17 September 2018

Would you visit a public pool if you had psoriasis?

New research finds that a large percentage of people shun those with psoriasis.

Though psoriasis is not contagious, many Americans shun people with the skin condition, new research indicates.

The study included a cross-section of about 400 Americans who viewed images of people with visible psoriasis. Large numbers wrongly thought psoriasis was contagious or only affects the skin, and about one-third said they wouldn't want to invite people with the condition into their homes.

Treating people with respect

"People with psoriasis feel they can't go to a public pool, go to a salon to get their hair done, or are worried about going on vacation with their families," said study senior author Dr Joel Gelfand, who called the burden on psoriasis patients "tremendous".

"This tells us how much work we need to do as a society to make sure people have good health literacy, and understand what these skin conditions are about and treat people with respect," he said. Gelfand is a professor of dermatology and epidemiology at the University of Pennsylvania's Perelman School of Medicine. 

Stigma and misconceptions

A chronic autoimmune disease estimated to affect about eight million Americans, psoriasis causes skin cells to grow too fast and accumulate, resulting in red, scaly patches. Lesions can come and go, and cover varying amounts of skin surface, triggering itching, pain and/or burning. 

Speaking to All 4 Women, South African dermatologist Dr Ayesha Moolla states that nearly 1 million South Africans are affected by this autoimmune disease. 

In moderate-to-severe cases, psoriasis increases the risk of other health conditions related to inflammation, including heart attack and stroke. While the condition can be treated, there is no cure.

Gelfand's team surveyed 187 medical students and 198 laypeople about their perceptions of people with psoriasis. Participants in the online survey were shown eight images of people with psoriasis along with enlarged photos of psoriasis lesions.

The survey participants' reactions underscore the stigma and misconceptions associated with the disorder, the researchers said.

Quality of life affected

More than 54% of lay participants said they didn't want to date someone with psoriasis, and nearly 40% didn't even want to shake hands with them. In addition, 32% didn't want someone with psoriasis in their homes, and 45% said people with psoriasis were unattractive.

The study also highlighted persistent myths: 27% of respondents thought psoriasis was contagious; and 53% considered psoriasis sufferers sick.

About one-third of respondents thought psoriasis only affects the skin, and more than a quarter said psoriasis isn't a serious disease, the findings showed.

Notably, medical students who took the survey showed less stigmatising views, which study lead author Rebecca Pearl called "encouraging".

The study was published online recently in the Journal of the American Academy of Dermatology.

"I think it takes our breath away a little bit in terms of how truly burdened psoriasis sufferers are," said Dr Richard Fried. 


"Psoriasis can be enormously capricious and can steal joy and involvement from people's lives, but it's often unrecognized," said Fried, who is a member of the medical board at the National Psoriasis Foundation. "The data from this study are enormously important."

The study authors said better education about the disease and contact with people who have it could help dispel myths and ease the stigma.

Pearl said it might help if TV commercials for psoriasis medications – which are common – showed patients' actual psoriasis lesions. This could educate the public about what psoriasis looks like to reduce misinformation, she said.

Image credit: iStock