Psoriasis and Shame

15/04/2019 - By Dr. Catherine O'Leary

post preview

I had my hair cut today. If like me you have psoriasis on your scalp, you’ll understand the stress associated with such an everyday activity.

I can’t face sitting in a busy salon with a dark towel over my shoulders. No matter how good the haircut, the embarrassment would be too much. Luckily, I have a kind and understanding hairdresser who cuts my hair in the back room of her house; but even then I cringe at the flakes that flurry onto my shoulders and the floor. I couldn’t bear to have strangers witness that as well. John Updike, the American author, captured the feeling of shame he also felt about his psoriasis:

Nov. 1. The doctor whistles when I take off my clothes. “Quite a case.”…….As I drag my clothes on, a shower of silver falls to the floor. He calls it, professionally, “scale”. I call it, inwardly, filth.

Vladimir Nabokov, another writer with psoriasis, also described his feelings of shame and humiliation “about my bloody underwear, blotchy mug and the scales pouring down on the carpet”.

I’m not alone in feeling ashamed. A study of over 900 people with psoriasis found that shame was one of the most common emotions experienced (Sampogna et al, 2012). Shame had a serious impact on the lives of people in this study; higher levels were associated with a lower level of educational attainment and difficulties in daily activities. 

Participants didn’t seem to get used to having psoriasis: the longer they’d had it, the more shame they reported.

It’s shame that makes us conceal our skin and avoid certain situations. Shame stops us going swimming, wearing t-shirts on hot days, and relaxing whilst getting our hair cut. It’s shame that stops us pursuing our goals and fulfilling our potential. Shame can even drive us to self-medicate with alcohol, drugs and food.

Our feelings of shame can also affect our physical health. Feelings of shame cause our bodies to release various stress hormones including cortisol and pro-inflammatory cytokines (Dolezal and Lyons, 2017). Over a long time, this physiological consequence of shame will cause wear and tear on the body and increase the likelihood of various health conditions such as weight gain, heart disease and hardening of the arteries.

But there are things you can to do help. Read how to manage your feelings of shame here.


  1. Updike, J. (1976). From the Journal of a Leper. 

    The New Yorker

    , July 19, 1976 P. 28.

  2. Nabokov, V. (2017). Letters to Vera (edited and translated by B. Boyd and O. Veronica). New York: Alfred A. Knopf.

  3. Sampogna, F., Tabouli, T., Abeni, D. et al (2012). Living with Psoriasis: Prevalence of Shame, Anger, Worry and Problems in Daily Activities and Social Life. 

    Acts Derm Venereol

    ; 92: 299-303.

  4. Dolezal and Lyons, (2017). Health-related shame: an affective determinant of health?. 

    B. Med Humanit

    ; 43: 257-263.