Psoriasis and Body Image

Psoriasis and Body Image

Joni Kazantzis was 15 years old when she woke up one morning covered with red, scaly spots that looked a lot like chickenpox. It happened overnight, so her mother thought it may have been an allergic reaction. But within the same week, she got a diagnosis: guttate psoriasis. That’s a type of psoriasis that shows up as small, round spots called papules. The papules are raised and sometimes scaly.

As a high schooler, being covered in spots made Kazantzis incredibly self-conscious and affected her confidence. In fact, she says she has no photos from that time because she wouldn’t let anyone take them. Treatment was an ordeal, too.

“When I was first diagnosed, I was sent home with a bunch of creams — really greasy and gross creams — with the instructions to put them on before bed and put on Saran Wrap to make sure it stayed on all night. I just remember it feeling disgusting and gross,” says Kazantzis, now 38 and living in Princeton Junction, NJ.

The Stigma

Research shows psoriasis can negatively affect body image, self-esteem, and quality of life. It may also impact your mental health and cause anxiety in social situations.

There’s often a level of stigma attached to the condition, according to Rebecca Pearl, PhD. She’s an assistant professor in the Department of Clinical and Health Psychology at the University of Florida.

“One of the common stereotypes that’s documented in the literature and that we hear from patients is the assumption that the skin disease is caused by poor hygiene, and that people are dirty when these physical lesions are seen,” she says.

Howard Chang, an ordained minister who’s had severe psoriasis since age 9, says he was bullied in high school. An incident in the boy’s locker room still stands out to Chang, now 49.

“A couple of boys from the football team really started to go at me. They asked me if I had AIDS and they said, ‘Get away from me. … ’ I thought that they were going to get violent,” he says. “I was really depressed and socially withdrawn, especially through those younger years into college.”


Kazantzis had a very accepting and supportive group of family and friends. It was assumptions and rude comments about her skin by adult strangers that left her feeling uncomfortable. As a teenager, she vividly remembers a middle-aged lady berating her for being on the beach with what she thought was chickenpox.

“A simple question would have changed the situation,” Kazantzis says.

Everyday Challenges

Something as simple as picking out what to wear each day can be hard. This was true for both Kazantzis and Chang. Each tried to hide their red, scaly skin as much as possible.

“I wore pants up until it was probably way over 80 degrees,” Kazantzis says.

For Chang, who grew up in Northern California, long sleeves and full-length slacks or pants became a wardrobe staple despite the scorching 105-degree summers. The only time he didn’t have a choice was when he ran track in high school, a sport he loved. Chang just wanted to run but couldn’t help feeling “self-conscious all the time.”


“Always being on guard” can take a toll on your mental health and affect day-to-day quality of life, says Pearl.

“These kinds of concerns about being judged by others, or being rejected by others, is a form of stress. And that kind of anticipated rejection from others, be [it] on one’s body or stigmatized characteristics, can be sort of a constant threat in their daily life,” Pearl says.

Coming to Terms

Joining a faith fellowship his sophomore year of college and finding a supportive group of friends, along with his wife, was a turning point for Chang.

“I found acceptance there,” he says. “They saw me

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