1 00:00:01,240 --> 00:00:05,800 Speaker 1: Welcome to Our Skin, a personal discovery podcast. I'm your host, 2 00:00:05,840 --> 00:00:08,320 Speaker 1: Holly Fry, and it is wonderful to have you here 3 00:00:08,360 --> 00:00:11,559 Speaker 1: with us. Connection is what this show is all about, 4 00:00:12,039 --> 00:00:15,680 Speaker 1: specifically connecting about things that we are sometimes afraid to 5 00:00:15,720 --> 00:00:18,520 Speaker 1: talk about. Today, we're going to be exploring the ups 6 00:00:18,520 --> 00:00:22,440 Speaker 1: and downs, past and present, personal and universal troubles we 7 00:00:22,520 --> 00:00:26,600 Speaker 1: have with our skin. Our skin is our most visible organ. 8 00:00:26,880 --> 00:00:29,800 Speaker 1: What happens on our skin affects the rest of our lives, 9 00:00:30,160 --> 00:00:33,960 Speaker 1: especially when dealing with a chronic condition. Getting diagnosed with 10 00:00:34,000 --> 00:00:37,480 Speaker 1: one of these, like psoriasis, can be overwhelming, but you're 11 00:00:37,520 --> 00:00:42,080 Speaker 1: not alone. Each episode features a personal story of resilience 12 00:00:42,200 --> 00:00:45,239 Speaker 1: and grace, but our personal stories are threads in a 13 00:00:45,320 --> 00:00:48,320 Speaker 1: larger tapestry, and there are lessons for us in the 14 00:00:48,400 --> 00:00:51,120 Speaker 1: history of how we treat our skin and the progress 15 00:00:51,159 --> 00:00:55,520 Speaker 1: we've made together. Caring for our skin is caring for ourselves. 16 00:00:55,880 --> 00:00:59,280 Speaker 1: Whether you're seeking inspiration for your own journey or curious 17 00:00:59,320 --> 00:01:03,320 Speaker 1: about the history of our skin, you'll find empathetic, transformative 18 00:01:03,360 --> 00:01:09,480 Speaker 1: conversations here on Our Skin. Today. We are joined by 19 00:01:09,560 --> 00:01:14,760 Speaker 1: well being coach, mindfulness guide, and skin empowerment leader Rena Ruperelia. 20 00:01:14,880 --> 00:01:18,240 Speaker 1: I am so glad to welcome her today. Rena has 21 00:01:18,280 --> 00:01:20,880 Speaker 1: lived with soriasis since she was in high school, but 22 00:01:21,000 --> 00:01:25,400 Speaker 1: she didn't start sharing about her experience until twenty years later. 23 00:01:26,120 --> 00:01:29,320 Speaker 1: She first noticed symptoms of sriasis when she was just fourteen, 24 00:01:29,440 --> 00:01:32,039 Speaker 1: and at the time, of course, as a teenager, that 25 00:01:32,200 --> 00:01:36,760 Speaker 1: experience was deeply isolating, Like many people facing a chronic condition. 26 00:01:37,000 --> 00:01:39,240 Speaker 1: For a while, she tried to hide what was going on, 27 00:01:39,400 --> 00:01:43,119 Speaker 1: hoping that maybe someday things might change on their own. 28 00:01:43,280 --> 00:01:45,800 Speaker 1: But when they did not, Rena hit a point where 29 00:01:45,840 --> 00:01:49,000 Speaker 1: she couldn't get by on hope alone. Her symptoms had 30 00:01:49,040 --> 00:01:51,600 Speaker 1: continued to intrude into her life for decades, and she 31 00:01:51,680 --> 00:01:54,360 Speaker 1: knew it was time to find treatment. So that, of course, 32 00:01:54,400 --> 00:01:56,880 Speaker 1: sounds really easy, go to a doctor, get a prescription 33 00:01:57,000 --> 00:01:59,920 Speaker 1: treatment treatment, But just as a lot of syriasis is 34 00:02:00,080 --> 00:02:03,680 Speaker 1: patients have experienced, the path to treatment for Rena was 35 00:02:03,720 --> 00:02:07,480 Speaker 1: anything but easy. She found herself battling a reluctance to 36 00:02:07,520 --> 00:02:10,760 Speaker 1: open up to her doctor and hesitancy from having used 37 00:02:11,000 --> 00:02:13,079 Speaker 1: treatments in the past that just didn't work at all, 38 00:02:13,280 --> 00:02:17,360 Speaker 1: or perhaps even exacerbated things. One of the sources of 39 00:02:17,400 --> 00:02:19,760 Speaker 1: strength that Rena was able to draw upon during this 40 00:02:19,840 --> 00:02:22,760 Speaker 1: difficult time. Was her mindfulness practice something that we're going 41 00:02:22,840 --> 00:02:25,760 Speaker 1: to ask about for sure in our interview today. And 42 00:02:25,800 --> 00:02:28,240 Speaker 1: she has also started sharing with others and putting her 43 00:02:28,320 --> 00:02:32,400 Speaker 1: journey out there online and finding that her story empowers 44 00:02:32,440 --> 00:02:35,960 Speaker 1: others as well as herself in the process. So eventually, 45 00:02:36,040 --> 00:02:40,160 Speaker 1: Rena fortunately found a doctor that understood and her soriasis 46 00:02:40,200 --> 00:02:43,840 Speaker 1: became more under control. So Rena had a new message 47 00:02:43,880 --> 00:02:47,040 Speaker 1: to share with her followers. Open up to your doctor 48 00:02:47,120 --> 00:02:49,680 Speaker 1: and you might be surprised what they're able to do 49 00:02:49,800 --> 00:02:53,320 Speaker 1: to help. And your story, Rena ties in perfectly with 50 00:02:53,400 --> 00:02:55,360 Speaker 1: the history that we're going to discuss today, which is 51 00:02:55,400 --> 00:02:58,000 Speaker 1: going to take us on a step by step tour 52 00:02:58,160 --> 00:03:01,640 Speaker 1: of the evolution of Sorias's Street from ancient times to 53 00:03:01,720 --> 00:03:04,919 Speaker 1: our modern medicines. And I am so excited to talk 54 00:03:04,960 --> 00:03:07,920 Speaker 1: to Rena today about her experience because there are a 55 00:03:07,919 --> 00:03:10,800 Speaker 1: lot of barriers for people that seek treatment, from stigma 56 00:03:10,840 --> 00:03:14,519 Speaker 1: and embarrassment to doctors who maybe aren't always that knowledgeable 57 00:03:14,639 --> 00:03:17,240 Speaker 1: about skin conditions. It is a lot to take on 58 00:03:17,760 --> 00:03:20,760 Speaker 1: as a patient and as a person. So Rena, welcome 59 00:03:20,840 --> 00:03:23,160 Speaker 1: to our skin I'm so delighted that you're here. 60 00:03:23,960 --> 00:03:28,520 Speaker 2: Thanks for that beautiful introduction, Holly, that was perfectly summarized. 61 00:03:29,880 --> 00:03:32,480 Speaker 1: I'm glad. I never want a misstep. It's always that 62 00:03:32,520 --> 00:03:35,680 Speaker 1: awkward thing when you're telling someone else's story while they're 63 00:03:35,720 --> 00:03:38,800 Speaker 1: sitting there. So I'm glad it all vibed right. I 64 00:03:39,000 --> 00:03:40,840 Speaker 1: would love it if you would take us back to 65 00:03:42,040 --> 00:03:45,040 Speaker 1: your first inclinations when you were like, I might actually 66 00:03:45,040 --> 00:03:48,280 Speaker 1: need to seek medical treatment for this skin condition. But 67 00:03:48,360 --> 00:03:51,720 Speaker 1: first I want to ask how did your symptoms manifest initially? 68 00:03:52,280 --> 00:03:58,119 Speaker 2: Yeah, they actually tie in perfectly together. So, like you mentioned, 69 00:03:58,320 --> 00:04:01,960 Speaker 2: I was in high school. We were just about to 70 00:04:02,000 --> 00:04:04,720 Speaker 2: go into high school. So it was like two months 71 00:04:04,760 --> 00:04:08,080 Speaker 2: before the summer. I was in England seeing my family, 72 00:04:08,320 --> 00:04:10,560 Speaker 2: living my best life, and all I just kept thinking 73 00:04:10,640 --> 00:04:12,960 Speaker 2: about was I can't wait for the first day of 74 00:04:13,000 --> 00:04:13,440 Speaker 2: grade nine. 75 00:04:13,440 --> 00:04:14,800 Speaker 3: I'm going to meet all these new people. 