Flaking vs. Acting
by Chagrined

Dear Ed: Has anyone ever written you who had to make a drastic career change because of their psoriasis? I'm 27, live in Chicago, and for the past seven years have sacrificed nearly everything to make it as a professional actor. It's the classic sob story. Day and night jobs waitressing and temping as a secretary or receptionist, hours of dance and voice classes, endless try-outs, an occasional chorus part or minor role, TV ads, hopping from agency to agency. In short, spending most of my disposable income trying to accomplish the career I so want to achieve.

Then, bam! Psoriasis! It broke out on my head, hands, elbows and knees. I was lucky compared to some of the folks whose stories I've read about at your web site: the first dermatologist I went to diagnosed my condition as psoriasis right away. She prescribed some ointments and it went away for a while, but it keeps coming back. Last winter I thought it was under control until a day I had a try-out. I woke up broken out all over. I can cover the elbows and knees with leotards (assuming the role I'm trying out for doesn't require me to expose these parts) and for stage work the scalp isn't a problem and makeup can sometimes cover small lesions on the face or hands. But I can't even try out for TV commercial gigs with these kinds of blemishes.

My dermatologist says the high-energy stress of pursuing my acting career may be contributing to my psoriasis, but if I give it all up I feel my depression is likely to make it worse, too. And what if I did give it up and the psoriasis went away? I'd just want to get back into acting again! -Chagrined in Chicago

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Ed's Response:

Dear Chagrined: Tough call. I've got to assume there are stage and screen actors with psoriasis, but haven't had any visitors here confess to that fact. Before I'd walk away from a career with which I was so in love, I'd pursue all options with the best derm I could find. Yours is an extreme case where "taking charge," personally, is all-important. You need to start keeping detailed records of how specific prescrips work for you: how fast, how long, what time of year, under what stress conditions, etc. Then you need to categorize the remedies so you can apply them appropriately. For less cataclysmic reasons, I've done this myself.

For example, I know that if I absolutely positively have to have a particular lesion disappear within a week it requires an intralesion steroid injection. There are caveats: (1) It'll come back almost as fast as it disappeared about three to four weeks later, (2) my derm won't give me more injections that soon, and (3) hands and head are off-limits for injections altogether. NOTE: These are my caveats. Other visitors here have had more or less success with the injections and some derms do (I'm told) allow them on the head.

Another example: High-potency corticosteroid ointments almost always clear up limb and torso lesions but require seven to ten days to stop the flaking and I will desensitize to their potency (they will stop working) unless I immediately switch to a less potent ointment the minute the flaking stops.

And one more example: Since injections and high-potency ointments are forbidden for use on my face, I use a low-potency corticosteroid there every day, whether the lesions are flaming or not. For the thin skin on my face, the low-potency corticosteroids appear to work as a preventative, too.

By passing along what works for me, I'm certainly not advocating the same treatment regimen for you. The point is that any regimen that works for you is bound to be YOUR PERSONAL REGIMEN. I hope your derm will go along with the experimentation.

My current derm is so psoriasis-savvy he encourages me to try just about anything (short of using my own pee as an unguent, which, evidently, some fringe group espouses).

I would also like to suggest that at the ripe old age of 27 you not let skin imperfections be the deciding factor in ANY career decision you might make. You may be a beautiful person operating under the assumption you must obtain beautiful-person roles in your acting career. Have you observed there are a lot more roles available for people that aren't necessarily beautiful in the classic, sculpted sense? An acting career is, I imagine, tough enough without your deciding that you are or are not going to make it. Maybe you need to leave that decision to the directors, producers, talent scouts and agents. Don't risk failure for lack of trying.

One final comment. Having had to work with a great number of people who appear on television in my own career, I know that most skin imperfections are easily fixed for the relatively insensitive lens of a camera. If you do have a shoot (or a try-out) on a day when an exposed lesion is flaming badly, just be sure and remove the loose flakes before showing up for makeup. Flakes are hard to cover and the makeup artist will be a little hesitant to do the peeling—but the redness that remains after loose flakes are removed can be easily covered up.

Too bad you wish to remain "anonymous." I, like most other Flake HQ visitors, would love to know who you are so that, come Oscar or Emmy night, we can point to you on the stage and go, "See! See! We can do it!" -Ed

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