Living with the pain of psoriasis can be an ordeal, but the psychological effects can be worse, writes Kitty Holland
When Keith Finnegan finishes his morning show on Galway Bay FM the red carpet in his studio has to be hoovered, for the second time, each day.
"I'm like a walking snow storm at the moment," he says, telling how the skin over most of his body is dry, flaking and scaly. "If I don't moisturise it it cracks and bleeds. To a lot of people it just looks disgusting, though thank God, I accept it and it doesn't bother me as much as it does an awful lot of people."
Keith (42) has had the skin condition psoriasis since he was nine. A chronic skin disorder, psoriasis was brought into many people's living rooms some years ago, with the sometimes harrowing depiction of a sufferer in Denis Potter's television drama The Singing Detective.
Though not all children of psoriasis sufferers will develop the condition, there is a 10 to 40 per cent chance they will, with risk increasing if both parents are sufferers. Put most simply the problem is caused by an over-production of skin. Where skin normally replenishes itself over a 30-day cycle, in psoriasis sufferers the same cycle takes just five or six days. Inevitably the body must shed the excess skin.
"That manifests itself as thickened, scaley skin, which looks pretty awful," says Dr Cal Condon, dermatologist at the Blackrock Clinic in Dublin. "It tends to happen at the elbows, front of the knees, scalp, the ears, under the arms, groin, lower back. It tends not to be so bad on the face."
Though it can be kept under reasonable control with creams and other outpatient treatments there are occasions when the skin is so badly affected and gets so red that there are problems pumping blood through it, says Dr Condon.
"This requires hospitalisation, for about two or three weeks. It is slow to get back under control. In very serious cases it can be fatal but I have never heard of a fatality in this country."
The condition is incurable and though uncomfortable - both itchy and sore - perhaps more devastating for most sufferers is the psychological impact. This is made even worse, says Keith, by the widespread ignorance.
"Well first of all people think it's contagious. It's not. A few years ago I was in a swimming pool with my two kids and there was a lady who screamed at her boys to get out of the pool. They weren't getting out and then she shouted, 'If you don't you'll catch what that man there has', and I'd say they were never so fast out of a pool. I was very hurt," he says. "That knocked me, especially because my own son looked at me a bit differently for a few days."
Caroline Irwin (44), from Castlecomer, Co Kilkenny and founder of the Psoriasis Support Group has also had psoriasis since she was nine. She tells how she recently went to a hairdresser and the woman washing her hair took out surgical gloves before she would touch her hair.
She says it's very difficult for women in particular as they frequently cannot wear short sleeves, strappy dresses, short skirts or sandals.
"The worst thing is trying on dark clothes in shops. You have to shake all the skin flakes out before you give the clothes back."
Though her face looks quite dry and flakes of her scalp dust her shoulders, Caroline does not, at first, appear badly affected. However, she rolls up her trousers to expose sore, hard, red and flaking skin on her legs and shows her hands, which pitted with small white sores, she says are "quite good at the moment".
"It's a very lonely and isolating disease for a lot of sufferers," she says. It affects self confidence and many give up sport or any activity where they may have to expose their skin. She says she was lucky, having met her husband when they were teenagers. He never shied away from touching or loving her because of her psoriasis.
The condition can however, severely curtail people in their personal life, making them feel unattractive, embarrassed about their appearance and undesirable. She says she knew of one sufferer who sometimes picks a fight with her husband before they go to bed so that she can sleep in the spare room, "just because she doesn't want him to touch her".
Both Caroline and Keith have tried a range of treatments. Over 25 years Keith turned from one alternative therapy to another, travelling to different doctors and healers, and even to England. He rubbed in steroid creams that dangerously thinned his skin, consumed a compound containing (unknown to him) arsenic that nearly caused liver failure; he tried Chinese medicine and faith healers. For four years he has been treated by a "terrific" conventional dermatologist, Dr Mary Garvey, in Galway.
Caroline similarly has tried various emollients, aqueous creams, and tablets. Both of them respond well to sunlight, saying sun holidays give them great relief, and ultra-violet treatment.
As no treatment suits everyone there is for almost all sufferers, a painstaking process of trial and error to see what works best for each individual.
"People though will try absolutely anything if they think it can give them some relief," say Caroline. "It ruins some people's lives, and the search for a 'cure' can take over their lives." She stresses the importance of seeing a good dermatologist. However, with a an acute shortage of dermatologists in the State, Dr Condon advises people to see their GP first.
"Between public and private there are 24 dermatologists in the country. In the US there is one to every 140,000 people. To achieve that level here there should, ideally, be about 100."
"It's a disease for life," says Dr Condon. "So if you live in the wrong part of the country, it's a life of travelling."
The Psoriasis Support Group will hold its next meeting at 8 p.m. on Wednesday, April 28th in the Clubhouse Hotel in Kilkenny. Caroline Irwin can be contacted in the afternoon on 086 3395308, or on email cirwin@witty.com