76 00:04:15,040 --> 00:04:17,880 Speaker 2: I'm so excited and thinking about all the boys and 77 00:04:17,920 --> 00:04:22,200 Speaker 2: all the fun and all the things. But my skin 78 00:04:22,240 --> 00:04:26,200 Speaker 2: had a different plan. So I just remember I was 79 00:04:26,200 --> 00:04:29,360 Speaker 2: in England and I looked down at my stomach and 80 00:04:29,400 --> 00:04:31,640 Speaker 2: I had these red dots. 81 00:04:31,960 --> 00:04:34,240 Speaker 3: They look kind of like chicken pox. I didn't know 82 00:04:34,240 --> 00:04:34,760 Speaker 3: what they were. 83 00:04:34,800 --> 00:04:37,560 Speaker 2: I thought maybe bug bites, but as the weeks went on, 84 00:04:37,640 --> 00:04:40,719 Speaker 2: the days went on, they were growing and kind of spreading, 85 00:04:41,240 --> 00:04:42,719 Speaker 2: but they still look similar. 86 00:04:42,920 --> 00:04:43,800 Speaker 3: So I ran to the. 87 00:04:43,800 --> 00:04:47,320 Speaker 2: Doctor and I was like, you got to fix this. 88 00:04:47,560 --> 00:04:51,440 Speaker 2: Like I'm about to start high school. I need to 89 00:04:51,440 --> 00:04:53,880 Speaker 2: get rid of this now. So he's like, oh, you 90 00:04:54,000 --> 00:04:57,120 Speaker 2: just have chicken pox. Like it's just chicken pox, right, 91 00:04:57,200 --> 00:04:58,880 Speaker 2: he didn't know it kind of looked like it. 92 00:04:59,000 --> 00:05:01,840 Speaker 3: I was happy. I went home, asked no questions. 93 00:05:01,880 --> 00:05:03,840 Speaker 2: But again, as I mentioned, as the days went on, 94 00:05:03,920 --> 00:05:06,560 Speaker 2: the weeks went on, it started growing even kind of 95 00:05:06,600 --> 00:05:08,960 Speaker 2: and spreading, and the scales went from these like red 96 00:05:09,000 --> 00:05:13,760 Speaker 2: dots to these silvery scales. And eventually I went back 97 00:05:13,800 --> 00:05:17,960 Speaker 2: again and he said, oh, I think you may have psoriasis. 98 00:05:18,960 --> 00:05:19,480 Speaker 3: I didn't know. 99 00:05:19,600 --> 00:05:23,120 Speaker 2: There was no Google then, right. It sounded like a dinosaur. 100 00:05:23,160 --> 00:05:25,599 Speaker 2: To be honest, I had no clue how to even 101 00:05:25,760 --> 00:05:28,120 Speaker 2: spell it. I didn't know what it was, never heard 102 00:05:28,120 --> 00:05:30,400 Speaker 2: of it. All I cared about was ken you get 103 00:05:30,520 --> 00:05:34,160 Speaker 2: rid of it. And that's kind of I think when 104 00:05:34,839 --> 00:05:38,400 Speaker 2: my life changed, especially when it comes to my skin. 105 00:05:38,560 --> 00:05:42,200 Speaker 2: So that was the moment, and the line you know 106 00:05:42,320 --> 00:05:45,520 Speaker 2: that I always remember is I can't confirm for sure. 107 00:05:45,720 --> 00:05:48,159 Speaker 2: You know you can try this cream, and there's no cure, 108 00:05:48,880 --> 00:05:51,000 Speaker 2: but we can find a way to manage it, but 109 00:05:51,040 --> 00:05:53,239 Speaker 2: we have to wait for the dermatologist. 110 00:05:53,920 --> 00:05:55,920 Speaker 1: That's just what a fourteen year old wants to hear too. 111 00:05:56,000 --> 00:05:57,880 Speaker 1: It's like we're gonna have a lot of guesswork ahead 112 00:05:57,880 --> 00:06:01,880 Speaker 1: of us, no problem. I wonder at that age, especially, 113 00:06:02,000 --> 00:06:04,600 Speaker 1: kids are not sharing the things that they're embarrassed or 114 00:06:04,640 --> 00:06:07,359 Speaker 1: self conscious about. Did you know anyone else that was 115 00:06:07,400 --> 00:06:10,160 Speaker 1: dealing with anything similar or did you feel like the 116 00:06:10,200 --> 00:06:12,200 Speaker 1: only person on earth that had this condition? 117 00:06:12,760 --> 00:06:15,680 Speaker 2: Yeah, what a good question. I thought I was the 118 00:06:15,720 --> 00:06:19,360 Speaker 2: only person on earth with the condition. I kept hearing 119 00:06:19,400 --> 00:06:21,200 Speaker 2: this story, and I still hear it to this day. 120 00:06:21,720 --> 00:06:24,200 Speaker 2: Your aunt had it on her finger. She got rid 121 00:06:24,240 --> 00:06:26,400 Speaker 2: of it by wrapping it up with this, this, and this. 122 00:06:27,000 --> 00:06:30,239 Speaker 2: Your grandmother rather has eggzema as well as my father. 123 00:06:30,800 --> 00:06:33,800 Speaker 2: But to be honest, no one was really talking about it. 124 00:06:33,839 --> 00:06:35,919 Speaker 2: There was just that story about my aunt wrapping up 125 00:06:35,920 --> 00:06:39,359 Speaker 2: her hands, which I said, like, I still here to 126 00:06:39,480 --> 00:06:42,280 Speaker 2: this day, and she was able to get rid of it. 127 00:06:42,360 --> 00:06:45,400 Speaker 2: I have brought myself up with everything and anything, and 128 00:06:45,680 --> 00:06:47,080 Speaker 2: I still had it, So it. 129 00:06:47,040 --> 00:06:50,440 Speaker 1: Did a Nobody knows if that was even what she 130 00:06:50,560 --> 00:06:53,120 Speaker 1: was dealing with right, like she may have had an 131 00:06:53,160 --> 00:06:57,160 Speaker 1: allergic reaction to something. There's no there's no actual science 132 00:06:57,279 --> 00:06:58,200 Speaker 1: data to put. 133 00:07:00,200 --> 00:07:03,200 Speaker 3: But it's brutal. Yeah, it truthfully all jokes aside. I 134 00:07:03,279 --> 00:07:05,200 Speaker 3: just remember just thinking like what is this? 135 00:07:05,360 --> 00:07:08,799 Speaker 2: And I did feel like I was the only one, 136 00:07:09,400 --> 00:07:12,480 Speaker 2: and so there was so much that went into that. Again, 137 00:07:12,520 --> 00:07:15,360 Speaker 2: like you mentioned, as a fourteen year old girl, I 138 00:07:15,480 --> 00:07:19,200 Speaker 2: was really worried about my image and fitting in looking 139 00:07:19,240 --> 00:07:23,440 Speaker 2: like everyone else. I didn't want to have this thing 140 00:07:23,720 --> 00:07:26,560 Speaker 2: or this skin that made me quote unquote different. 141 00:07:27,160 --> 00:07:29,800 Speaker 1: Right, you did not think you were turning into an 142 00:07:29,880 --> 00:07:31,400 Speaker 1: X man. You just thought you were. 143 00:07:32,800 --> 00:07:35,520 Speaker 3: I wish that's what happened, If I'm honest. 144 00:07:35,920 --> 00:07:40,840 Speaker 1: By the way, I'm mistique now just funny exactly. I'm 145 00:07:40,880 --> 00:07:43,760 Speaker 1: wondering too, though you mentioned like the words that were 146 00:07:43,840 --> 00:07:46,440 Speaker 1: terrifying were like, we don't really know, we're gonna try 147 00:07:46,480 --> 00:07:51,440 Speaker 1: some things. What challenges were there in those initial treatment stages. 148 00:07:51,520 --> 00:07:54,440 Speaker 1: I know, even just like talking to a doctor as 149 00:07:54,480 --> 00:07:57,360 Speaker 1: a teenager about anything is already tough, so then to 150 00:07:57,400 --> 00:07:59,720 Speaker 1: be in this loop where you're having to give feedback 151 00:07:59,720 --> 00:08:02,840 Speaker 1: and time about what doesn't doesn't work and what things 152 00:08:02,880 --> 00:08:05,640 Speaker 1: feel like. What was that all like probably very scary. 