Psoriasis is an inflammatory condition that causes skin cells to grow rapidly and build up on the skin’s surface. In addition to being itchy and painful, these plaques can cause redness and change the appearance of the skin, which may lead to body image issues.

Many people with psoriasis find that their self-esteem is impacted by their condition. Body image issues and poor self-esteem can also lead to anxiety, further impacting the quality of life of people with this condition.

However, research suggests that developing coping mechanisms and a strong support network can help improve confidence and acceptance among people with psoriasis.

To better understand how psoriasis can impact body image and the strategies you can take to cope with these issues, we spoke with advocate Alisha Bridges. She is a health activist, comedy enthusiast, and fashionista with a passion for sharing her psoriasis journey.

Bridges was diagnosed with psoriasis at 7 years old after a case of chicken pox left her skin 90% covered in psoriasis patches. In this article, she shares how psoriasis has impacted her body image both as a child and an adult, and how she has learned to embrace her condition and overcome her issues with low self-esteem.

This interview has been edited for brevity, length, and clarity.

Psoriasis has definitely had a negative impact on how I look at myself. I’m very critical about myself and my physical looks. It has affected my confidence and my self-esteem.

There are a lot of societal pressures when it comes to looks and attractiveness and what beauty means. Those challenges are even more difficult being a Black woman.

I remember growing up with this condition, and a lot of my peers — especially Black peers — had never heard of psoriasis or knew what it was.

That lack of knowledge impacted my experience because I spent a lot of time trying to explain psoriasis to others. Psoriasis is not heavily talked about in the Black community, and having to explain my condition to peers was a lot of responsibility for an adolescent.

Growing up, psoriasis impacted the clothes I wanted to wear and my willingness to do certain activities — like go to the pool, learn how to swim, play sports — because I did not want to have to wear the uniforms.

There was a lot of stuff that I would have liked to do but didn’t because I was scared of what people would say when they saw my skin.

I remember being on the track team in the fifth grade and being terrified of having to wear the uniforms because of what people may say. I also remember taking a swim class and having to put on a swimsuit. The questions from my peers at that time were just too overwhelming. That’s the moment when I started to isolate and hide.

As an adult, body image issues do not come up as often as they used to because of the work that I’ve been able to do in advocacy. I’ve been working as an advocate for the last 10 years. I’ve built a lot of confidence through that work.

I definitely have empathy for my past self and what she had to deal with, though. Today, dealing with psoriasis is a totally different experience, but I’m also no longer 90% covered due to effective treatments. I do often wonder how I would handle going back to being 90% covered as the new person I am today.

I have several strategies that have helped me embrace my condition. One would be working with the National Psoriasis Foundation. I first worked with them was through a mentorship program, where they connect you with another person living with psoriasis who is thriving and not letting it stop them.

Then I went to a volunteer conference, and for the first time, I was seeing other people living with psoriasis. It really inspired me to stop living in shame with the disease.

Since then, I’ve just been able to talk about my condition in a very public way. The more I talk about it out loud, the more comfortable I get with it. When you share your story, you start to have all these people come to you like, “Oh, I have psoriasis. I deal with insecurities.” That vulnerability has definitely helped me to get rid of a lot of the shame with this condition.

I remember when I first started sharing my story, all these people from college who also had psoriasis started confiding in me. These were people that I crossed paths with on a regular basis, and none of us knew that we were dealing with that condition at the same time.

I also suggest surrounding yourself with supportive people. I used to fear going out to the pool, going to the beach, or other public spaces, because I didn’t want anyone to think I was contagious. What helped with that was having friends around me in those moments because it kind of sends the message, “All right, she has other people around her. Other people shouldn’t be afraid.” That gives me a lot of comfort.

The most important thing you can do is work on your confidence, and that process is going to be different for everybody. You have to understand that when someone has something negative to say, it’s less about you and more about their inability to have empathy and compassion for something that’s different outside of themselves.

You can’t control that. The reality is you may encounter people who aren’t very understanding or kind when it comes to seeing visible conditions. You can’t control whether somebody is going to be negative toward you. And because you can’t control that, it’s best to gain the tools and the skills needed to deal with it.

For many people living with psoriasis, the visible symptoms of their disease can negatively impact their body image, self-esteem, and mental well-being.

But with a supportive network of friends, family, and peers, overcoming these issues and embracing your skin is possible.

Sharing your story or hearing from others with psoriasis can help build a sense of community and remind you that you are not alone. If you are looking for somewhere to start, the National Psoriasis Foundation has a mentorship program that can help connect you with someone else living and thriving with psoriasis.

Alisha M. Bridges is an award-winning writer, public speaker, media consultant, and health activist. She advocates on behalf of patients to bridge the gap between the medical community and those living with chronic disease.