When Libby walked into a new dermatologist's office recently, the doctor took one look at her and said, oh, you're here for your psoriasis. No, Libby replied, actually she had a wart on her hand that she wanted him to look at. Once the doctor had taken care of her hand, the conversation returned again to psoriasis. OK, said Libby, tell me what's the latest for psoriasis, just for the heck of it. He gave her a sample of cream. "I don't even know what it is," says Libby. "I just took it and put it in my bag."
Libby has had severe psoriasis that covers 70-80% of her body for about three decades, and she is used to doctors and others assuming that she is always seeking the latest treatment. However, that is not really the case. She has tried some treatments over the years, but she hasn't found any of them to be worth continuing. Ointments and creams are absurdly impractical. "Sometimes I get a small tube to try as a sample on my body," she says. "But I have it all over. Which area should I try first? One-eighth of an inch on my ankle?" Once, she participated in a clinical trial involving PUVA. It worked great, she recalls. Her skin cleared and she got a nice tan. However, she was worried about possible side effects, like liver damage, so she stopped going. "You only get one liver in life," she says. [Note: liver problems are more commonly seen with methotrexate than with PUVA, although oral psoralen can adversely impact the liver in some cases.]These days, her preferred psoriasis treatment is a swim in the ocean. She lives in LA about a half an hour from the beach, and during the summer she fits in a dip in the salt water whenever she can. "If I went into the ocean every day, I'd be clear," she says. The sunlight and salt water are "absolutely the best."
Other than that, she pretty much just lives with her psoriasis, but she doesn't let it interfere with her busy life. She works full time as the registrar in a high school, helping students and their families with college applications. Because her husband is disabled, Libby has sometimes worked two jobs, day and night. Plus, she is very social person, spending a lot of time with her wide circle of family and friends. She thinks that her fast paced life might make her psoriasis worse. "Maybe if I just stopped for a bit and read a book or something," she says, "but I'm on the go. I'm just an 'always in the mix' sort of person."
Libby developed what she calls "a textbook case" of guttate psoriasis when she was in her early 30's after recovering from a bout of strep throat. It started on her knees and elbows and then spread to cover most of her body. She was the first person in her family to be diagnosed with psoriasis, but since then her sister, her brother, her nephew, and her great-nieces have all developed some type of psoriasis. Libby's mother had severe vitiligo, a disease that causes loss of coloration of the skin. "So our entire family has this skin thing going on," says Libby.
While Libby doesn't go out of her way to hide her psoriasis, there are limits to what she is comfortable with. She wears short sleeves in the summer, but she is shy about being in a bathing suit around other people. When she goes to the beach, she keeps a towel wrapped around her legs. "I'd love to try snorkeling and go to Hawaii, but that is shorts and t-shirts territory, which is certainly not in my comfort zone," she says. "Too many stares."
In addition to appearing in the Calendar, Libby has participated in a walk to raise money for psoriasis research, and she does what she can in her daily life to raise awareness about psoriasis. When she encounters people who might be nervous about her psoriasis, at the gym for example, she tries to take the initiative and volunteer information about the condition. She thinks there is still a little bit of a stigma attached to having psoriasis, but that it is lessening. "More and more people I find are coming up to me and telling me about their psoriasis," says Libby. "I think it's been in the closet for a lot of years and now people are coming out and saying, 'Hey, I have psoriasis!'"
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