153 00:08:06,000 --> 00:08:09,680 Speaker 2: Absolutely, And I will say, although I've gotten better with 154 00:08:09,720 --> 00:08:13,360 Speaker 2: having the conversations now, it still continues to be challenging, 155 00:08:13,480 --> 00:08:15,640 Speaker 2: right to figure out what's gonna work, what's not gonna work, 156 00:08:15,640 --> 00:08:19,320 Speaker 2: because treatments need reevaluation and change often, which I didn't 157 00:08:19,360 --> 00:08:23,360 Speaker 2: know but in the beginning stages the first Okay, so 158 00:08:23,440 --> 00:08:26,440 Speaker 2: after I actually got diagnosed with SIISIS, which in itself 159 00:08:26,680 --> 00:08:29,960 Speaker 2: was a horrible experience because I was feeling so vulnerable 160 00:08:30,400 --> 00:08:33,160 Speaker 2: and the doctor, the dermatologists at this point, came in, 161 00:08:33,559 --> 00:08:35,680 Speaker 2: took a look at my skin, didn't really talk to me. 162 00:08:36,360 --> 00:08:39,120 Speaker 2: I waited three months for this appointment. Side note, like 163 00:08:39,200 --> 00:08:41,200 Speaker 2: three months, you know, I'm like, he's going to cure me, 164 00:08:41,559 --> 00:08:42,520 Speaker 2: or they're going to cure me. 165 00:08:42,760 --> 00:08:45,760 Speaker 3: Wherever it is. This person is going to cure me. 166 00:08:46,280 --> 00:08:48,720 Speaker 2: And when I went to the actual office, like I said, 167 00:08:48,760 --> 00:08:51,840 Speaker 2: he took a quick look, then brought all of his 168 00:08:51,960 --> 00:08:53,080 Speaker 2: students in. 169 00:08:53,200 --> 00:08:55,400 Speaker 3: And they also, I guess my mom must have given 170 00:08:55,400 --> 00:08:55,960 Speaker 3: them permission. 171 00:08:56,000 --> 00:08:58,160 Speaker 2: And I'm just sitting there right like a specimen on 172 00:08:58,160 --> 00:08:59,280 Speaker 2: the table like it was. 173 00:08:59,760 --> 00:09:02,559 Speaker 3: I just remember feeling humiliated, embarrassed. 174 00:09:02,640 --> 00:09:04,240 Speaker 2: I was covered at this point as well, because it 175 00:09:04,280 --> 00:09:06,480 Speaker 2: was all over my legs, now spread from my stomach 176 00:09:06,520 --> 00:09:09,000 Speaker 2: to my back to my arms, and they're all kind 177 00:09:09,040 --> 00:09:09,960 Speaker 2: of just looking at me. 178 00:09:10,160 --> 00:09:12,000 Speaker 3: And eventually he gives. 179 00:09:11,880 --> 00:09:15,000 Speaker 2: Me this crude cold tar and it's exactly what it 180 00:09:15,040 --> 00:09:18,240 Speaker 2: sounds like. It's like this green, kind of dark brown, 181 00:09:18,360 --> 00:09:22,640 Speaker 2: slimy paste that smells like mothballs. So you slather it 182 00:09:22,679 --> 00:09:27,120 Speaker 2: on at night. It stains everything and then you wake 183 00:09:27,200 --> 00:09:29,840 Speaker 2: up in the morning and you wipe it off with towels. 184 00:09:29,840 --> 00:09:33,600 Speaker 2: My mother had to help me, and it really smelled 185 00:09:33,679 --> 00:09:37,520 Speaker 2: number one, but number two, the skin didn't really clear. 186 00:09:38,080 --> 00:09:40,880 Speaker 2: I still had like so I'm you know, South Asian, 187 00:09:40,960 --> 00:09:43,520 Speaker 2: so I have more melanated, darker skin. And then I 188 00:09:43,640 --> 00:09:46,640 Speaker 2: ended up with these like light patches where the psoriasis 189 00:09:46,840 --> 00:09:51,160 Speaker 2: was everywhere. The hyperpigmentation was brutal, but it never went away. 190 00:09:51,160 --> 00:09:53,600 Speaker 2: It was still itchy all day under my clothes. All 191 00:09:53,640 --> 00:09:56,080 Speaker 2: I remember is just wanting to scratch my skin off. 192 00:09:56,360 --> 00:09:58,840 Speaker 2: And so the beginning parts of treatment included, you know, 193 00:09:58,920 --> 00:10:01,320 Speaker 2: something like that. I went for like light treatment like 194 00:10:01,360 --> 00:10:04,600 Speaker 2: a lot of people do. I did cortisone creams and 195 00:10:04,640 --> 00:10:08,320 Speaker 2: it was always sticky fingerprints everywhere, you know, smelling not 196 00:10:08,520 --> 00:10:12,480 Speaker 2: very good and Also I was in these clothes that 197 00:10:12,640 --> 00:10:15,480 Speaker 2: just covered every part of my body, like where this 198 00:10:15,640 --> 00:10:18,480 Speaker 2: risees showed, so that I didn't want to do gym class. 199 00:10:18,559 --> 00:10:18,760 Speaker 3: I was. 200 00:10:18,920 --> 00:10:21,200 Speaker 2: People are like, aren't you hot? Like I just remember 201 00:10:21,200 --> 00:10:23,160 Speaker 2: that question, aren't you feeling hot? Like no, I'm fine, 202 00:10:23,280 --> 00:10:28,360 Speaker 2: I'm fine, I'm always cold. Meanwhile, yeah, sweltery link sweltering. 203 00:10:28,800 --> 00:10:31,400 Speaker 2: It was like my favorite time of day was coming 204 00:10:31,440 --> 00:10:34,800 Speaker 2: home after school, taking off everything and going for like 205 00:10:34,800 --> 00:10:38,120 Speaker 2: a scratch fest and like it was so bad for 206 00:10:38,160 --> 00:10:40,440 Speaker 2: the skin, but I was just it was the only 207 00:10:40,480 --> 00:10:41,440 Speaker 2: relief I had. 208 00:10:41,520 --> 00:10:43,520 Speaker 3: So I lived a lot of that. 209 00:10:43,520 --> 00:10:46,920 Speaker 2: First part of my journey with just creams and potions 210 00:10:47,000 --> 00:10:50,040 Speaker 2: and anything. Nothing took it away because work for me, 211 00:10:50,160 --> 00:10:51,960 Speaker 2: I guess it's different for everyone. For me, it meant 212 00:10:52,000 --> 00:10:54,840 Speaker 2: clearing the skin completely and nothing was working. 213 00:10:55,520 --> 00:10:58,880 Speaker 1: You have also talked before about how transformative it was 214 00:10:58,920 --> 00:11:02,719 Speaker 1: when you finally found a doctor who actually understood How 215 00:11:02,760 --> 00:11:05,480 Speaker 1: did you know? Because I think this is whether you're 216 00:11:05,520 --> 00:11:08,040 Speaker 1: dealing with a chronic condition or not. Finding that right 217 00:11:08,120 --> 00:11:11,280 Speaker 1: doctor that you click with is really really hard. How 218 00:11:11,320 --> 00:11:13,800 Speaker 1: did you know when you had found the doctor that 219 00:11:13,880 --> 00:11:15,839 Speaker 1: was right for you? What were the green flags where 220 00:11:15,840 --> 00:11:17,040 Speaker 1: you're like this one's different. 221 00:11:17,240 --> 00:11:21,280 Speaker 2: Yes, that's a really good question. It's really ideal to 222 00:11:21,360 --> 00:11:24,720 Speaker 2: find the right doctor. But depending on where people live, 223 00:11:25,360 --> 00:11:28,840 Speaker 2: depending on the access they have, it might not be 224 00:11:29,000 --> 00:11:33,320 Speaker 2: possible to find the right doctor because there might not 225 00:11:33,360 --> 00:11:35,200 Speaker 2: be a choice of people around. You know, I live 226 00:11:35,240 --> 00:11:38,080 Speaker 2: in an urban center. We have dermatologists everywhere, so I 227 00:11:38,120 --> 00:11:41,160 Speaker 2: do have choices. But how I knew doctor yadav is 228 00:11:41,200 --> 00:11:42,840 Speaker 2: my doctor here in Toronto. 229 00:11:43,720 --> 00:11:45,440 Speaker 3: She was different. 230 00:11:45,520 --> 00:11:48,160 Speaker 2: She was very, very confident. So first of all we 231 00:11:48,240 --> 00:11:50,840 Speaker 2: had like an offline conversation. We were like creating a 232 00:11:50,880 --> 00:11:54,440 Speaker 2: piece together and then kind of when we finish the work, 233 00:11:54,559 --> 00:11:57,400 Speaker 2: she said to me, you know, Rena, you don't have 234 00:11:57,440 --> 00:12:01,520 Speaker 2: to live like this, Because I was like, I am 235 00:12:01,600 --> 00:12:04,160 Speaker 2: happy in my skin. I am here for it. I'm 236 00:12:04,200 --> 00:12:06,120 Speaker 2: taking care of myself. But if I have some risis, 237 00:12:06,120 --> 00:12:08,240 Speaker 2: it's fine. But I was uncomfortable, like I didn't have 238 00:12:08,280 --> 00:12:10,559 Speaker 2: a goal for clear skin. At that point, I had 239 00:12:10,600 --> 00:12:13,679 Speaker 2: given up. And she when she said I can help you, 240 00:12:14,120 --> 00:12:17,480 Speaker 2: something in me was like, what you can help me? 241 00:12:18,320 --> 00:12:19,200 Speaker 3: What like are you? 242 00:12:19,400 --> 00:12:23,960 Speaker 2: And she was so confident And that's the part of it. 243 00:12:24,080 --> 00:12:27,400 Speaker 2: I think that really worked and clicked for me. There 244 00:12:27,520 --> 00:12:29,800 Speaker 2: was that her ability to say like I want to 245 00:12:29,800 --> 00:12:33,720 Speaker 2: help you, like we will find something that works and 246 00:12:33,960 --> 00:12:36,839 Speaker 2: you don't have to feel this way, like, yes, you 247 00:12:37,000 --> 00:12:39,200 Speaker 2: found a way through, and yes you feel empowered and 248 00:12:39,240 --> 00:12:43,800 Speaker 2: okay with the way your skin is, but there's hope. 249 00:12:44,080 --> 00:12:46,440 Speaker 1: It sounds almost like this is the first time you 250 00:12:46,520 --> 00:12:50,640 Speaker 1: really felt like taken care of by a doctor. Like 251 00:12:50,679 --> 00:12:52,400 Speaker 1: doctors are always there to take care of you, but 252 00:12:52,440 --> 00:12:54,480 Speaker 1: it's a different thing when you're like I feel taken 253 00:12:54,520 --> 00:12:54,880 Speaker 1: care of. 254 00:12:55,480 --> 00:12:58,559 Speaker 3: Yes, that's like on the money. 