By Amber McKnight, as told to Shishira Sreenivas
The first time I started to notice white flakey patches, it kind of almost burned a little bit on the back of my ear. It was March 2019, and I was 24 at the time. I was working at Disney World and I had to wear a hair net and a fun hat. I thought it must be the sweat and irritation from wearing them because the hat and net sat right on that spot. I just thought they were rubbing me the wrong way.
I went to urgent care and showed it to them. I was hoping for a cream or an ointment to put on it. They gave me topical steroids and told me it should go away in a bit. I thought, “great!” I had eczema for a while so I thought it might be a flare-up. But I decided to keep an eye on it.
The steroid cream helped. The patches went away.
In 2020, I started physical therapy school in Atlanta, GA. By the end of the year, the eczema-like patches started to pop up all over my body: stomach, back, breasts, arms, and legs, especially in the crooks of my elbows and the backs of my knees. However, the patches from my neck up were the most severe -- the crown of my head, behind my ears, and the nape of my neck.
But every time I showed it to a doctor, they just kept brushing it off. They said, “oh that’s just eczema.”
Psoriasis Can Affect Your Quality of Life
I looked like a scaly lizard. And I was both embarrassed and frustrated. Basically, you could see everything, so I had to cover up everything. The summer heat in Atlanta did not help the situation, either.
For school, especially during PT labs, I had to wear my hair up and have a mask on. This meant everyone could see my scaling, plagued skin. They could see huge chunks of white stuff fall off of my skin. In fact, I had some people come up to me and say I had rice in my hair.
PT school required a lot of hands-on touching and therapy. For the lab, we would have to take off our clothes. I simply couldn’t. It was so uncomfortable for me. So I wore full-length leggings and a sweatshirt in the middle of summer. Plus, the patches were either flaking, itching, or painful. I started to skip some of my labs.
I have had a ton of skin issues in the past, but these patches looked different and new to me. It looked similar to the patches I had in 2019. It just couldn’t be eczema. These patches had a different texture, largely connected, were very flakey, and peeled a lot. It was awful.
At this point, I decided to see a dermatologist.
Getting a Psoriasis Diagnosis Can Be Tricky
I went to a number of doctors – primary care doctors and dermatologists. They all said it didn’t look good or it was just eczema. One even sent me to a wound care specialist. And they said they couldn’t fix it. Some of the spots were starting to get infected with staph infections.
At this point, I was going in for two appointments a week for a month. I tried a few medications, but nothing helped.
One dermatologist decided to do an allergy test to see if I was reacting to something. When I went back to have my results read, it was a different dermatologist from the one I normally saw. She happened to be covering for the other doctor.
She took one look at my scalp and said, “that’s 100% psoriasis. I have no idea why no one has said this to you.”
They biopsied a couple of different spots. Some were eczema, but others, it turns out, were psoriasis. The type I had was called guttate psoriasis.
It can happen after you’ve had strep throat. And I commonly get strep throat and staph infections. It’s what apparently caused the confusion about differentiating eczema from actual psoriasis. The patches on my scalp, however, were plaque psoriasis.
I finally got a diagnosis in January 2022.
Find Ways to Control Stress and Manage Psoriasis
After I was diagnosed with psoriasis, they put me on injection medications, which helped a lot. All of the doctors said it was important to manage stress.
I didn’t realize I was stressed. I mean, I was working at Disney World when it all started. I thought it was the happiest place on Earth. But I took some measures to change a few things about my lifestyle.
The big thing I did that helped was I stopped using any lotion or cream with petroleum jelly in it. I believe it caused some of the irritation. I swapped to cleaner products and it has made a world of difference.
I regularly feel my scalp or my elbows for psoriatic patches. If I feel patches beginning to form, I immediately increase my sleep, drink more water, and figure out what might be stressing me out. I basically pulled back from constantly being on the go. Now, I love to take long nature walks. It helps me stay calm.
I also think I tend to scratch my arms more when I’m stressed. I think it’s my body’s subconscious reaction to distract me from whatever is stressing me. But scratching makes psoriasis worse. So, I do whatever it takes to stop myself from scratching. I wear long sleeves or a jacket. Sometimes, I’ll just sit on my hands and remind myself to stop it.
But overall, once I started treatment and made changes to my lifestyle, my skin has been relatively calm. If I notice the patches getting worse, I’ll see a doctor.
Find a Good Support System
Dealing with an autoimmune condition like psoriasis in your 20s can be hard. If I could talk to my younger self, I would say, “It is ok. You’ll be fine. Stop scratching, stop looking, and stop obsessing.”
Obviously, it’s hard to deal with it but it’s important to stay calm, take a step back, and reassess the situation.
It’s important to find a good support person or system. I was lucky to have a really good friend with me in Atlanta when all of this happened. She always let me vent.
It helps to have someone go to the doctor with you because it can be intimidating. I’ve had times when I lost hope. It’s always good to have someone who knows what’s going on or who can just be there for you if you start to shut down or spiral.
And keep advocating for yourself. At the end of the day, you know your body more than anybody else.
Photo Credit: Konstantin Sud / Eyeem / Getty Images
Amber McKnight, 27, physical therapist from Belmar, NJ.