honestly, would you think badly of me for this?

[snowsnowsnow1]

just wondered would this honestly put you off, or make you think negatively at all?

Im in a profession where I see clients and I sit approx 1.5m meter away from them. But I have horrendous psoriasis which flares up and down and unfortunately right now is very much a flare up. Im covered all over my neck, scalp, ears, edge of my face and across my body with it. Its just the typical psoraisis plaques and it looks pretty awful. I've been under dermatology for years but am stuck between a rock and a hardplace with treatment- we have tried everything available topically and nothing controls it, but its not widespread enough to merit biologics etc. Phototherapy didnt helping either and can't be carried out over my scalp anyway because of my hair. The only thing that helps in the short term is oral steroids so I usually get prednisone to take. anyway, im digressing and ill probably make another thread about treatments etc, but ill get back to the original point of my thread now.

as a client, would this put you off seeing me? or would you honestly think anything negatively at all? im self conscious but thought it was something people would undoubtably notice but not say anything about but ive had quite a lot of stares and grossed out looks in public at the shops and ive had a few comments too unfortunately recently

it doesn't affect my ability to do my job and I usually sit about 1.5m from patients so near enough to for them to notice but its not actually near them IWSIM. and its not on my hands or arms.

would this put you off seeing me or make you think negatively about me? suppose I just wondered what people would honestly think (I promise im not going to get all offended if its not good)
Thanks x

No, it wouldn’t bother me at all.
When I was having my 2nd child my midwife was very obviously having a flare up. I felt for her because it looked painful but it certainly didn’t put me off or make me think badly of her. She was fab.
I think most people would recognise what it is. I’m just sorry you suffer with it and hope you find something that eases it.

OP do you ever have children in the room? I would hope most adults would be understanding but kids can have very vivid imaginations AND ask all kind of questions, so if you do have kids come in, a simple explanation might ease things. And it might help to have a couple of ready answers. They can be silly ones. Eg 'what happened to your skin?' 'Malfoy put a nasty spell on me!'

No it would make zero difference to me.

However it depends what job you did, and what the power relationship is, unfortunately. If you need their business, and they are possibly not tolerant then think of a quick one liner to say which puts it in context, and means you can just get down to business. Something which isn’t apologetic, you have nothing to apologise for, but which acknowledges and moves on the conversation and gets rid of the ‘elephant in the room’.

Ahh fellow psoriasis person here. I would just explain to clients on a bad day: ‘I have a skin condition, it’s not contagious, I’m having a flare up’ You have a right to do your job and there is no reason whatsoever to think badly of you ❤️Mine is currently covering most of my back, scalp, elbows and knees, I really need to go back to the GP.

I wouldn't judge. My son had psoriasis from a teenager, it got so bad over his entire body and face that he looked like a burns victim. One look from a DECENT GP and found a specialist some 40 odd miles away and got him an appointment that Sunday.

He was put on immuno supressant drugs often used in cancer patients. It entirely cleared it up with very little side effects apart from obviously a compromised immune system and he had to have semi regular lft tests.

He stopped taking it for this reason due to the COVID pandemic fear. It does come back at times of extreme stress - such as when he became a father (his hair fell out too) but both seem to have calmed down now thankfully. Pretty sure it was Methotrexate.

I never call it a skin condition because people then think "disease". I just explain I have a problem with my immune system which causes this. It's an internal problem rather than an external problem.

I would not care and would barely notice. I know what psoriasis is, but even if I didn't I know people deal with all kinds of skin issues. I have eczema that was almost this bad until I figured out how to keep the flare ups at a minimum. To give some perspective though- and to show how prevalent shitty people are, one of my best friends has psoriasis and she went on full disability because it got really bad and no one would hire her. She would cover it with makeup, but that would just make her skin worse and even more painful. As soon as they saw her skin, even with makeup, they would decline her the position. I'm in the US and it's pretty difficult to get approved for disability but when they heard her talk about how people treated her in interviews they approved her. She is so smart and capable, but can't work just because of the way her skin looks. People are morons. It's not you, it's them.

I wouldn't be offended or put off. I would appreciate if you offered an explanation if it looked raw and sore.

If I were you I would like to wear a mask and clear shield so that open wounds had less chance of being infected.
I would also like a partially open window for fresh air just because that always makes me feel healthier wherever I am.

If many people were alarmed you could have short explanations about the condition printed ready to hand out so you didn't have to repeat yourself.

It makes me cross that people comment negatively on this and make you feel so self conscious. I have a different skin condition that can be covered with make up but there have been times when I’ve gone out without it and random women have asked what’s wrong with my face! It’s just rude 🤬 I wouldn’t think about your psoriasis at all, apart from maybe to think it must be sore. I’d be more interested in whether you are good at your job and your skin has literally nothing to do with that.

Why have you not had ANY systemic treatment, given that your psoriasis seems quite severe? Once youve failed either methotrexate or retinoids you'd be eligible for biologics.

I realize biologics come with their own problems, but in your shoes I'd definitely want to give them a try.

It wouldn't put me off. I don't have psoriasis either. I did have the most virulent acne as a younger person so I'd just be sympathetic.

I saw a dermatologist privately and he brought my intractable acne under control. I think I would go private if I could.

