Those who follow my blog, will know that I was hoping to get some tattoos done on my arms. However, I do suffer from psoriasis. It's mostly on my lower legs and my scalp. It's never affected my arms ever. So I didn't even think about it being a problem. But after speaking to the pharmacist, I was advised to be cautious. Apparently even on unaffected skin, trauma can trigger psoriasis outbreaks on the area damaged. And that can happen even if an area has never been affected previously. And when it does happen, it can affect just the tattoo, which means it looks awful. It's something called the Koebner Effect. It can happen straight away or sometimes months later. And it occurs in about 30% of psoriasis sufferers that get tattoos. So I'm not going to go ahead, even though I really want some ink. My health is very important, especially as a carer. And I also can't risk anything that makes dressing difficult or impossible, as I need to dress to keep my mental health intact. So it's bye bye to tattoos for me. I've survived 61 years without them, and I can cope with the disappointment.
It also means that I need to be careful about hair removal. Waxing is definitely out. So is epilation. I need to be careful shaving. I was told it would be best not to remove any body hair at all. Well that's definitely not an option. So it will have to be careful about it. But it's not going to hold me back. I've survived until now with this condition, and I will carry on surviving.
Hmm, I'm not convinced you should give up on the idea just because of one piece of advice even if it does come from a professional. Pharmacists are notoriously negative. After all, they deal with sick people all day long and nothing positive ever comes their way. It takes its toll on their outlook on life.
ReplyDeleteAs someone who herself suffers a debilitating and restrictive skin problem (eczema in my case), I know how careful you need to be at times. But I'd check with your doctor and request a dermatology test that will tell you the risk in your particular case. You could also have a tiny test tattoo done by a reputable artist with clean materials somewhere discreet and see what effects it has. (By "somewhere discreet" I mean on your body, not that hotel that rents rooms by the hour.) Then if that "I love mum" heart on your bum starts to itch, you know tattooing is not for you, and can also explain you have a less embarrassing thing there, like piles.
Kidding, but you know what I mean.
Sue xx
The difference between eczema and psoriasis is that having eczema in one or more areas of the body, is a problem with that area. It's caused by the skin itself being prone to drying and cracking. But unlike eczema, psoriasis is an auto immune disorder. It's the body's nervous system mistakingly attacking itself. So damaging the skin can cause the area of damage to have the overreaction of the immune system which causes the redness and flaking of psoriasis. It's a nasty phenomenon called the Koebner Effect. That said, I've never had the raised and nasty looking plaques that some people have. You can't see a dermatologist on the NHS at the moment because global warming has triggered a skin cancer epidemic in the UK, so the waiting lists are several years. I will give it some thought. "I LOVE MUM" on my bum may be a little inappropriate though.
DeleteYou're not wrong but I should've explained that my own eczema is also immune related, and can arise in odd places for no apparent reason, but it's not psoriasis. So tattoos, jewellery, laser hair removal, makeup and whatnot are stuff I have to think carefully about.
DeleteSorry to hear about the NHS. State sponsored health systems are not in a good state anywhere as far as I can tell but the UK's NHS seems to be really bad right now, at least from what everyone says about it. The test tattoo may be the only way ... ;-)
Sue xx
I think I might try and get a referral to a private dermatologist to check out my psoriasis. And I might get a spot test done by the tattoo artist. I know that I tried to put a brave face on it, but was really disappointed not to be able to something that makes me feel femme 24/7.
DeleteDee xxx
Hi Dee, I'm sorry to hear about the tattoos, but if there's a 30% risk of stimulating a Koebner effect through having a tattoo, I would consider that's too high a risk. On other things, however, such as shaving, waxing etc., I've had plaque psoriasis (amongst other dermatological issues) for about 25 years and have not noticed that effect being stimulated by skin damage (shallow or deep, e.g. surgical excision of a BCC on my snout). Btw, I'm not sure about the 'nervous system' aspect. Plaque psoriasis is auto-immune and is due to areas of uncontrolled cell division in the dermis. Fashionably, its appearance is also considered to have links to the gut biome and/or diet. Also, the NHS will not help in assessments/treatments regarding 'cosmetic' issues (tattoos, or in my case, skin tags!) Also, if the Koebner effect can arise months after damage, would a spot test solve anything?
ReplyDeleteNikki xxx
Sorry, that reads rather negatively ... xxx
DeleteIt's not negative, it's cautious, which is a big difference. At the moment I'm beginning to question my diagnosis of psoriasis, because it doesn't fit the templates for any of the main types of psoriasis and the strong topical steroids and vitamin d treatments, I've taken for it down the years have made no difference to it at all. Also my so called scalp psoriasis seems to be slowly clearing up with a new scalp hydration treatment. So I may have a form of eczema or dermatitis that was wrongly diagnosed by a very poor GP. Apparently people with psoriasis do have test tattoos done. It's a big no no to tattoo damaged skin but my arms have never been affected.by this condition. I think I put nervous system instead of immune system by mistake. I'm so used to writing about nervous system issues because of my wife's neurological condition. Thank for your comment Nikki.