255 00:12:58,559 --> 00:13:04,679 Speaker 2: There absolutely when someone gives you that feeling of self assuredness, 256 00:13:05,000 --> 00:13:08,320 Speaker 2: she really does want to make her patients feel better 257 00:13:08,400 --> 00:13:10,920 Speaker 2: and give them a better quality of life. She takes 258 00:13:10,920 --> 00:13:13,320 Speaker 2: that extra step, And I think that is the person 259 00:13:13,440 --> 00:13:17,760 Speaker 2: I fell cared for. And yeah, scene and she understood 260 00:13:17,800 --> 00:13:20,280 Speaker 2: like it was tough, like I was having a rough time. 261 00:13:21,120 --> 00:13:24,000 Speaker 1: One of the things that you talk about, it's like 262 00:13:24,040 --> 00:13:27,120 Speaker 1: the animating idea of all of your work is you 263 00:13:27,240 --> 00:13:30,320 Speaker 1: deserve to feel good. And it's such a simple and 264 00:13:30,400 --> 00:13:33,920 Speaker 1: basic concept, but I think for a lot of people 265 00:13:34,000 --> 00:13:37,360 Speaker 1: that's very hard to really internalize, especially when they're dealing 266 00:13:37,400 --> 00:13:40,920 Speaker 1: with a chronic condition. There's all of this weird mental 267 00:13:40,920 --> 00:13:44,280 Speaker 1: and emotional baggage that comes with it. Sometimes there's whether 268 00:13:44,320 --> 00:13:47,280 Speaker 1: you're conscious of it or not. People will think there's 269 00:13:47,320 --> 00:13:49,840 Speaker 1: something bad or wrong about them, or that they did 270 00:13:49,880 --> 00:13:53,480 Speaker 1: something wrong in their skincare or in their health care. 271 00:13:54,280 --> 00:13:58,320 Speaker 1: But this idea, if they could just get it into 272 00:13:58,360 --> 00:14:01,240 Speaker 1: their minds, is something to embrace, deserve to feel good. 273 00:14:01,960 --> 00:14:04,199 Speaker 1: But I want to know how that has shaped your 274 00:14:04,400 --> 00:14:05,920 Speaker 1: particular brand of activism. 275 00:14:06,840 --> 00:14:06,880 Speaker 3: Ugh. 276 00:14:07,320 --> 00:14:09,439 Speaker 2: I also found it to be such a powerful line, 277 00:14:09,480 --> 00:14:11,800 Speaker 2: hence why I put it on the website, because it 278 00:14:11,840 --> 00:14:15,200 Speaker 2: was something I didn't believe. I thought, because I was 279 00:14:15,280 --> 00:14:18,679 Speaker 2: sick and I had this skin condition, that feeling good 280 00:14:18,800 --> 00:14:22,000 Speaker 2: was beyond my reach. It was beyond what was possible 281 00:14:22,040 --> 00:14:24,720 Speaker 2: for me, and that I didn't deserve it. 282 00:14:25,240 --> 00:14:26,640 Speaker 3: I didn't deserve this. 283 00:14:26,720 --> 00:14:30,240 Speaker 2: Feeling of peace of ease in my body, regardless of 284 00:14:30,240 --> 00:14:34,119 Speaker 2: what my skin looked like. And so as I started 285 00:14:34,640 --> 00:14:38,080 Speaker 2: taking care of myself and opening up more about my 286 00:14:38,200 --> 00:14:42,840 Speaker 2: story online, I started to challenge what I believed what 287 00:14:42,920 --> 00:14:45,840 Speaker 2: was possible for me as an individual and as a human. 288 00:14:46,320 --> 00:14:50,120 Speaker 2: So it was really important for me to take care 289 00:14:50,360 --> 00:14:53,000 Speaker 2: of myself and learn how to do that. 290 00:14:53,720 --> 00:14:54,880 Speaker 3: Even if my skin. 291 00:14:54,640 --> 00:14:58,760 Speaker 2: Was flared, I was still deserving of a massage. 292 00:14:58,840 --> 00:15:02,120 Speaker 3: I was still deserving going to a beach. That was 293 00:15:02,160 --> 00:15:03,480 Speaker 3: something that I wouldn't do. 294 00:15:03,880 --> 00:15:05,320 Speaker 2: You know, if someone had a pool party or we 295 00:15:05,360 --> 00:15:08,360 Speaker 2: went on a vacation, I would go tan on the 296 00:15:08,400 --> 00:15:11,480 Speaker 2: other side of the beach because I didn't want anyone 297 00:15:11,520 --> 00:15:14,360 Speaker 2: to see me. And I had to learn to tell myself, 298 00:15:14,720 --> 00:15:17,240 Speaker 2: you deserve to be here, You deserve to be part 299 00:15:17,280 --> 00:15:19,600 Speaker 2: of this as well. You deserve to dance, you deserve 300 00:15:19,640 --> 00:15:22,120 Speaker 2: to wear these clothes like you are deserving of these 301 00:15:22,160 --> 00:15:25,160 Speaker 2: things as well. Your skin doesn't make you unworthy. Your 302 00:15:25,200 --> 00:15:28,520 Speaker 2: skin doesn't make you less than. What are the things 303 00:15:28,600 --> 00:15:31,440 Speaker 2: that somebody who cares about themselves, who gives a damn 304 00:15:31,520 --> 00:15:32,680 Speaker 2: about themselves would do? 305 00:15:32,880 --> 00:15:34,680 Speaker 3: What does that look like? 306 00:15:35,240 --> 00:15:38,800 Speaker 2: And so that started as me putting out these challenges 307 00:15:38,840 --> 00:15:41,960 Speaker 2: when I first started my page. You know a lot 308 00:15:42,000 --> 00:15:44,400 Speaker 2: of people and I don't think this is just with skin. 309 00:15:44,480 --> 00:15:48,080 Speaker 2: Will say when my skin is clear, then I will 310 00:15:48,240 --> 00:15:51,200 Speaker 2: dot dot dot, wear the shorts, go to the beach, 311 00:15:51,400 --> 00:15:54,120 Speaker 2: go to the wedding, and sandals. These like tiny little 312 00:15:54,160 --> 00:15:56,320 Speaker 2: things that maybe a lot of people don't think about. 313 00:15:56,640 --> 00:15:59,120 Speaker 2: I was thinking about them all the time, and so 314 00:15:59,280 --> 00:16:02,480 Speaker 2: it was starting to challenge myself. And then as I 315 00:16:02,520 --> 00:16:05,160 Speaker 2: started to feel good and see that a lot of 316 00:16:05,200 --> 00:16:07,680 Speaker 2: these barriers were only built up in my mind. Like 317 00:16:07,760 --> 00:16:10,440 Speaker 2: most people were receiving me in a good way. This 318 00:16:10,720 --> 00:16:15,160 Speaker 2: was an evolution, and so feeling good or feeling better 319 00:16:15,240 --> 00:16:18,520 Speaker 2: and giving myself the opportunity to challenge what I thought 320 00:16:18,520 --> 00:16:22,720 Speaker 2: I didn't deserve really helped me break into Yeah, starting 321 00:16:23,240 --> 00:16:26,040 Speaker 2: to feel good and giving myself things that would help 322 00:16:26,080 --> 00:16:27,400 Speaker 2: me feel whole and content. 