Why the Pain of Psoriasis Keeps Me From Caring For My Skin

Living with psoriasis is simply painful. I make this statement with confidence after forty-plus years of battling chronic, severe psoriasis.

There are the trials and tribulations of countless treatments tried and failed. I can share story after story of the stares and questions that have come with having a stigmatized skin disease. Not to mention the exorbitant out-of-pocket costs for moisturizers, medication copays, and doctor visits that add to the cost of living with psoriasis.

All very painful. It’s the physical pain of psoriasis, though, that often goes unmentioned. I don’t really talk about it. I just feel it.

How my painful psoriasis impacts my life

Some people associate psoriasis more with itch than pain. My psoriasis hurts as much as it is itchy. When I do scratch, the psoriasis lesions feel like they are burning or on fire. They become sore. That momentary sense of relief from scratching that itch unfortunately can lead to cracking and bleeding skin.

Even if I don’t scratch my psoriasis, the plaques often feel tender from the inflammation alone. In those moments just sitting in my chair to work, or laying down on my side to sleep, becomes a painful experience with achy psoriasis.

If my psoriasis is flaring and especially reactive, the discomfort ramps up exponentially. Existing lesions get redder, thicker, broader, and inflexible. This new outbreak is sensitive to the touch. When psoriasis hurts I become withdrawn and want to avoid thinking about or dealing with my skin--including starting my evening skincare routine.

Delaying my evening shower

I shower every evening without fail. It’s the first item to tackle on my skincare routine. I like the feeling of washing off the dirt of the day. Applying cream after washing replenishes and traps the moisture in my skin. All good.

Showering when my skin hurts, however, is something I tend to avoid. The water from the shower stings my skin. Caring for my psoriasis with creams and ointments after the shower means touching tender plaques.

So, when it’s time to shower in the evening, my brain searches for something else to do instead. I start to watch a Netflix show or catch up on the news of the day. I might even do some work or reply to emails - anything to avoid dealing with my skin.

Getting Behind Schedule

I inevitably get behind schedule when I put off starting my skincare routine, which leads to going to bed too late to get a solid night’s sleep. If my skin is irritated I also find it difficult to fall asleep. Eventually, I’m dealing with a major psoriasis trigger for me: not getting enough rest.

I end up feeling guilty that I’m not taking better care of myself and my skin. When my wife reminds me I need more rest it’s not that I don’t already know I do. I want to shower and get to bed at a decent time. It’s the psoriasis pain and irritation I’m avoiding that overwhelms my best intentions.

Breaking the Avoidance Cycle

At the moment, avoidance feels like a good way to respond to anything unpleasant. Psoriasis is something I count as irritating and frustrating. I can understand why I don’t want to face my psoriatic skin any time of the day. But with that avoidance comes the consequence of potentially worsening psoriasis.

Breaking the negative cycle of avoiding painful psoriasis begins with a thought. I imagine a big yellow sticky note that says, “Care for your skin. Soothe the inflammation that is causing the pain.” If it helps you to break a cycle of avoidance you can come up with a personalized reminder or use a real sticky note. Whatever method works attack the problem at its source.

Share the pain

I’m working on sharing the pain with others too, and I feel better. Telling my wife the other day that my skin hurts led to her better understanding of my evening procrastinations. She hadn’t realized how much soreness and stinging I experienced, or why I took my shower so late. I felt heard and motivated to overcome the avoidance.

I also need to reach out to my dermatologist when my psoriasis is especially symptomatic. I’ve discussed possible treatment options with her to try when my current treatment isn’t working as well. I need to check with my doctor when the pain of psoriasis hinders my ability to function well in my daily life.

Tonight, I’ll face that daily challenge of starting my skincare routine with painful psoriatic skin. My scalp psoriasis is flaring these days, so washing my hair isn’t high on my list of things I want to do. This time when the clock strikes that hour, though, I’ll pull up in my mind that imaginary sticky note. What happens next is up to me.