Psoriasis is often considered to be a cosmetic problem but it can have a severe psychological impact, writes MARESE MCDONAGH
PSORIASIS HAS traditionally been regarded as a cosmetic problem but in fact the psychological impact of the skin condition is so devastating that some sufferers contemplate suicide, according to one expert.
Senior clinical psychologist Dr Helen Richards says studies have shown that about 10 per cent of sufferers have suicidal thoughts while the chronic condition can have a profound impact on the lifestyle of both patients and their families.
Psoriasis is a chronic immune disorder which is not contagious but which affects more than 100,000 people in Ireland. It is incurable but many people respond very well to the wide and increasing range of treatments.
Richards, who has spent 15 years working with psoriasis sufferers, says that because the condition is genetic, some women are reluctant to have children. “In extreme cases women will not want to have children because they don’t want to pass it on,” she says.
The psychologist, who is based at Mercy University Hospital in Cork, says that traditionally the impact of the condition was underestimated, even by some doctors. “Historically it was not taken seriously and was seen as a cosmetic nuisance but in recent years it has been getting more attention from clinicians and researchers,” she says.
As well as the physical discomfort and pain for those who are very badly affected, many people suffer significant psychological trauma which should not be ignored, says Richards.
“Some people shower in the dark. It can affect people’s sex lives, perhaps because of the physical discomfort if they have it in the groin area but also because people are embarrassed,” she says.
An estimated one in four psoriasis sufferers experience “significant psychological distress” because of the condition.
Members of the Psoriasis Association of Ireland have spoken of how stigmatised they feel and how reluctant they are to go to swimming pools, changing rooms or join in social occasions.
“People do fear being shunned and some tend to avoid social situations such as parties or going to the shops. There are women who wear two or three pairs of tights to hide the plaques on their legs and people wear long sleeves to cover up,” says Richards.
She says the fear of being shunned was often well-founded. “You will get parents pulling their children out of the swimming pool when they see someone covered with psoriasis,” says the psychologist. “It is improving but there is still a level of ignorance there.”
Psoriasis can occur anywhere on the body, but it normally affects the scalp, elbows and knees. Most people are affected in a few small areas. But some people experience outbreaks that cover large parts of the body and, according to Richards, some are practically covered from head to toe.
Symptoms of psoriasis can appear at any age, but it most frequently arrives between the ages of 11 and 45, often starting at puberty. It affects equal numbers of men and women. The condition is hereditary but is often triggered by a major stressful event or by a throat infection or injury to the skin.
Up to 20 per cent of psoriasis sufferers may also have psoriatic arthritis, which can cause severe discomfort and pain.
The Psoriasis Association of Ireland is conducting a survey, called Psoriasis Uncovered, until March, aimed at revealing the impact of the condition on patients and their families. The address is psoriasisuncovered.ie and sufferers are invited to participate anonymously.
Caroline Irwin, chairwoman of the association, says it is vital that people seek help from their GP or a dermatologist if they have the condition as there are a wide range of treatments available.