day (e.g. once in the morning also). However, Ella says she doesn’t want to because it’s time-consuming, makes her skin and hairline greasy, and she can’t put her make-up on top of the creams. Ella suggests that doctors should think about how the treatments are going to affect the patient’s day-day life rather than expecting everyone to be able to follow treatment advice to the letter. She thinks that being aware of the emotional side of psoriasis is important too. Her advice to other young people with psoriasis is that it probably isn’t as bad as you think it is and that it’s other people’s problem if they take issue with you having psoriasis.

Moisturising her face helps Ella’s psoriasis but can be tricky with acne.

Age at interview 16

Gender Female

Age at diagnosis 3

Ella says using topical steroids is an extra thing to fit in.

Age at interview 16

Gender Female

Age at diagnosis 3

Ella’s friends are supportive and try to reassure her when she feels self-conscious.

Age at interview 16

Gender Female

Age at diagnosis 3

Ella remembers a time when hurtful comments were made at school about psoriasis on her ears.

Age at interview 16

Gender Female

Age at diagnosis 3

Ella stayed in hospital for about a week. She remembers being frightened.

Age at interview 16

Gender Female

Age at diagnosis 3

Ella thinks doctors are sometimes unaware about the impracticalities of treatments in young people’s lives.

Age at interview 16

Gender Female

Age at diagnosis 3

Ella will soon be treated under adult dermatology and thinks this will mean being more independent.

Age at interview 16

Gender Female

Age at diagnosis 3

Ella talks about some of her psoriasis triggers.

Age at interview 16

Gender Female

Age at diagnosis 3

Having psoriasis in and around her ears caused complications, including temporary hearing problems, for Ella.

Age at interview 16

Gender Female

Age at diagnosis 3

Ella finds acne treatments dry out and irritate her psoriasis, whilst psoriasis treatments are greasy on her acne.

Age at interview 16

Gender Female

Age at diagnosis 3

Ella feels self-conscious about skin flaking and finds it’s difficult to cover her psoriasis with make-up.

Age at interview 16

Gender Female

Age at diagnosis 3

Ella’s choice of clothing has been shaped by having psoriasis on her chest.

Age at interview 16

Gender Female

Age at diagnosis 3

Ella’s less worried about her clothing choices now she feels in control of her psoriasis.

Age at interview 16

Gender Female

Age at diagnosis 3

Ella’s explains about psoriasis to her peers but finds their responses can be hurtful and frustrating.

Age at interview 16

Gender Female

Age at diagnosis 3