323 00:16:28,160 --> 00:16:33,000 Speaker 1: I also wonder because with any medical condition, it's for 324 00:16:33,040 --> 00:16:35,560 Speaker 1: the most part, especially something like this, that can progress 325 00:16:35,600 --> 00:16:38,480 Speaker 1: and shift. It's not like it all happens at once. 326 00:16:38,560 --> 00:16:41,400 Speaker 1: It's something that's slowly growing over time. So your brain 327 00:16:41,480 --> 00:16:43,320 Speaker 1: is sort of adjusting to you. I guess this is 328 00:16:43,360 --> 00:16:47,440 Speaker 1: the new normal, and you're not really cognizant of how 329 00:16:47,520 --> 00:16:50,400 Speaker 1: much you've given up until you like have one great 330 00:16:50,480 --> 00:16:52,680 Speaker 1: day and then you're like, what it could be like 331 00:16:52,680 --> 00:16:55,560 Speaker 1: this all the time. So I think that's also important 332 00:16:55,600 --> 00:16:57,840 Speaker 1: for people to remember, right, this is kind of a 333 00:16:57,920 --> 00:16:59,120 Speaker 1: mantra you need to maintain. 334 00:17:00,160 --> 00:17:03,160 Speaker 2: Yes, like you said, there was this feeling when I 335 00:17:03,240 --> 00:17:07,320 Speaker 2: found the right treatment and my skin started to clear. 336 00:17:08,640 --> 00:17:12,520 Speaker 2: I didn't know it was possible to feel this way, 337 00:17:12,560 --> 00:17:15,320 Speaker 2: And I'm so grateful that for me that I was 338 00:17:15,359 --> 00:17:17,919 Speaker 2: open to treatment and that I was open to trying 339 00:17:17,920 --> 00:17:21,960 Speaker 2: something new, because it really has made all the difference. 340 00:17:22,680 --> 00:17:24,840 Speaker 1: Rina, thank you so much for sharing your story with us. 341 00:17:25,000 --> 00:17:27,080 Speaker 1: When we come back, I have some history I'm going 342 00:17:27,160 --> 00:17:28,879 Speaker 1: to share with you, some of which is going to 343 00:17:28,960 --> 00:17:32,359 Speaker 1: sound very familiar. After this break, we will take a 344 00:17:32,400 --> 00:17:36,400 Speaker 1: look at siasis treatment throughout our history, starting with Hippocrates 345 00:17:36,520 --> 00:17:39,640 Speaker 1: in ancient times, running all the way through to advanced 346 00:17:39,680 --> 00:18:01,640 Speaker 1: treatments that are available today. We've covered in previous episodes. 347 00:18:01,720 --> 00:18:05,600 Speaker 1: Ciriasis has always been with us. The ancient Greeks were 348 00:18:05,600 --> 00:18:07,600 Speaker 1: well aware of it, although they did not call it 349 00:18:07,640 --> 00:18:11,520 Speaker 1: psoriasis for quite a while. The physician Hippocrates, who lived 350 00:18:11,520 --> 00:18:15,040 Speaker 1: around four sixty to three seventy BCE, is often credited 351 00:18:15,320 --> 00:18:17,800 Speaker 1: with being one of the first to document treatments for 352 00:18:17,880 --> 00:18:22,080 Speaker 1: skin condition that we now recognize as psoriasis. One of 353 00:18:22,119 --> 00:18:26,760 Speaker 1: his go to remedies was pine tar. That's right, thick, sticky, 354 00:18:26,800 --> 00:18:30,160 Speaker 1: and pungent pine tar. Pine tar has actually been used 355 00:18:30,160 --> 00:18:33,240 Speaker 1: for centuries as a topical treatment because of its supposed 356 00:18:33,240 --> 00:18:37,760 Speaker 1: ability to reduce inflammation and relieve itching. So over the 357 00:18:37,760 --> 00:18:40,800 Speaker 1: centuries it's been applied to the scalp the trunk, the limbs, 358 00:18:41,600 --> 00:18:45,040 Speaker 1: pretty much anywhere of those suffering from psoriasis, and while 359 00:18:45,080 --> 00:18:48,879 Speaker 1: in some cases it actually could provide some relief, it 360 00:18:48,960 --> 00:18:52,680 Speaker 1: obviously comes with some downsides. The heavy, dark substance could 361 00:18:52,680 --> 00:18:55,760 Speaker 1: also irritate some people's skin, so that is the opposite 362 00:18:55,800 --> 00:18:59,200 Speaker 1: of the desired effect, and there's that strong, lingering odor 363 00:18:59,720 --> 00:19:03,520 Speaker 1: not super pleasant. With the advent of the Industrial Revolution, 364 00:19:03,800 --> 00:19:07,880 Speaker 1: pine tar's cousin which Rina mentioned, coal tar, came into 365 00:19:07,920 --> 00:19:11,159 Speaker 1: the picture, and coal tar is of course thick, heavy 366 00:19:11,200 --> 00:19:14,760 Speaker 1: oil that's derived from coal. It emerged as a ciasis 367 00:19:14,840 --> 00:19:18,800 Speaker 1: treatment due to its similar anti inflammatory and anti itch properties, 368 00:19:18,800 --> 00:19:22,200 Speaker 1: and by the early twentieth century, coal tar had become 369 00:19:22,280 --> 00:19:26,120 Speaker 1: a staple in the dermatologist toolkit. So each of these 370 00:19:26,119 --> 00:19:29,200 Speaker 1: types of tars are distilled the same way from their 371 00:19:29,240 --> 00:19:34,320 Speaker 1: origin substances using extreme heat. Basically, if coal or wood 372 00:19:34,440 --> 00:19:37,200 Speaker 1: is burned at really really high temperatures in an absence 373 00:19:37,240 --> 00:19:40,000 Speaker 1: of oxygen, the result is a tar that can be 374 00:19:40,040 --> 00:19:44,399 Speaker 1: put into soaps, lotions, foams, other kinds of topical applications. 375 00:19:44,840 --> 00:19:49,240 Speaker 1: And actually why tars sometimes work on poriasis is not 376 00:19:49,960 --> 00:19:53,600 Speaker 1: still super well understood. But coal tar, as we know 377 00:19:53,640 --> 00:19:57,400 Speaker 1: from Rena's story is still recommended today by the American 378 00:19:57,440 --> 00:20:00,439 Speaker 1: Academy of Dermatologists, and the best that we can tell 379 00:20:01,000 --> 00:20:04,480 Speaker 1: is that these tars slow down skin cell growth, which 380 00:20:04,520 --> 00:20:08,240 Speaker 1: can reduce the severity of the plaques that often accompany pariasis. 381 00:20:09,160 --> 00:20:13,200 Speaker 1: But these are, after all products that also have industrial uses, 382 00:20:13,240 --> 00:20:16,600 Speaker 1: so they are not necessarily gentle. Side effects can be 383 00:20:16,720 --> 00:20:19,919 Speaker 1: very serious, including in some people an increased risk of 384 00:20:19,960 --> 00:20:23,960 Speaker 1: certain cancers, and some people, such as anyone who's pregnant, 385 00:20:24,359 --> 00:20:27,560 Speaker 1: is not recommended to use these kinds of treatments. So Rena, 386 00:20:27,840 --> 00:20:29,960 Speaker 1: I was a little bit shocked that the ancient Greeks 387 00:20:29,960 --> 00:20:32,600 Speaker 1: were like, yes, let's put pine tar on people. I 388 00:20:32,720 --> 00:20:35,440 Speaker 1: didn't know until working on this show that people were 389 00:20:35,440 --> 00:20:37,639 Speaker 1: still using col tar, and you are an example of 390 00:20:37,640 --> 00:20:40,520 Speaker 1: that today. Did you know that pine tar was in 391 00:20:40,560 --> 00:20:41,000 Speaker 1: the mix? 392 00:20:41,680 --> 00:20:42,800 Speaker 3: I had no clue. 393 00:20:42,960 --> 00:20:45,440 Speaker 2: I am I'm shocked, but I have used pine tar, 394 00:20:46,040 --> 00:20:47,200 Speaker 2: which is interesting. 395 00:20:47,240 --> 00:20:48,960 Speaker 3: I feel like someone gave it to me because I 396 00:20:49,000 --> 00:20:51,120 Speaker 3: did have it. You know what, people are always like, hey, 397 00:20:51,160 --> 00:20:52,360 Speaker 3: if you tried, does have you tried? 398 00:20:52,400 --> 00:20:55,560 Speaker 1: That's I'm shocked, like an old wives remedy that they're like, 399 00:20:55,600 --> 00:20:58,760 Speaker 1: I prepared some Yeah, apparently they're going all the way 400 00:20:58,760 --> 00:21:03,480 Speaker 1: back to Hippocrates. With that, you also mentioned some light 401 00:21:03,560 --> 00:21:06,520 Speaker 1: therapies That goes back to nineteen twenty five, when an 402 00:21:06,520 --> 00:21:11,080 Speaker 1: American dermatologist named William Gekerman discovered that combining coal tar 403 00:21:11,480 --> 00:21:15,920 Speaker 1: with ultraviolet light therapy was particularly effective in treating pariasis. 