"You have to advocate for yourself."

Candice Puccio
Chapter 1
Under Control, Until It Isn't

I've had psoriasis for years, but honestly it was a long time after I first noticed the symptoms that I finally received a firm diagnosis. I first noticed patches when I was 18 years old, right after I graduated high school. It was after I got married that a doctor finally mentioned, in passing, "Oh, you've got psoriasis there on your elbows," and I thought, "So that's what that is."

Parts of my body had been itchy, on and off, for years, but the psoriasis had been quite stable. That doctor gave me some cream, and what I thought was just dry skin went away for the most part. At least it didn't flake as badly as it had before, and I figured that was the end of that. I used the cream and it stayed largely under control until after I had my second child. That's when I had my first, bad flare. That was also right around the time that we moved from South Carolina to our new home in upstate New York, where I found a new doctor and began to get everything under control again -- with dietary changes, stress management, new topical creams, that kind of a thing. Luckily -- from my perspective, anyway -- I haven't had to do any biologics so far.

Chapter 2
Teaching Tool

Like so many people, my understanding of psoriasis when I was first diagnosed was extremely limited. In fact, my concept of this condition was that my own vanity might take a hit -- it might have an effect on what clothes I wear in the summer or something -- but that would be the extent of the problem. I simply did not comprehend, at first, what a chronic condition entailed -- and how severe psoriasis can really be.

You know, I remember when the symptoms first began, I was right out of high school working at a grocery store, and we had this little old lady as a regular customer. Keep in mind, this was the South, and she would see these marks on my skin and offer to, as she put it, "pray away" my warts. That's what she thought it was: warts. That always made me really self-conscious. And even later, when I knew what I had, people would say things that made me uncomfortable. I remember wearing shorts to a doctor's appointment, and my daughter's pediatrician looking at me and asking, "My God, what did you do to your knee?"

But my husband and I have tried to use my condition as a teaching tool, in a way. We're very straightforward about it with our two girls. When they were younger, they would come up to me and say, "Oh, a boo-boo!" and they'd want to kiss it and make it better. As they got older, we could talk more openly about it. Poor things -- with a mom who's a nurse, sometimes maybe they get a little too much information!

Chapter 3
Knowledge Is Power

This might not be the most original advice for anyone newly diagnosed with psoriasis, but it's worth repeating: educate yourself. Research and keep researching, because there are so many advances taking place in the study and treatment of this disease, especially right now. Don't misunderstand me: there's never a good time to receive a psoriasis diagnosis. But I do think that right now it's far better than it was even ten years ago. There are more treatments out there and there's a lot more research being done. But even with all of that, you have to advocate for yourself.

All that being said, it's easy to get too much information. Wikipedia is wonderful, but no one should ever, ever consult it for medical advice. The National Psoriasis Foundation's website, on the other hand, is a great place to start. It helps so much to realize that there are other people out there, many other people, who truly understand how you feel. And there is hope in that sort of community.

But maybe the most important thing people need to understand right away is that this condition affects your whole body, and you have to take care of your whole body in order to fight it effectively. Too many people think of psoriasis only as a skin problem. But it's not. And the quicker someone diagnosed with psoriasis understands that, the better his or her chances of taking control of it really are.