From healthcentral.com
India Bolton opens up about navigating life, motherhood, and flare-ups with plaque, guttate, and inverse psoriasis
Psoriasis comes in many forms (seven, to be precise)—from the most common plaque psoriasis (up to 90% of people with the condition have this type) to the less common inverse psoriasis (affects 21% to 30% of people with psoriasis). India Bolton has both of these—and it doesn’t end there. The 25-year-old homemaker and mother from Pennsylvania also has guttate psoriasis, which is even less common, affecting an estimated 8% of people with psoriasis.
“Guttate psoriasis is my baseline form,” Bolton reveals. “I was diagnosed with it when I was 18 after small guttate plaques appeared on my legs." Guttate psoriasis is a type of psoriasis characterised by small, red, scaly spots that typically appear suddenly on the trunk, arms, and legs, often triggered by infections like strep throat. “I also had a quarter-sized one on my right cheek, and it then spread to my earlobes,” says Bolton. Initially, she thought the plaques on her legs were just bug bites, as it was the end of summer, until they appeared on her face and ears.
In October 2024, after seven years with guttate psoriasis, Bolton’s spots became more widespread. She then caught strep throat, COVID-19, and two bouts of flu during the fall and winter. “Since then I have also had inverse psoriasis,” she says. This type of psoriasis causes smooth, red, inflamed patches in skin folds such as under the breasts, around the genitals, and in armpits, often worsened by friction and sweating. “For seven months last year, I struggled with large plaque psoriasis on my whole back and stomach,” she says. “However, I am grateful to have my plaque psoriasis in ‘remission’ at this time.”
Finding Treatment
Bolton’s treatment journey started with topical steroids, but like many people, she discovered after using them for several years that they became ineffective for her. Because she is super sensitive to medications and is allergic to a lot of things, even antibiotics, the only medical psoriasis treatment she uses is UVB light therapy: “It’s the most ‘natural’ medical thing I can do,” she explains. “Last year, I had twice-weekly sessions of UVB for seven months—a lot longer than most people, as I was told it’s not usually used for cases as severe as mine.”
Bolton is also a passionate advocate of natural healing and stress management, recognizing how strongly anxiety can trigger her psoriasis. In addition to skin-specific treatments, she attends therapy, works out regularly, spends time outdoors, and makes space for hobbies like reading—all of which help her manage stress and support her overall well-being.
Managing Flare-Ups and Triggers
Typically, every other year Bolton experiences a really bad flare: “It’s painful and usually affects my legs, torso, face, and scalp. Last year, I had a full-body flare that lasted almost the full year—my longest yet.” When a flare starts, Bolton ramps up her at-home therapies: lots of rest, self-care, sunlight, avoiding her triggers, and taking Epsom salts baths. She has a tried-and-tested diet she follows when her skin is in rough shape, which involves avoiding her biggest trigger foods: gluten, dairy, nightshades, spice, and ground beef.
Emotional and Social Challenges
Having three different types of psoriasis means Bolton never knows which of them might flare at any particular time. But the physical aspects of psoriasis don’t pose the biggest challenge, she reveals. “The hardest thing to deal with is the staring and pointing from strangers,” she says. And this spreads to Bolton’s online world; despite her commitment to raising awareness of the condition via her social media accounts, where she shares advice, product recommendations, and personal ups and downs, “I’m asked several times a month online if I have AIDS,” she says.
The mental and emotional load of living with a chronic, unpredictable, and at times an incredibly painful condition is another pressure that can never be completely eliminated. “I was very depressed last year during my pregnancy,” Bolton shares. “During my first pregnancy, I barely had any flaring at all, but this time was the complete opposite.” She accurately points out that about half of women see remission or improvement in their psoriasis symptoms during pregnancy, adding, “I was unlucky my second go-around…It was really hard,” she shares. “But connecting with my online community during this time helped me enormously.”
Her son is now 6 months old, joining two older sisters, ages three and eight. Bolton is grateful that her psoriasis has never impacted her parenting in any major way.
Finding Strength and Positivity
The challenges of living with severe psoriasis are evident, but Bolton says having three different types of the condition has brought many positives into her life. “Because of my psoriasis I have higher self-esteem than I used to, which is kind of ironic really!” she says. “It’s also forced me to find genuine friendships and connections that value me as a person—for who I am, not just what I look like.”
Bolton believes that having psoriasis has helped to shape her to be the woman she is today. “It has made me more aware of those around me with challenges, and I am actually so grateful for that,” she says. “I’m also grateful for the self-love I have found as a result of my psoriasis, as well as the ability I now have to help others in their own journey.”
On that note, her advice to someone who has been diagnosed with psoriasis and is finding it difficult to cope is simple: “Your skin does not define you.” It’s something she tells herself and others frequently—and you might have to do the same, because it can take a while to get to that stage of recognition. Something else Bolton has learned in the years since her first diagnosis is that there’s a huge amount of power in knowledge. “Take every chance that comes your way to advocate for yourself and educate others,” she says.
https://www.healthcentral.com/condition/psoriasis/what-its-like-managing-three-kinds-of-psoriasis
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