404 00:21:16,440 --> 00:21:19,920 Speaker 1: That method, still known as gekermann therapy, involves applying coal 405 00:21:19,960 --> 00:21:23,600 Speaker 1: tar to the skin and then exposing it to UVB light, 406 00:21:24,080 --> 00:21:27,520 Speaker 1: and that combination helps slow down rapid skin cell turnover, 407 00:21:27,840 --> 00:21:31,919 Speaker 1: which is what characterizes psoriasis. It provides significant relief to 408 00:21:31,960 --> 00:21:35,520 Speaker 1: a lot of patients, but we can't pat ourselves on 409 00:21:35,560 --> 00:21:39,400 Speaker 1: the back too much. Long before Geckerman's discovery, sunlight itself 410 00:21:39,440 --> 00:21:42,520 Speaker 1: was already recognized as a valuable ally in the fight 411 00:21:42,640 --> 00:21:47,360 Speaker 1: against sariasis. Ancient physicians noted that exposure to sunlight could 412 00:21:47,440 --> 00:21:50,919 Speaker 1: help alleviate the symptoms, especially if it was used in 413 00:21:50,960 --> 00:21:55,639 Speaker 1: conjunction with topical treatments. However, not everyone could afford to 414 00:21:55,680 --> 00:21:59,080 Speaker 1: spend hour sunbathing, and of course we know excessive sun 415 00:21:59,080 --> 00:22:02,440 Speaker 1: exposure has its own set of risks, including skin damage 416 00:22:02,440 --> 00:22:06,720 Speaker 1: and an increased risk of skin cancer. Light therapy, which 417 00:22:06,800 --> 00:22:08,600 Speaker 1: I want to ask you about because you've done It 418 00:22:08,640 --> 00:22:11,679 Speaker 1: can be used alone or in combination with topical medications 419 00:22:11,760 --> 00:22:15,119 Speaker 1: or tablets that will increase your sensitivity to UVB or 420 00:22:15,200 --> 00:22:18,520 Speaker 1: UVA light. The latter of those is prescribed for young 421 00:22:18,680 --> 00:22:21,840 Speaker 1: or more sensitive patients, and those sessions, according to our 422 00:22:21,840 --> 00:22:24,439 Speaker 1: research I've never done one can last just a few minutes, 423 00:22:24,800 --> 00:22:26,920 Speaker 1: and they're typically given two or three times a week 424 00:22:26,960 --> 00:22:29,040 Speaker 1: for like a six to eight week run. But the 425 00:22:29,080 --> 00:22:32,600 Speaker 1: effectiveness and options depend on a wide range of factors, 426 00:22:32,600 --> 00:22:35,960 Speaker 1: including the type of severity of psoriasis, other health conditions, 427 00:22:35,960 --> 00:22:39,360 Speaker 1: as well as any medication. So you mentioned light therapy. 428 00:22:39,480 --> 00:22:42,160 Speaker 1: Tell us about that. It sounds in theory to someone 429 00:22:42,160 --> 00:22:43,880 Speaker 1: that's not done it very nice, like, oh, you need 430 00:22:43,920 --> 00:22:46,560 Speaker 1: a sunbath, let's do light therapy. But what is it 431 00:22:46,640 --> 00:22:47,320 Speaker 1: actually like? 432 00:22:47,680 --> 00:22:51,040 Speaker 3: I know, imagine, yeah, you go into this beautiful zen spot. No, 433 00:22:51,280 --> 00:22:52,840 Speaker 3: actually it's like that at all. 434 00:22:54,000 --> 00:22:57,120 Speaker 2: So, like you mentioned, in addition to the coal tar 435 00:22:57,560 --> 00:22:59,600 Speaker 2: that I was putting on every night, now three times 436 00:22:59,640 --> 00:23:01,720 Speaker 2: a week, we were going to this light therapy. So 437 00:23:01,720 --> 00:23:05,959 Speaker 2: it's a chamber essentially, and you're in there for like 438 00:23:06,080 --> 00:23:09,360 Speaker 2: ten seconds, but I remember, to get there it would 439 00:23:09,400 --> 00:23:11,679 Speaker 2: take an hour, and to get back it would take 440 00:23:11,720 --> 00:23:14,439 Speaker 2: an hour because it was so far. So it's just 441 00:23:14,440 --> 00:23:16,760 Speaker 2: like going into a tanning booth, but a standing up 442 00:23:16,800 --> 00:23:19,479 Speaker 2: tanning booth. You kind of do this for ten fifteen seconds. 443 00:23:19,480 --> 00:23:22,360 Speaker 2: It wasn't a few minutes. It was very quick, and 444 00:23:22,400 --> 00:23:25,159 Speaker 2: that was that, and it works. It worked for me 445 00:23:25,240 --> 00:23:28,199 Speaker 2: at least, and it's worked for people who I've talked to. 446 00:23:28,800 --> 00:23:32,240 Speaker 2: But eventually you're just like, I don't this seems a 447 00:23:32,280 --> 00:23:34,560 Speaker 2: bit odd just to drive for a ten second stand 448 00:23:34,640 --> 00:23:35,760 Speaker 2: up session and come home. 449 00:23:35,920 --> 00:23:39,240 Speaker 3: Some people bring them into their house, right, thousands of dollars, 450 00:23:39,320 --> 00:23:39,520 Speaker 3: you know. 451 00:23:39,800 --> 00:23:43,040 Speaker 2: So for me it did help, but I got really 452 00:23:43,119 --> 00:23:45,960 Speaker 2: tired very quickly, so after the first stint I was done. 453 00:23:46,119 --> 00:23:46,280 Speaker 3: Well. 454 00:23:46,320 --> 00:23:48,520 Speaker 1: It's good that you mentioned that, though, because it is 455 00:23:48,520 --> 00:23:50,560 Speaker 1: a cool therapy. It does work for a lot of people, 456 00:23:50,600 --> 00:23:53,640 Speaker 1: but it doesn't mean that it's easily accessible for everybody. 457 00:23:54,240 --> 00:23:57,120 Speaker 1: You know, if you're not in a metro area, your 458 00:23:57,160 --> 00:24:00,359 Speaker 1: odds of finding one in driving distance are probably pretty low. 459 00:24:01,200 --> 00:24:04,000 Speaker 1: And the other option is to go to great personal 460 00:24:04,040 --> 00:24:04,920 Speaker 1: expense to build one. 461 00:24:05,119 --> 00:24:07,040 Speaker 2: It's true, and not to go to the tanning booth. 462 00:24:07,560 --> 00:24:09,640 Speaker 2: Because a lot of people are going to the tanning booth. 463 00:24:09,720 --> 00:24:12,520 Speaker 2: I think it's not the same thing. It's that like 464 00:24:12,600 --> 00:24:16,600 Speaker 2: you mentioned UVB versus UVA, So right, yes. 465 00:24:16,400 --> 00:24:20,800 Speaker 1: Don't do that, that's not your treatment. I do want 466 00:24:20,840 --> 00:24:23,520 Speaker 1: to shock you with more things, because moving into the 467 00:24:23,600 --> 00:24:27,159 Speaker 1: Victorian era, there were some very alarming treatments going on, 468 00:24:27,359 --> 00:24:31,280 Speaker 1: including diluted tinctures of arsenic and mercury that were used 469 00:24:31,280 --> 00:24:35,920 Speaker 1: to treat various skin conditions, including psoriasis. These are obviously 470 00:24:35,920 --> 00:24:39,600 Speaker 1: incredibly toxic and their use usually did more harm than good. 471 00:24:40,119 --> 00:24:43,439 Speaker 1: In some cases, people were even advised to inject these 472 00:24:43,680 --> 00:24:47,680 Speaker 1: very dangerous chemicals directly into their bodies. That's a stark 473 00:24:47,760 --> 00:24:50,720 Speaker 1: reminder though, of how desperate people have been over the 474 00:24:50,720 --> 00:24:54,760 Speaker 1: ages to get some relief and how limited medical knowledge 475 00:24:54,880 --> 00:24:58,199 Speaker 1: was at the time, and that combination was brutal and 476 00:24:58,359 --> 00:25:01,720 Speaker 1: probably deadly for some people. We don't really have any 477 00:25:01,760 --> 00:25:04,280 Speaker 1: hard data on how many people died from injecting our 478 00:25:04,359 --> 00:25:06,880 Speaker 1: snack to treat skin conditions, but I bet you it happened. 479 00:25:07,520 --> 00:25:09,520 Speaker 1: And then in the early nineteen hundreds, there was another 480 00:25:09,560 --> 00:25:13,480 Speaker 1: topical treatment that came into play called dithronol. This compound 481 00:25:13,600 --> 00:25:16,240 Speaker 1: is derived from the bark of the aerobatry and it's 482 00:25:16,280 --> 00:25:19,240 Speaker 1: found to be effective in slowing down skin cell production. 