Photo Courtesy of Jay Wofford
It’s just a weird-looking pimple; maybe a mosquito bite. That’s what Jay Wofford thought when he noticed a breakout on his abdomen the summer before his senior year in college. Within a week, dozens of small red spots covered his back, chest, abdomen, arms, and legs. He made an appointment with a dermatologist, who took one look at Wofford’s lesions and knew right away what it was: psoriasis, a chronic inflammatory disease that typically affects the skin and, sometimes joints.
Like many people with the condition, Wofford was diagnosed with plaque psoriasis. One of five types of psoriasis, it’s characterized by red, raised patches of skin covered with thick, silvery-white scales—also known as plaques—that appear on the scalp, elbows, knees, lower back, hands, and feet.
“The immediate impact on my life was pretty drastic,” says Wofford. Most notably, his social life took a hit. Things he didn’t think twice about before his diagnosis, like dating or hanging out at the pool during the summer with friends, suddenly seemed out of the question.
Wofford began treating his lesions with a combination of steroid creams. Also, per his doctor’s recommendation, he got regular exposure to sunlight, which, because of its UVB rays, can slow the rate of psoriasis skin growth.
One thing he wasn’t able to change? His exercise routine. A long-time competitive tennis player, Wofford didn’t have the luxury of taking time off from the courts. “We had a regimented workout schedule, which continued,” he says. He survived with the help of a few wardrobe work-arounds. “I chose different clothes, usually long pants and sleeved shirts, whenever I went to the rec center or gym for workouts,” he remembers.
After about four months, his skin cleared up. Over the next several years, Wofford was lucky enough to experience very few flare ups, and minor ones at that—much less severe than his initial bout. However all of that changed in 2012. The then 24-year-old started medical school and discovered first-hand how stress can be a huge trigger for psoriasis.
Ironically, he’d long dreamed of becoming a dermatologist; his diagnosis gave him an added impetus. He specifically chose a program in Dallas headed up by an expert in psoriasis. But the immense studies and a practical workload sparked bad flare ups. “I suspect the move to Dallas and starting my internship played a role in my condition worsening,” says Wofford. “Until then, I was able to control my condition. However the psoriasis covered significant parts of my skin and had become more recalcitrant to topical treatment. I tried different oral systemic treatments, none of which made a significant long-term difference in my skin.”
As he learned more about the disease—both on a personal and professional level—he came to understand why depression is a common side effect. “Even when my psoriasis flares cleared up, I knew it was always lurking in the background and it was only a matter of time before it returned.” Wofford, now in a committed relationship, didn’t have to worry about navigating the dating world. But living with the unsightly plaques, and the fear that something like catching a cold could trigger a flare, he could certainly understand how all of the above could impact mental health. “People who don’t know what psoriasis is or looks like often think it might be something contagious and they make comments or stay away,” he says. “This is one of many reasons that depression is a well-known comorbidity with psoriasis, and depression rates are significantly higher in psoriasis patients than the general population.”
Knowing this, Wofford decided to be proactive about his mental health. “I knew the alterations I was making to my life during flares were temporary, so I started to look at the condition as more of an annoyance and inconvenience rather than a chronic disease. I focused on short-term and long-term life goals, like studying dermatology,” he explains. Because I was able to continue working toward these goals without any negative effects from psoriasis, I was able to regain my happiness and keep my mental health in check.”
Now 34 and married, and a practicing dermatologist in Dallas, Wofford knows first-hand how far the dermatological community has come in developing groundbreaking and extremely effective treatments for psoriasis. “Prior to this, when there weren’t as many good treatments, my psoriasis was intermittent and would show up at inopportune times,” he says. “Now, with appropriate treatment, psoriasis has little to no effect on my life.”
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