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It’s Just Cosmetic…NOT!


Dr. Katie Beleznay is a Clinical Instructor with the University of British Columbia Department of Dermatology. She focuses her research in the areas of acne, rosacea, psoriasis and photo protection. You can follow Dr. Beleznay on Twitter here or on LinkedIn here.

One of the complaints I hear most often from patients who suffer from chronic spontaneous urticaria (CSU) and psoriasis is that other people with “normal” skin don’t understand what it’s like to deal with a chronic skin condition. People will often say things like, “Don’t worry, it’s just cosmetic” or “Can’t you just put some lotion on it or cover it up with makeup?” I’ve even heard people comparing it to birthmarks. I’m sure that those replies make me as angry as they make you. The reality – as anyone who suffers from one of these conditions knows – is much different. Sometimes you have to just face the truth that people just don’t understand.

How it affects your feelings

Dermatologists use a quality of life score to assess the severity of certain skin conditions known as a Dermatology Quality of Life Index, or DLQI score. The DLQI is a 10-question questionnaire that looks at six different domains including symptoms and feelings, daily activities, leisure, work and school, personal relationships and treatment. Want to know which skin conditions make the list of being some of the worst-scoring? Ding ding ding! If you guessed chronic urticaria and psoriasis, you’re right1! What that means is that patients with these conditions often suffer greatly, with the effects reaching far beyond the skin. A chronic skin condition can impact a person’s relationships, social activities, work and overall self-confidence.

Not just cosmetic

For anyone out there thinking that these skin conditions are “just cosmetic,” it’s important to understand that there are symptoms on many levels. The condition itself can cause significant discomfort. Just look at how it can affect you when looking for a job or exercising. And yes, there are cosmetic concerns that many patients have. Red flares and flaky skin is not exactly a fashion accessory. But unlike other skin conditions, psoriasis and CSU have symptoms that a patient may endure for years.

For someone with a chronic condition, obviously the manifestations on the skin are a primary concern, and getting flare-ups under control is the first objective of any treatment plan. At the same time I always counsel my patients on the potential emotional and psychological side effects. Even when a flare-up may not be active, there is often anxiety that persists. My goal is to help patients feel like they can remain in control of their lives.

If you are dealing with psoriasis or CSU, it is important to acknowledge how your condition affects various aspects of your life: how you dress, what you do and how you interact with others. While treatment plays an important role in managing a chronic condition, knowledge and self-awareness are essential to improving overall quality of life.

  1. Lewis and Finlay, J Invest Dermatol Proc 2004; 9:169-180.

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