483 00:25:19,800 --> 00:25:23,880 Speaker 1: And therefore reducing the severity of plaques that develop. However, 484 00:25:24,000 --> 00:25:26,640 Speaker 1: it was not widely used in the United States because, 485 00:25:26,760 --> 00:25:29,879 Speaker 1: like other treatments, it could discolor the skin and stain 486 00:25:29,960 --> 00:25:33,639 Speaker 1: clothing and bedding. That's not super practical for everyday use. 487 00:25:34,200 --> 00:25:38,080 Speaker 1: As recently as nineteen fifty six, medical literature still mentioned 488 00:25:38,200 --> 00:25:42,920 Speaker 1: using mercury in topical ointments for psoriasis. We know now 489 00:25:43,000 --> 00:25:46,240 Speaker 1: that mercury is highly toxic and can cause serious health issues, 490 00:25:46,720 --> 00:25:49,399 Speaker 1: but even in the mid twentieth century it was one 491 00:25:49,440 --> 00:25:51,800 Speaker 1: of the few options that was really available to doctors 492 00:25:51,800 --> 00:25:56,480 Speaker 1: and patients. So throughout history there have been various unorthodox treatments, 493 00:25:56,520 --> 00:26:00,320 Speaker 1: herbal concoctions, and then my favorite, snake oil, which were 494 00:26:00,359 --> 00:26:03,119 Speaker 1: often touted as miracle cures. We use the term snake 495 00:26:03,119 --> 00:26:05,960 Speaker 1: oil today to talk about something that is a fake 496 00:26:06,040 --> 00:26:09,320 Speaker 1: medicine or like something a carpetbagger would sell you that's 497 00:26:09,359 --> 00:26:10,840 Speaker 1: not going to do any good and might in fact 498 00:26:10,880 --> 00:26:14,040 Speaker 1: harm you. But there are actual snake oils that work. 499 00:26:14,640 --> 00:26:17,800 Speaker 1: The snake oil concept derives from an old Chinese remedy 500 00:26:17,800 --> 00:26:20,760 Speaker 1: that made use of the black banded secret it's also 501 00:26:20,800 --> 00:26:23,720 Speaker 1: known as a Chinese water snake, and that had legit 502 00:26:23,800 --> 00:26:27,920 Speaker 1: anti inflammatory effects because Chinese water snakes have a very 503 00:26:28,000 --> 00:26:32,320 Speaker 1: high concentration of omega three fatty acids. But when that 504 00:26:32,400 --> 00:26:36,679 Speaker 1: remedy made its way to North America via immigration, there 505 00:26:36,680 --> 00:26:38,639 Speaker 1: were a lot of Charlatans that picked up on it, 506 00:26:38,720 --> 00:26:42,040 Speaker 1: particularly in the American West, and they started making their 507 00:26:42,080 --> 00:26:45,040 Speaker 1: own version of the Chinese cure. But they used just 508 00:26:45,080 --> 00:26:48,520 Speaker 1: about any snake they could find, including rattlesnakes. Those do 509 00:26:48,640 --> 00:26:52,000 Speaker 1: not have the same beneficial omega threes, and that is 510 00:26:52,040 --> 00:26:55,560 Speaker 1: how that term transitioned to become snake oil in our 511 00:26:55,640 --> 00:26:59,640 Speaker 1: lexicon as something that's worthless and possibly dangerous in terms 512 00:26:59,640 --> 00:27:03,560 Speaker 1: of health treatments. There are also, of course, indigenous tribes 513 00:27:03,600 --> 00:27:05,879 Speaker 1: that have had their own remedies, including the use of 514 00:27:05,880 --> 00:27:08,840 Speaker 1: buds from the balsam poplar that has been used to 515 00:27:08,880 --> 00:27:12,480 Speaker 1: treat soriasis in other skin conditions. And of course, today, 516 00:27:13,520 --> 00:27:17,199 Speaker 1: as Rena knows, there are a lot of changes in 517 00:27:17,240 --> 00:27:20,240 Speaker 1: our understanding of psoriasis. We know it's not just a 518 00:27:20,280 --> 00:27:22,359 Speaker 1: skin condition, which is how it used to be treated. 519 00:27:22,760 --> 00:27:26,280 Speaker 1: It is an autoimmune disease. This means that the body's 520 00:27:26,280 --> 00:27:30,679 Speaker 1: immune system is mistakenly attacking healthy skin cells. That's what 521 00:27:30,800 --> 00:27:33,840 Speaker 1: leads to that rapid skin cell turnover we've been talking about, 522 00:27:34,119 --> 00:27:37,600 Speaker 1: and that's what causes those characteristic red and scaly patches. 523 00:27:38,359 --> 00:27:40,959 Speaker 1: Here's what I wonder as I'm talking about all of this, rena. 524 00:27:41,040 --> 00:27:44,120 Speaker 1: There are so many treatments now for psoriasis that I 525 00:27:44,119 --> 00:27:47,280 Speaker 1: imagine even that becomes its own. While it's like they're 526 00:27:47,320 --> 00:27:49,520 Speaker 1: an array of things we can try. That is probably 527 00:27:49,560 --> 00:27:52,840 Speaker 1: intimidating in and of itself. Since you have a community 528 00:27:52,880 --> 00:27:54,760 Speaker 1: around this, do you find that a lot of people 529 00:27:54,960 --> 00:27:57,520 Speaker 1: are going through trial and error? And what is that 530 00:27:57,920 --> 00:28:01,120 Speaker 1: like again mentally in emotion? Is there a point where 531 00:28:01,119 --> 00:28:03,840 Speaker 1: some patients are just like I'm done, I'm not going 532 00:28:03,880 --> 00:28:04,920 Speaker 1: to deal with this anymore. 533 00:28:05,680 --> 00:28:08,160 Speaker 3: Yes, I found that with myself and with others. 534 00:28:08,480 --> 00:28:11,639 Speaker 2: It is exhausting, especially when something doesn't work and you 535 00:28:11,720 --> 00:28:16,000 Speaker 2: have so much hope. You're trying everything, You're hoping it's 536 00:28:16,040 --> 00:28:18,600 Speaker 2: going to work, and it doesn't, and then you're like, 537 00:28:18,680 --> 00:28:21,480 Speaker 2: should I bother going through the whole process of getting 538 00:28:21,520 --> 00:28:25,080 Speaker 2: something else? So, yes, people get tired, And I always say, 539 00:28:25,160 --> 00:28:28,919 Speaker 2: you know, it's okay to take a break, but don't quit, Like, 540 00:28:29,320 --> 00:28:31,840 Speaker 2: just try as much as you can. And I would 541 00:28:31,880 --> 00:28:34,600 Speaker 2: give that same advice to myself who went through years 542 00:28:34,600 --> 00:28:36,880 Speaker 2: and years of just giving up completely and my skin 543 00:28:36,960 --> 00:28:39,040 Speaker 2: going wild. I was like, nothing's going to work, So 544 00:28:39,080 --> 00:28:41,800 Speaker 2: what's the point. So I think people do get tired, 545 00:28:41,840 --> 00:28:45,080 Speaker 2: and there is trial and error, but take a break, rest, 546 00:28:45,360 --> 00:28:47,800 Speaker 2: give yourself a moment, and then get back on that horse, 547 00:28:47,840 --> 00:28:51,760 Speaker 2: because as I've said, for me, I've found something that works. 548 00:28:52,160 --> 00:28:55,120 Speaker 2: And the science is so much more sophisticated than it was, 549 00:28:55,760 --> 00:29:01,440 Speaker 2: you know, years ago. So as you educated me with today, 550 00:29:01,880 --> 00:29:03,920 Speaker 2: I was like, I'm still happy I wasn't born in 551 00:29:03,960 --> 00:29:04,560 Speaker 2: the twenties. 552 00:29:04,640 --> 00:29:09,280 Speaker 1: Yeah, right, And the thing is too we mentioned and 553 00:29:09,320 --> 00:29:14,080 Speaker 1: we know topical treatments don't address the root cause of psoriasis, right. 554 00:29:14,520 --> 00:29:16,720 Speaker 1: They may help with your skin, but you're still having 555 00:29:16,760 --> 00:29:20,440 Speaker 1: an autoimmune system. This is where, of course, a much 556 00:29:20,480 --> 00:29:24,000 Speaker 1: newer treatment comes in, which is biologics. Biologics are a 557 00:29:24,000 --> 00:29:26,680 Speaker 1: class of drugs that was first approved in the US 558 00:29:26,760 --> 00:29:29,840 Speaker 1: by the FDA in the early two thousands, and they 559 00:29:29,880 --> 00:29:32,920 Speaker 1: target specific parts of the immune system involved in the 560 00:29:32,960 --> 00:29:37,920 Speaker 1: inflammatory process, and by inhibiting certain immune responses, biologics can 561 00:29:38,400 --> 00:29:42,320 Speaker 1: significantly reduce the symptoms of psoriasis and improve quality of 562 00:29:42,360 --> 00:29:45,880 Speaker 1: life for a whole lot of patients. Biologics have obviously 563 00:29:45,920 --> 00:29:50,760 Speaker 1: revolutionized the entire treatment possibilities for moderate and severe psoriasis. 