Remembering the exact moment a mean-spirited sorority sister commented on an insecurity in the middle of a chapter meeting was a turning point in a certain writer’s life. Simply because she didn’t like a new rule her House Manager instilled, “Shay” blurted out, “She’s just mad because she’s balding!”. A room of 60 snickering girls (most of whom could have used a good scrub down and A LOT more mascara), combined with having Androgenetic Alopecia, created a heart-wrenching moment that is forever branded into memory. The kicker is that “Shay” was the absolute cliche-brought-to-life of the stereotypical, low-IQ sorority girl who should’ve been given a chastity belt… and some mouthwash. Nonetheless, the psychological effects of skin disorders go deeper than the eye can fathom. Being bullied, enduring commentary from peers and/or constantly hearing “clear skin, clear skin, clear skin” on every other TV commercial can punish the self esteem. Before passing judgment or failing miserably at nonchalantly glancing in someone’s direction, educate yourself. And for goodness sake, stop staring.
Below is a brief explanation of common skin disorders and does not include conditions caused by lifestyle choices (such as Stasis Dermatitis caused by poor circulation/skin ulcers from being overweight), diseases (like Dermatitis Herpetiformis in the Celiac-afflicted) or infections (ie. Ringworm or Herpes). Because, we’d be here all day…
- Acne is a skin disease that occurs in anyone from pubescent boys to menopausal women and produces unsightly pustules, deep-rooted blackheads and inflamed skin. There are 4 grades of Acne and the higher grades may cause severe infection, painful nodules, impaired barrier functioning and large pock marks. Medical prescription intervention is usually necessary for severe cases and Acne can take years to resolve and heal, leaving behind scars and painful memories. Pimples are not always thought to be a “big deal” by most, but severe Acne is painful, chronic and not easily disguised. And since texture is more difficult to camouflage than pigmentation, cosmetics can actually worsen both the condition and appearance.
- Androgenetic Alopecia, commonly called Male/Female Pattern Baldness, is a genetic disorder characterized by a hormonal imbalance that leads to hair loss in a specific pattern. This pattern of hair loss (in an “M” shape for most) is chronic and usually happens in later adulthood. On a positive note, if this condition sets in before the age of 30, the thinning hair usually stays the same instead of progressing. Although it’s equally as debilitating with both sexes, balding in men is more culturally accepted than with females. Minoxidil (Rogaine) and Finasteride (Propecia) are commonly used to regrow hair, despite the fact that neither are technically unisex in nature. When utilizing these topicals, females may also notice excessive facial hair growth and/or increased Acne, which can be problematic and deter females from seeking further treatment. Androgenetic Alopecia should not be confused with autoimmune Alopecia Areata, a condition in which the immune system starts to attack the hair follicles. Areata occurs in patches instead of a set pattern and localized cortisone shots may help regrow hair. It can be reoccurring and may be triggered by hormones (usually post-pregnancy or pre-menopause) , stress or traumatic events.
- Psoriasis is a chronic, autoimmune disorder with a distinguishable rash-like appearance. It is the most misunderstood and “judged” condition if you’re not educated. In a nutshell – the body tries to heal itself by creating extra skin cells, but the Epidermis is not able to “keep up” or shed this skin like it normally does. Thus, inflamed patches of flaky skin form and these may be extremely itchy, red, scaly or “plaque-like”. The skin becomes hypersensitive to medications, fragrances, certain materials/fabrics, temperature changes, stress and inflammatory foods. Psoriasis usually favors the elbows, knees, hands and feet since these areas contain large amounts of bone; which is why Psoriatic Arthritis is Psoriasis’ big brother. Almost always, steroids are the only relief and most individuals develop Psoriasis and/or Psoriatic Arthritis before the age of 40.
- Eczema, also referred to as Atopic Dermatitis, usually begins in infancy and occurs in three stages (infancy, childhood, adulthood) with flare-ups being minimal between stages. This chronic and genetic disorder may be triggered by allergies, topical products, stress and climate changes. Extreme itching, lichenification (thick skin patches) and dark markings from a continuous cycle of scratching, healing and scarring are common. Quick bouts of “Eczema” during/after pregnancy and during cold seasons may not actually be Eczema, but rather it’s temporary irritation and sensitized skin from lifestyle changes and/or environmental factors. These symptoms usually subside, whereas Eczema is genetic and incurable.
- Hyperpigmentation is the darkening of the skin, with inflammation being the main culprit. Hyperpigmentation may occur due to UV-exposure (freckles, sun-spots), hormonal changes (Melasma) or post-trauma (Acne, Eczema, scarring). The surface area afflicted by Hyperpigmentation varies, with Melasma covering a larger area of the face in a symmetrical pattern and UV-exposed areas being more dispersed with smaller, possibly darker “spots”. Melasma is usually the most noticeable and difficult to treat since it is hormone-induced (birth control, pregnancy, menopause, HRT) and may not subside, even after the hormone imbalance is normalized. UV-exposure deepens the color and widens the affected area. Nevus Flammeus or “Port Wine Stains” affect children/infants and are often mistaken for birth marks. These are caused by weakened nerve fibers, which leads to expanded capillaries under the surface. These capillaries increase the amount of blood flow to the area, thus, forming a bruise-like appearance. Port Wine Stains cannot be prevented during pregnancy and may change in color and texture over time. They also do not usually go away on their own and Laser Therapies may be used if this discoloration affects the child’s self-esteem (especially during teen years).
- Hypopigmentation is the lightening of the skin, also caused by inflammation; and can come from scars, burns and UV-exposure. Two types of Hypopigmentation are more serious and chronic than others: Vitilago is an Autoimmune Disorder which causes the body to attack the “pigmented” skin cells. Smooth, white patches of skin may appear all over the body, hands and face. Some prescriptions may trigger the melanocytes to produce color in the skin and “re-pigment” areas. Albinism is an inherited disorder that involves the absence of pigment from the hair, skin and eyes. Albinos are extremely sensitive to the sun since their defense mechanism (melanin and the ability to tan) is completely nonexistent. There is no cure for Albinism and animals may also be affected by this condition.
- Dermatosis Papulosa Nigra (DPN) involves growth of dark “moles” on the surface of the skin. These growths are benign, do not affect the skin’s health and are usually limited to darker skin tones. Size and amount usually increase with age, but they only need to be removed by Laser or Cryotherapy for cosmetic purposes. Morgan Freeman is a great example of someone with DPN. The cause of DPN is unknown but is usually hereditary. Actinic Keratosis is very similar, except these lesions are caused by years of sun exposure and the growth tends to be flatter, flesh-colored and scaly. These AK patches are not typically worrisome, but a small percentage may develop into skin cancer with unprotected UV exposure. Dermatologists sometimes refer to AK as being “pre-cancer” and may remove an area after examining.
This article wasn’t written so you may take pity; but instead, to incite understanding and empathy while learning to control initial negative reactions. Your skin is an accessory you can never take off. And people are mean. Chronic, unpreventable conditions may be cause for an ossified lifestyle and reluctance to engage in social activities, all because of something that is out of our control. Most inflicted individuals spend hard-earned money and time on minimizing symptoms or attempting to disguise conditions entirely, while most treatment isn’t covered by insurance. It’s an uphill battle and easy to roll right back down after a quick, judgmental glance or snarky comment. Sticks and stones may break your bones but scrutiny is the real self esteem killer.