It took decades for Caroline Irwin to find an effective treatment for her psoriasis, which she has had since childhood. She tells Ailin Quinlan about living with the condition.
CAROLINE Irwin was just nine years old when it started.
There was no apparent cause, or at least, none that her doctor could see for the thick, scaly, itchy crust which formed on her scalp and gradually inched its way down over her forehead.
The horrified child applied the creams he gave her and grew a fringe to cover the ugly condition which, the doctor explained, was psoriasis, a chronic inflammatory skin disease.
“There was no treatment back then apart from the steroid creams,” recalls the 56-year-old from Ballyfoyle in Co Kilkenny.
The ointments worked to an extent, but were difficult to apply properly and, she recalls, there was no information or advice to be had about the condition, which gradually worsened as the years passed.
By the time she was 18, the thick itchy combination of silvery scales and dry red patches which are a hallmark of plaque psoriasis, covered 80% of the teenager’s body.
“It was terribly uncomfortable, itching and bleeding. I was always scratching my skin and shedding skin flakes,” she recalls.
Asked to rate the discomfort level on a scale of one to 10 she jokes that psoriasis rates an 11.
“I was always scratching, shedding skin, and moisturising.”
The disease has had a huge effect on her life. Caroline never learned to swim out of fear of what people might think of her unsightly skin, exposed as it would be in a swimsuit.
She avoided trying on clothes in changing rooms as scales would flake off on the garments, and rarely stayed in hotels as the sheets were left covered in flakes of skin and spots of blood.
Psoriasis even affected her ability to get work as a teenager.
“I got a two-week trial in a deli and was doing well. I was wearing long sleeves but the management decided that staff would have to wear short sleeves.
“They saw my arms and I ended up not getting the job.”
Not surprisingly, depression can be a side-effect of the disease, and the condition certainly got to Caroline at times, she recalls: “You’d end up feeling quite low,” she says, adding that the emotional and psychological effects of the disease can be very negative.
“I’ve met people who are afraid to go outside the door with it, and people who were almost suicidal because of it.
“You spend your life covering up with long sleeves, long dresses and long pants. You learn to camouflage it as much as possible.”
She was admitted to hospital on three occasions with the condition.
Each time the treatment cleared the condition but within three or four weeks, the problem always returned.
During her late 20s and early 30s Caroline lived in Holland, and was treated there, for several years.
“I got similar treatment to what was on offer in Ireland at the time but none of the beneficial effects lasted long term.
“I was quite depressed about it at that stage,” recalls Caroline, whose three adult children have all had mild cases of the condition.
It wasn’t until she was in her early 40s that Caroline — now director of the Irish Skin Foundation which represents people with eczema, skin cancer, psoriasis, and other skin problems — managed to find a treatment that really worked.
“I’m currently on a series of injections which I have been having for 12 years and the psoriasis is almost gone. The injections work very well and I can dress normally,” she says, pointing out that last year the World Health Organisation recognised psoriasis as a chronic illness.
“Anyone with psoriasis has a higher risk of heart disease, type two diabetes, and obesity so we really need to view this condition as more serious than just a skin disease.”
Caroline welcomes the fact that an Irish-made treatment for mild to moderate plaque psoriasis this month becomes available in pharmacies without prescription.
Dovonex Psoriasis Ointment, which has been available on prescription only for the past 24 years, works by slowing down the production of skin cells, which in turn helps to flatten and clear psoriasis plaques.
A once-a-day treatment, it’s popular with psoriasis patients because it doesn’t contain steroids, which means that long-term, it won’t damage the skin.
It will now be both easier and cheaper to buy (about €25 compared to €35 on prescription) because patients will no longer require a prescription for it.
Medical card holders will not be affected by the change, as Dovonex will still be available on prescription and therefore covered by the card.
Things you may not know about psoriasis
- It’s a chronic, inflammatory skin disease.
- It has no known cause.
- It affects the life cycle of skin cells, causing cells to build up rapidly on the surface of the skin and form thick, silvery scales as well as dry red patches that can be itchy or painful.
- Psoriasis affects the skin of the scalp, elbows, and knees and may appear as small flattened bumps, thick plaques of raised skin, pink dry skin, or big flakes of dry skin.
- There is believed to be a genetic predisposition to developing it.
- Psoriasis is not contagious.
- Its intensity can vary at times, so that patients can have periods of clear skin.
- Although medication can control it, it is currently incurable.
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