More Than Skin Deep
Scott Steele, the 32-year-old managing director of the Classical Chinese Garden in Portland, Oregon, still remembers a trip to a hair salon as a teenager. The hairdresser took one look at the psoriasis outbreak on his scalp and forehead and actually backed away. Even after Steele explained that it wasn't contagious, the woman refused to cut his hair. Interactions like that surely contributed to Steele's self-described image: a homebody and introvert.
Steele's psoriasis first showed up as a spot on his knee when he was 10 years old. By 13, it had spread to his elbows and hands. His scalp was completely inflamed and the scaly patches had crept down his forehead. It turned his teenage life into a nightmare. "It was emotionally horrific," he says. "I'm 100 percent certain that it shaped the future of my life, and not for the better."
During high school, Steele suffered from depression and even thought about suicide. He tried creams, ointments, ultraviolet-light therapy. Eventually, the spots on his scalp and face began to fade. Through college, he kept his skin partly in check with a combination of topical steroids and light therapy. Gradually, Steele came to terms with his disease. He realized that he'd accepted psoriasis when he looked at the prescription his dermatologist had written for a steroid cream. She'd prescribed the medication not by the ounce, but by the pound. All Steele could do was laugh.
However, bigger challenges loomed just ahead. By his mid-20s, Steele experienced significant pain in his back, then in one of his toes. He visited a rheumatologist, who diagnosed psoriatic arthritis. According to the National Psoriasis Foundation, 10% to 30% of patients with psoriasis develop psoriatic arthritis. For Steele, the diagnosis was a blow. His doctor showed him his spinal X-ray, which revealed two vertebrae nearly fused due to calcification. "At 27, you don't expect that. It was hard to take," he says.
Today, Steele manages his disease with a number of drugs, including pain medication and the biologic Humira (adalimumab), which blocks tumor necrosis factor. The biologics, in particular, made a huge difference. "I still have pain," he says, "but I would not be able to get out of bed unless I was taking biologics."
Still, Steele worries about his future. Will he be able to walk in five years? He also wonders about whether he'll meet someone, get married, have kids. "Especially with psoriasis and later with arthritis, it affected my self-image," he says. "It kept me from seeking out relationships." Despite his concerns, Steele refuses to dwell on the negative aspects. Although psoriasis and arthritis have a negative impact on a daily basis, he says, they haven't prevented him from living his life. "As with any chronic disease, you can let it take over your life," Steele says, "or you can say: 'Well, I have this. It sucks. I'm going to move on.' That's the choice I've made."