How I Dealt With Psoriasis

Photographed by Lauren Perlstein.
A few months ago, I got a super-mild case of strep throat. It had happened pretty much right after I was traveling, so I didn't even think twice or try to "wait it out" — I went right to ZocDoc, booked an appointment, and told my doctor that he was going to give me amoxicillin, which he did. A week and a bottle of Juice Press Proviotic later, I was all better — cured!

Then, about one week later, I noticed some bizarre red dots lining the insides of my arms. They were dry and sort of scaly, so I called in a whole host of insanely rich body lotions and creams and hoped they'd go away. To my utter annoyance, nothing worked.

Another week later, it got bad. The red dots began to appear all over my back, legs, chest, abdomen, and arms — even in my damn belly button. After one night of particularly heavy drinking, I became a bona fide red reptile. I immediately scheduled an appointment with my dermatologist, and hid under layers of clothing in the meantime.

This is where the story gets complicated. I was asked if I had ever had psoriasis (no), if anyone in my family has (texted Mom: also, no), and if anything like this has ever happened before (no). It must be an allergic reaction, the derm said, and I was sent away with a prescription for a steroid called prednisone.

Guess what? The patches cleared up! Until I finished the prescription, of course. The very next morning (I shit you not), I was a DISASTER — red, itchy, angry patches appeared all over again. This time, they showed up on my forehead and crept up my neck behind my ears. I had to appear on camera with Candice Swanepoel covered in the patches, because God is cruel.

Finally, a second opinion revealed the diagnosis: guttate psoriasis, a skin condition triggered by the strep virus.

The tricky thing about this condition, according to dermatologist Michael Gold, MD, is that there's still a whole lot of learning to be done about it. But, luckily, it's being researched now more than ever. "It's a genetic, immune disease that results in the skin turnover of cells working much faster than in others, resulting in what we call 'plaques' of silvery scales," he explains. "It most commonly occurs in areas of trauma — elbows, knees, buttocks, scalp — but can be anywhere on the body."

Treatments vary. Sejal Shah, MD, a dermatologist here in Manhattan, prescribed a topical steroid cream for me to use twice-daily five times a week. But, if I went even a single day without it, I felt like I'd be almost back to square one. I switched to a topical retinoid, and I liked the results a lot better. "You can also use moisturizers and salicylic acid, lactic acid, urea creams, coal tar, or bathe with sea or epsom salts," says Dr. Shah. 

Eventually, she recommended phototherapy — exposure to specific wavelengths of light — because the condition was slow to respond. She wanted me to come in three times a week. "It only takes five minutes." I responded: "You must not work for the Internet." (Plus, I wasn't too comfortable with the UV exposure, anyway.)

It wasn't until I was getting a facial at Thermes Marins in Monte Carlo that I had an epiphany. "You're just like me," my facialist, Gabriela, said with a smile when I took off my shirt. "Guttate psoriasis, right?"

I actually hugged her. It sounds so silly — especially considering all of the things people go through with their bodies and image, and that I was still healthy and doing totally fine — but it was nice to know someone else had gone through this, and could see it in me! I was tired of feeling self-conscious when I was naked in front of my boyfriend, for example, or have to skip out on a beach trip with my family because I was embarrassed about my body. Macrene Alexiades, MD, PhD, another NYC-based dermatologist, points out that 2 to 3% of the population suffers from psoriasis, but it can often manifest as so mild that it goes unnoticed.

Gabriela immediately told me I was doing everything wrong. She instructed me to throw away any scrubs, all chemicals unless they were salicylic, and lower my dose of retinol. She told me I needed to stay away from cheese (which, as you already know if you've read my writing, I simply won't do), and to avoid alcohol (which I did do). "This is your body telling you to take care of yourself," she said. 

Dr. Alexiades echoes this sentiment, telling me to find time to exercise and, yes, to cut back on the booze. "You have to stay on top of treatments and consult your dermatologist regularly," she says. 

I'm only now starting to clear up — it's gone from my arms, miraculously, and it's starting to disappear from my torso. I have been using loads of CV Skinlabs body products, and I'm seeing faster results than I did with any steroid or topical retinoid. 

But, there's another end of the psoriasis spectrum — it can be painful, red, and intensely itchy. "Severe cases need biologic drugs to be cleared," Dr. Alexiades says. "They're called anti-TNF (anti-tumor necrosis factor) drugs, but they can cause risk of life-threatening infections." Still, all three doctors consulted for this piece agree that they work the best. 

Dr. Gold names a few — Enbrel, Humira, and Stelara — and adds that a few others are still making an entrance to the market. "They're injectable medicines that affect the immune system, targeting the blood products that actually cause the skin to turn over so rapidly."

With these drugs, even the most severe cases of psoriasis can expect to see results in two to three weeks. I, on the other hand, have been experiencing recurrences for the past five months. I'm hoping time will heal all, and I'm keeping up with my daily body lotions. But, it's good to know there are other options out there...especially as swimsuit season approaches. 


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