Dealing With the Stigma of Psoriasis

When it comes to facing the stigma of psoriasis, there's one incident that sticks out in Robert Schwartz's mind: the time he was kicked out of a restaurant because of his condition.

After sitting down with a plate of food from a buffet, he remembers being approached by the restaurant manager and quizzed about his condition. "I tried to explain I was not contagious," says Schwartz, a Las Vegas man who has psoriasis on 75% of his body. He suggested that the manager could confirm it with any doctor. 

But the manager was adamant. Schwartz could take food to-go, but he wasn't allowed to eat with everyone else. "I felt dejected," says Schwartz.

Schwartz has many other stories about the stigma of psoriasis -- being ordered by a casino employee to put on a long-sleeved shirt to cover his skin, being told he couldn't try on clothing at a store.  Tragically, his experiences are not unusual. There are 7.5 million people in the U.S. with psoriasis. Many face similar humiliations day after day.

"I hear it all," says Mark Lebwohl, MD, chairman of the medical board of the National Psoriasis Foundation. "I hear about people with psoriasis being turned away from hairdressers, kicked out of swimming pools, and prevented from donating blood at blood banks."

The stigma of psoriasis can be crushing. But how can a person with psoriasis fight back against ignorance and prejudice? WebMD turned to some psoriasis experts to find out. 

Living With Psoriasis

"The impact of psoriasis on a person's life is profound," says Robert Brodell, MD, a dermatologist at Northeastern Ohio Universities College of Medicine. "You're wearing the disease on the outside of your body." And even though it's not infectious, people tend to see the symptoms and connect them with whatever deadly diseases are making news. "People might assume it's HIV, or drug-resistant staph," says Brodell.

The stigma of psoriasis can quickly undermine the confidence of even the most self-assured. Well-meaning family members and friends may suggest you ignore how other people react. That's fine advice, but it's often not realistic. If someone flinches when you offer your hand, it's not something you forget. It's an experience that can radically change how you feel about yourself.

"People really can feel like lepers when they have psoriasis," says Alan Menter, MD, president of the International Psoriasis Council. "They're shunned."

The stigma of psoriasis can have a particularly destructive impact on a person's intimate relationships. "Psoriasis doesn't only show up on knees and elbows," says Brodell. "It can also appear on the genitals." Some people with psoriasis give up on dating altogether, rather than having to explain their condition.

Because of the stigma of psoriasis, many people keep it a secret if they can. "Psoriasis is a very hidden condition," says Menter. "It's amazing how often people will hide it for a lifetime from their families, even from their siblings or their children." They just wear long sleeves and long pants and never say a word.

While there are celebrities with psoriasis, Menter says, it's been almost impossible to coax them into speaking out about the condition. "They're afraid to let the public know that they have psoriasis because of the potential stigma," Menter tells WebMD. "So that's why you're not going to see a celebrity doing a telethon for psoriasis."