I have rheumatoid arthritis, and take methotrexate and a biologic for it. To be honest, I really thought the methotrexate didn't do a great deal, but my rheumatologist was keen for me to continue taking it so who am I to argue?

I really must admit that I don't feel any adverse effects from methotrexate, but I gather some people do. Anyway, the point is, that my rheumatologist was away, and I was due to have my normal six monthly visit with a Locum who came down with Covid and then had to do a phone consultation. As a result, I didn't get my script for the methotrexate, and mentioned it to my GP who gave me a script for a smaller number of tablets. Now I'm in Australia so I just assumed the things might be different, but out of idle curiosity, I looked it up on Google – so it may not be completely accurate – and it said GPs in the UK can dispense it.

I do have to have a blood test every three months to check liver function, but that's no problem, and also take a megafolate tablet (10mg I think) the next day after I take the methotrexate.

There is a bit of an irony as the first biologic I took was Humira, and developed a not uncommon side-effect of it - psoriasis. Lucky me. The biologic improved the RA and the quality of my life so much that I was prepared to put up with this psoriasis, but a change to a different biologic largely got rid of the psoriasis.

This is my opinion but may be different to others.

Why should the person living with a debilitating condition have to explain themselves to anyone.

So not only do they have to deal with it, they also have to openly come out with all that and potentially expose themselves to a load of inept questioning. No way should they have to put themselves through that, in my view. And having to say "it's not contagious" I have no words.

my colleague at work has it and as far as I'm concerned they are like anyone else, just that they have a skin condition. It makes no difference to me or the rest of the team. We're all socially adept adults though!

I had a boss years ago who was in a highly paid front-facing role, and he suffered terribly from psoriasis. It certainly didn't affect his career. Other than, perhaps the stress of the role in turn affected the psoriasis? I don't know.

When he sat in a swivel chair on the phone, he'd end up with a semi-circle of dead skin on the floor. We all just thought poor guy, that must be a bugger to live with.

I'd be surprised if any of your clients judged you for a medical condition.

In any situation where the person did not choose the condition they have, I think that it must cause them so much pain and have empathy. I don't understand the discrimination against people who face many more challenges every day than I do. Wouldn't bother me at all.

I would be distracted by food on your top or flakes of dandruff but nothing like that would make me think you can not do your job.

If you were a dermatologist I would wonder if that is what brought you to the profession, then it would work in your favor as I would hope you would be more understanding.

Absolutely not an issue for me and I don’t know why anyone would see it as a problem.

In my previous job, a direct report of mine had bad eczema and used to suffer flare ups that would affect her arms, chest, neck and face, usually due to weather or stress.

I felt awful for her as it really affected her confidence. We agreed some practical accommodations such as not having to automatically turn her camera on for teams calls, if she had had a bad night’s sleep due to itching etc the night before, she could start later and catch up her hours or finish early, take a midday break etc, have a humidifier in the office (PAT tested of course) to help with the air conditioning drying out her skin further etc.

When I left that company in April, her consultant still hadn’t managed to get it under control and she was having to take loads of strong steroids for lengthy periods just to make it some way acceptable, where her skin was splitting and weeping. It was so demoralising and frustrating for her as it always seemed like they’d found the right combo of drugs, they’d seem to work for a while and then it would deteriorate again. Plus she was left waiting for ages to see her dermatology consultant to add to the frustration.

As someone who suffered for 3 years with spots, hyperpigmentation and melasma (still got the melasma) after coming off the pill to TTC, I know how hard it can be to have a visible issue and how self conscious you become, thinking everyone you talk to will be fixated on that zit on your chin or your dark patch that makes you look like you have a moustache! But when I think about myself and how much I take in when speaking to people, I honestly don’t tend to notice that much/look too closely at the detail of people’s faces. So what is a huge, ultra visible issue for you likely won’t even be spotted by the people you are interacting with.

If you’re good at what you do, I’m sure no one will care in the end! 😘

No of course it wouldn’t. Same as most replies, I would just have sympathy, empathy I hope, and admiration for you. It must be very difficult, but you’re also brave for asking the question.

I would feel sympathetic towards you and how painful it must be, but it absolutely wouldn’t affect my opinion of you.

I've psoriasis too , so I'd take no notice . I'd be care of steroid use though because it can cause rebound flares and actually make it worse.

Wouldn’t bother me at all. I’d only be concerned with the reason I was seeing you.

I have a friend with ot. It depends on the job as a 'might' have an issue secretly. (Would never say ) I am a bit phobic about hygiene and of I was with you In a medical or food capacity it would bother me if I'm honest, if it's a professional capacity, banking etc. Absolutely wouldn't bother me at all.

I would keep pressing for treatments tbh don't get fobbed off

Zero judgement.
However, a lot of people have no understanding of the condition and their imaginations can run wild with the 'elephant in the room'.
Just mention the unmentionable, put it to rest. Particularly if you work with children. 🌷

Absolutely not! I've had my fair share of skin problems so I'd probably feel more comfortable with you if anything.

I have psoriasis, I'd be entirely understanding, well actually I'd not mention it but in my mind that would be because I hate it if someone draws attention to mine.