Jack
(Audio or text only clips) Jack developed guttate psoriasis at age 20. He looked up the diagnosis online which was confirmed by a GP. Jack has felt self-conscious about psoriasis, though less so now that he older and has been prescribed a tacrolimus cream which works for him.
Jack first realised that he had guttate psoriasis when he looked up his symptoms online. He noticed some small red dots on his body during his first year at university. Jack felt relieved that it wasn’t another illness and the diagnosis of psoriasis was confirmed by a GP. Jack wasn’t too concerned at first as the psoriasis patches were very small and he hoped it would settle down. However, his psoriasis became more severe over time‚Äö√Ñ√∂‚àö√ë‚àö√Ütending to be itchy but not flaky‚Äö√Ñ√∂‚àö√ë‚àö√Üand the physical appearance had emotional impacts. His psoriasis almost entirely cleared up one summer when he was in the sun a lot. However, a few months later, the psoriasis returned and started affecting other parts of his body, such as legs and arms. Jack says it is difficult to pinpoint triggers for his psoriasis and he doesn’t think there is an obvious association with stress. He thinks though that there may be a link to him having strep throat on and off for several years which led to having his tonsils removed. He also knows about the Koebner phenomena’, whereby psoriasis can develop at the site of an injury, and thinks that this may explain why some psoriasis has particularly affected parts of his face where he had acne as a teenager.
Jack has seen several GPs about his psoriasis and tried lots of different creams and ointments. He has also bought emollients from over-counter and these, in combination with prescribed medicines, have been quite costly. The first GP prescribed him a steroid cream and Jack remembers being told that he needed to be careful with not using too much of this. However, it was tricky to apply to only the guttate patches and so he would cover blocks of skin at a time. The lifestyle Jack had at university meant that it was difficult to stick to a routine and he would often forget to apply creams. His psoriasis spread quite a lot, including onto his face which made him self-conscious when meeting new people. Jack has often felt unable to speak up to his doctors about the treatments being ineffective and would sometimes wait several months before making a new appointment. Recently, he was seen by a GP with a special interest in dermatology and has since started new treatments, including Protopic (tacrolimus), which are working well. Jack says he has more of a routine now with his job which helps in using treatments.
Although Jack tried to not let psoriasis affect his social life, he used to feel self-conscious when meeting new people and would sometimes avoid social events. It was also difficult to motivate himself to go to lectures during university when his psoriasis was flared up. Jack feels better about his psoriasis now that he is working, has more time to come to terms with it and the new treatments are helping. He says that psoriasis doesn’t impact his job physically, but it can affect his mood and set you up for a bad day sometimes. Jack also has to be clean-shaven for his work which requires him to be careful not to cut the skin and the shaving cream can sometimes flare up his psoriasis. Jack has several tattoos, some of which he got since being diagnosed with psoriasis. He didn’t think initially about whether getting tattoos might make much of a difference until his most recent one developed psoriasis and took a long time to heal.
Jack hasn’t talked much to other people, including his family members or housemates, about the physical or emotional impacts psoriasis can have. He knows of online support forums but prefers to read rather than post. He says that it can be therapeutic to know that others are going through it too. He thinks that GPs should be more aware of the psychological impacts of psoriasis, though adds that he himself is now in a good place with this. Jack wishes that he had seen a doctor with more specialist knowledge sooner; he encourages other young people with psoriasis to be active and persevere in seeking help from healthcare professionals.