The Skin I’m In

I don’t like public pools. I also don’t like white clothing, no matter what time of year it is, or shorts. I refuse to wear shorts. I won’t sunbathe, or wear short sleeved shirts in public. I don’t like tight clothing, or thick stiff fabrics (I would suck in the Navy).

But I’m not the Grinch Who Stole Summer – although that would make life a bit easier for me. I have severe psoriasis. I have it everywhere.

“Do you have it in your intergluteal cleft?” a young doctor once asked me. He had very intense blue eyes, hair that looked like it came out of a mold, and Superman’s chin.

“My what?

“Intergluteal cleft” he said more slowly, as if that would help the words make sense to me. It did.

“You mean my BUTT CRACK?”

Let me take a moment here to explain a bit about my relationship with doctors. I am simultaneously a young doctor’s wet dream and worst nightmare. They walk in the room after reading my chart with stars in their eyes. I am like the only live creature in a freak show. I go to a teaching hospital, which means the senior doctors will literally bring their interns in to my appointments for “show and tell”. This usually doesn’t bother me one bit. I am ALL FOR doctors learning about the conditions I live with.

Yes, for fuck’s sake. Study me. Take a real good look. Learn the difference between pustular psoriasis and dermatitis. Be able to tell the difference between Behcet’s Disease and Herpes Simplex, and you may avoid ruining some poor girl’s life.  

I’m a fascinating medical oddity to young med students, and they can’t wait to check me out, but usually an appointment or two with me, and those stars in their eyes fall with the downcast glance as they hear all of the unsuccessful treatments I’ve tried.

Poor Baby Doc. I too once held the hope that you’d bring me a cure. There, there, now Baby Doc. There, there.

But sometimes I’m in a mood, or maybe the Baby Docs just look a little too much like a super hero wanna-be for their own good. Misplaced confidence has no place in the medical field. That’s when I’m there to bring them down a notch.

Doctor Superman couldn’t bring himself to say the words “butt crack”. So I said it a little bit louder.

“Are you asking if I have psoriasis in my BUTT CRACK? Yes, I do. I HAVE PSORIASIS IN MY BUTT CRACK. It hurts. WHY??”

He turned a very amusing shade of pink and took notes.

That’s the thing about some of the baby docs; once they’re done with their rotations, they get to apprentice in an office. All this means is that the Doctor in charge of you gets to send you in to the office to do all of the dirty work. Then after they’ve asked all of the humiliating questions, the Real Doctor enters the room like a rock star, takes a quick glance at you to confirm or correct Baby Doc’s observations, then prescribes something useful that will solve the problem. Baby Doc is left in a cloud of Real Doctor dust; all of the work and none of the glory.

On that particular day it was a 0.5% cortisone cream, but enough about my butt crack. I was talking about public pools.

I look like a drunk toddler attacked me with pink and red markers. I am not kidding. I have pink and red splotches all over me that come and go. Some of them leave scars. Others, like the patch that takes up most of my left shin, never go away.

Sometimes it looks like the measles, or chicken pox. Other times it gets really scaly, and I can tear tags of skin off the size of corn flakes. It will develop thick, white “plaques”. Get those in the right place, and they crack. Then you have what I assume is called a “fissure” which is basically a crack in your skin that doesn’t heal.

Those fissures, and sometimes the skin under the large flakes that come off of me, will weep a clear liquid. You’ve seen it when you pick a scab too soon. It’s your skin’s moisturizing heal-cream or some such. That shit will dry and make your skin stick to your clothes. You don’t notice it right away. Then you move, and suddenly you’ve waxed a random part of your body, except that body part didn’t have any hair, and you just ripped a small part of you off with your shirt.

Blood is way stickier than the clear liquid. And it really sucks when you get it along your bikini line, let alone your “intergluteal cleft”. Imagine the feeling of someone running a sharp knife up your butt crack every time you take a step. That’s what it feel like when you’ve got psoriasis in your crack.

Psoriasis isn’t picky. Psoriasis is much like the Honey Badger, and it really does not give a shit what you think. It’s gonna go where it wants, when it wants, and do what it wants.


In fact, that Honey Badger probably has psoriasis in its butt crack too.

But aside from the pain and weird splotchiness of it all, it itches. It itches worse than anything I’ve ever experienced. It’s the kind of itchiness that will drive you mad. Literally, it makes you kind of crazy. I have had moments when I scratched until my skin was raw, and still not had any relief. It’s an itchiness that truly makes you want to scream, cry and rip your own skin off, and it really isn’t something that’s part of a healthy, productive lifestyle. When you fantasize about ripping off your own flesh like a possessed person in a horror movie, going grocery shopping at the neighborhood store can be … awkward.

The relief you feel from scratching isn’t decent either, but that isn’t because of the pain. The satisfaction you get from scratching that itch is best left behind closed doors or with your intimate partners. It’s the kind of satisfaction that digs a buzzing laughter from the bottom of your gut that tickles the tip of your nose. It’s a reflex, it’s unstoppable. It makes you feel like a junkie getting a fix. It might be the second best thing to sex. This is particularly awkward when you’ve got psoriasis up your nose. No one wants to feel that good while picking their nose. Just trust me on that.

Then there’s the blood. There’s the blood from the fissures, the blood from the flakes. The blood from the scratching. Not that I ever wore a lot of light colored clothing, but I had to give almost all of it up, because I got so tired of cleaning blood spots out of my clothes. It usually isn’t much, unless I’ve been scratching. I have had people pull my hand away from my body, only to find my fingers and fingernails encrusted with blood. I don’t even notice.

There are the occasional benefits. I’ve had dear ones who lovingly took the time to apply ointment to the spots on my back, one by one. “Anointing” they called it. I’ve had my spots called “constellations”, or “braille that says ‘I love you’ over and over.” I’ve been told it makes me unique, that it’s actually kind of iridescent and pretty. I want to believe them. I do. I try to tell myself that a map to a fantastic world is surfacing on my skin and sinking in the tides of my flesh. An invisible painter comes to me in the night and paints my body like a canvas. One of the benefits of always having brand new skin – psoriasis is the immune system attacking the skin, causing the rapid dying off and replenishing of skin cells – is that it is very sensitive. That can make a tender touch blissfully  overwhelming on a good day.

I am ever changing, a chameleon. I am unique, even from myself.

It creates a very odd distance between me and my skin. I often feel like an unwelcome tenant. But I am here.

So you’ll forgive me for not donning my itsy bitsy teeny weeny bikini and running to the nearest pool full of kids on their summer break. Even when shopping at my local Target, I’m mindful of the glances I get when my patches show. I can’t really blame them, they don’t know that I’m not contagious. If I was in a pool of water, I’d be nervous if someone with open wounds came at me in their birthday suit too.

My birthday suit and I have a complicated relationship.


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