564 00:29:51,080 --> 00:29:55,480 Speaker 1: They are typically administered by injection or intravenous infusion, and 565 00:29:55,520 --> 00:29:58,640 Speaker 1: they can actually provide some very long lasting relief. And 566 00:29:58,760 --> 00:30:01,800 Speaker 1: as we reflect on the h of soriasis treatments, it 567 00:30:01,880 --> 00:30:04,120 Speaker 1: is clear we have come a very long way from 568 00:30:04,160 --> 00:30:06,680 Speaker 1: the days of pine tar and arsenic thankfully, and other 569 00:30:06,720 --> 00:30:10,520 Speaker 1: toxic chemicals. Our understanding of the condition has deepened and 570 00:30:10,560 --> 00:30:14,080 Speaker 1: with it our ability to manage it effectively. And while 571 00:30:14,080 --> 00:30:17,840 Speaker 1: there is still no cure, advances in medical research continue 572 00:30:17,840 --> 00:30:20,640 Speaker 1: to bring hope to millions of people living with this 573 00:30:20,760 --> 00:30:25,080 Speaker 1: challenging condition. So I think the most important takeaway from 574 00:30:25,120 --> 00:30:27,680 Speaker 1: all of this is that we really have come very 575 00:30:27,800 --> 00:30:30,680 Speaker 1: very far right. Treatment is way more effective than it 576 00:30:30,760 --> 00:30:34,120 Speaker 1: was in the early days, no more arsenic. So if 577 00:30:34,160 --> 00:30:36,680 Speaker 1: someone has been reluctant to open up to a doctor 578 00:30:37,000 --> 00:30:39,840 Speaker 1: and see what treatments are available, now is a great 579 00:30:39,920 --> 00:30:43,200 Speaker 1: time treating a chronic skin condition. I know we've said 580 00:30:43,200 --> 00:30:45,480 Speaker 1: it a million times, but it bears repeating. It's not 581 00:30:45,560 --> 00:30:48,960 Speaker 1: a straight line, as our dip into history shows, but 582 00:30:49,000 --> 00:30:52,720 Speaker 1: it is really amazing to know that there's a lot 583 00:30:52,760 --> 00:30:55,280 Speaker 1: that's been done to make living with poriasis so much 584 00:30:55,320 --> 00:30:59,960 Speaker 1: more doable and so that people can embrace the idea 585 00:31:00,240 --> 00:31:02,560 Speaker 1: that they deserve to feel good. There are things you 586 00:31:02,600 --> 00:31:05,440 Speaker 1: can do every day to feel better emotionally and physically, 587 00:31:05,480 --> 00:31:07,360 Speaker 1: and you just had to find what works for you. 588 00:31:07,960 --> 00:31:10,000 Speaker 1: So I want to come back to that idea arena 589 00:31:10,120 --> 00:31:13,160 Speaker 1: of you deserve to feel good, because we all deserve that. 590 00:31:13,760 --> 00:31:16,880 Speaker 1: But that is also not a straight line. What got 591 00:31:16,880 --> 00:31:19,440 Speaker 1: you through those times where treatment wasn't working or you 592 00:31:19,600 --> 00:31:21,400 Speaker 1: just weren't feeling good about the whole. 593 00:31:21,320 --> 00:31:25,000 Speaker 2: Journey, you know, I just went through that phase in 594 00:31:25,080 --> 00:31:29,320 Speaker 2: December recently, on New Year's Eve. I yeah, my treatment 595 00:31:29,400 --> 00:31:31,280 Speaker 2: just wasn't working and I had to And now again 596 00:31:31,320 --> 00:31:33,360 Speaker 2: I've found good treatment because I went back. I didn't 597 00:31:33,400 --> 00:31:37,080 Speaker 2: give up. But during that really hard time, I noticed 598 00:31:37,080 --> 00:31:41,600 Speaker 2: how everything I intellectually knew just went out the window. 599 00:31:41,800 --> 00:31:44,280 Speaker 2: I didn't follow any of my own advice. I just 600 00:31:44,320 --> 00:31:47,040 Speaker 2: felt hopeless. I laid in bed, I was swollen, I 601 00:31:47,160 --> 00:31:51,040 Speaker 2: was sad, and what helped me was asking for help, 602 00:31:51,680 --> 00:31:54,320 Speaker 2: going to my therapist, which I'm lucky enough to have, 603 00:31:55,000 --> 00:31:58,160 Speaker 2: asking my family for support, telling my friends I'm struggling. 604 00:31:58,280 --> 00:32:00,960 Speaker 3: I really need someone here with me, and. 605 00:32:00,920 --> 00:32:06,000 Speaker 2: Then also telling myself it's okay, like having some self compassion. 606 00:32:06,520 --> 00:32:09,040 Speaker 2: It's okay that you're here and you're having a hard time. 607 00:32:09,040 --> 00:32:12,120 Speaker 2: You're not doing the quote unquote things you should be 608 00:32:12,240 --> 00:32:13,440 Speaker 2: doing or could be doing. 609 00:32:14,080 --> 00:32:14,760 Speaker 3: It's okay to. 610 00:32:14,760 --> 00:32:18,080 Speaker 2: Have a moment and be sad and grieve the pain 611 00:32:18,280 --> 00:32:22,880 Speaker 2: and give yourself what you need. But I said to myself, 612 00:32:23,320 --> 00:32:26,800 Speaker 2: you know, after a week of this, you're not going 613 00:32:26,880 --> 00:32:29,840 Speaker 2: to pack your bags and move into the space. It's 614 00:32:29,880 --> 00:32:31,840 Speaker 2: time to get back on the horse, like get the 615 00:32:31,880 --> 00:32:35,000 Speaker 2: support that you need, like I said, and also go 616 00:32:35,160 --> 00:32:38,120 Speaker 2: back to the doctor and talk to her about what 617 00:32:38,360 --> 00:32:40,920 Speaker 2: is possible. And we were able to find something that worked. 618 00:32:41,160 --> 00:32:42,640 Speaker 2: I was nervous because I'm like, oh, I'm going to 619 00:32:42,680 --> 00:32:45,160 Speaker 2: go right back to where I was. But yes, it's 620 00:32:45,360 --> 00:32:50,040 Speaker 2: it's truly learning to ask for help and support and 621 00:32:50,080 --> 00:32:52,720 Speaker 2: knowing that I don't have to do it alone. That's 622 00:32:52,800 --> 00:32:53,560 Speaker 2: changed my life. 623 00:32:54,320 --> 00:32:58,200 Speaker 1: Rina, you are an angel and your story is so powerful. 624 00:32:58,600 --> 00:33:01,360 Speaker 1: If you could send one mess to listeners who might 625 00:33:01,400 --> 00:33:04,320 Speaker 1: be grappling with their own diagnosis, what would that be. 626 00:33:06,120 --> 00:33:08,520 Speaker 2: I think everything that we've said through this, but it 627 00:33:08,560 --> 00:33:11,760 Speaker 2: would be that there is a hope and that there 628 00:33:11,880 --> 00:33:15,120 Speaker 2: is change, and although right now you may not know 629 00:33:15,160 --> 00:33:18,880 Speaker 2: what direction you need to go, it is possible to 630 00:33:18,920 --> 00:33:21,520 Speaker 2: find the care. Just don't give up and be open 631 00:33:21,720 --> 00:33:23,120 Speaker 2: to what might be possible for you. 632 00:33:23,600 --> 00:33:25,680 Speaker 1: I love it. Thank you again so much. You're such 633 00:33:25,680 --> 00:33:26,160 Speaker 1: a delight. 634 00:33:26,560 --> 00:33:28,360 Speaker 3: Thanks Hollie, love to convo. 635 00:33:33,760 --> 00:33:37,520 Speaker 1: Our Skin is hosted by myself, Holly Frye, and executive 636 00:33:37,560 --> 00:33:41,200 Speaker 1: produced and engineered by Ryan Martz. Our senior producer and 637 00:33:41,200 --> 00:33:44,760 Speaker 1: writer is Meredith Barnes. If you enjoy the show, share 638 00:33:44,800 --> 00:33:47,600 Speaker 1: it with your friends. You can also listen and follow 639 00:33:47,840 --> 00:33:51,520 Speaker 1: on the iHeartRadio app, Apple Podcasts, or wherever you get 640 00:33:51,560 --> 00:33:52,440 Speaker 1: your podcasts.