DeleteDee xxx
So sorry to read that you’re not going to be able to get the tattoos you had your heart set on, Dee. It must be really disappointing, but as you say, your health has to come first and it’s definitely not worth taking any risks.
ReplyDeleteI was also going to suggest trying a small, discreet tattoo like Sue mentioned, just to see how your body reacts, but I completely understand why that may not be an option now.
It’s also a shame that waxing isn’t going to be possible for your hair removal journey either. Hopefully you’ll find alternatives that work well for you.
Hugs
Lotte x
There is some hope, as I have never experienced any problems with my arms, and the fact that the so called 'Gold Standard' treatments for psoriasis have never worked a nd my rash doesn't look like any typical psoriasis, could mean I haven't got that condition at all but something different, which may allow me to go ahead. I'm seriously thinking about a patch test. But not 'I LOVE MUM' on my bum as Sue suggests. Thanks for your comment, Lotte.
DeleteDee xxx
I'm sorry you can't get body-altering that you want. I lack knowledge of the subject to opine so let me just offer sympathy.
ReplyDeleteAs we age and experience various ailments certain options get closed off. That's unavoidable. Better than to mourn those losses I find it healthy to focus on things we can still do and change. It may be Pollyanna-ish but it leads to joy instead of despair.
Those are wise words and I thank you for them. Whilst I have totally given up on getting a tattoo, I will just accept it. It's not even an age thing but a condition I have had since I was in my mid 30s, but I accept that in time, other things will happen to close off avenues, and I will just have to concentrate on the things that are left and find joy in them.
DeleteDee xxx
You know, Dee, reading through all the comments, especially your reply to Nikki, this suggests that you don't actually have a formal diagnosis of your condition from a consultant dermatologist.
ReplyDeleteI mentioned that I have had eczema all my life and for decades it was attributed by dozy doctors and grumpy dermatologists to the usual environmental causes. But the last serious bout, which prevented my shaving or wearing makeup, was the day I insisted on having an in-depth consultation in the teeth of GP doubts and excuses. It transpired that my eczema was caused not so much by the environment but an auto-immune problem. I stopped the near useless topical creams I'd had periodically all my life and went onto immunosuppressants and that made a big difference.
Doctors throughout history have always wanted to fob off patients with a quick aspirin prescription (or leeches or purgatives or sacrifices to the gods) because most stuff clears up on its own eventually. But with doctors, even more so now with the NHS wanting to cut corners and save costs, you have to be insistent. Be a pain in the bum, basically (tattooed or not). Since you aren't certain of your psoriasis diagnosis, maybe it's time to insist they get to the bottom of your problem once and for all. When I explained to the last consultant, at Guy's Hospital, that my eczema was killing my life as a trans woman so my dysphoria was rocketing, making me miserable and preventing my being out and arranging help and meet-ups for other trans people, he really sat up and took note. "We definitely need to get to the bottom of this and find a real solution," he said. Now I know and I can cope a lot better both with the skin and with the dysphoria.
I don't see why you should tamp down your desire to have a tattoo that means a lot to you if you don't know one way or the other if it will cause problems. If you mention to the medical profession that your skin condition affects your gender dysphoria, that's two issues for the price of one and you may make progress. The tattoo concerns could then be discussed after diagnosis and treatment.
Just to add that a spot check by tattoo artists only lets them know if there is going to be an immediate flare-up. Some reactions to ink or the tattoo process don't flare up for days or even months. So keep your tattoo dream alive. Then get that discreet test tattoo on your bum. If you don't like the classic "I love mum" heart, you could make it "The NHS cured my itch." That has the added benefit of keeping those annoying admirers away!
Sue xx
My history with this condition goes back to 2002. I was on holiday in New York, and a round red patch about 3 inches in diameter appeared on my right shin. It became dry and flaky. The GP said it was psoriasis. But it never developed the raised plaque and silvery scales that is a characteristic of psoriasis. I was given a vitamin D cream. It didn't work. I was given a topical steroid combined with vitamin d.It reduced the redness but didn't stop the condition. It appeared on my left lower leg
DeleteAnd it's been there ever since. Sometimes quite visible, sometimes barely there. The GP insisted it was psoriasis, but fairly stable and in control, so wouldn't need a referral to a dermatologist. In the end I gave up using the topical steroid because it wasn't working and it was affecting my adrenal glands. When I stopped it,I stopped completely overnight. Apparently that was wrong and should have triggered a big rebound of tge condition, making it far worse. It didn't. It just stayed the same. Probably because it wasn't making any difference so there was nothing to rebound. This steroid was the gold standard treatment for psoriasis. But it did nothing for my condition. I tried to get a diagnosis from my new GP, or a referral to a dermatologist. They said as it stable, it wasn't worth it. So I have a diagnosis of psoriasis that I am doubtful of. But NHS dermatologist now have a waiting list of several years. The condition looks more like dermatitis or eczema than psoriasis. And the fact that it hasn't responded to the treatments probably indicates a wrong diagnosis.
Dee xxx