Speaker 1: Welcome to Our Skin, a personal discovery podcast. I'm your host,
Speaker 1: Holly Fry, and it is wonderful to have you here
Speaker 1: with us. Connection is what this show is all about,
Speaker 1: specifically connecting about things that we are sometimes afraid to
Speaker 1: talk about. Today, we're going to be exploring the ups
Speaker 1: and downs, past and present, personal and universal troubles we
Speaker 1: have with our skin. Our skin is our most visible organ.
Speaker 1: What happens on our skin affects the rest of our lives,
Speaker 1: especially when dealing with a chronic condition. Getting diagnosed with
Speaker 1: one of these, like psoriasis, can be overwhelming, but you're
Speaker 1: not alone. Each episode features a personal story of resilience
Speaker 1: and grace, but our personal stories are threads in a
Speaker 1: larger tapestry, and there are lessons for us in the
Speaker 1: history of how we treat our skin and the progress
Speaker 1: we've made together. Caring for our skin is caring for ourselves.
Speaker 1: Whether you're seeking inspiration for your own journey or curious
Speaker 1: about the history of our skin, you'll find empathetic, transformative
Speaker 1: conversations here on Our Skin. Today. We are joined by
Speaker 1: well being coach, mindfulness guide, and skin empowerment leader Rena Ruperelia.
Speaker 1: I am so glad to welcome her today. Rena has
Speaker 1: lived with soriasis since she was in high school, but
Speaker 1: she didn't start sharing about her experience until twenty years later.
Speaker 1: She first noticed symptoms of sriasis when she was just fourteen,
Speaker 1: and at the time, of course, as a teenager, that
Speaker 1: experience was deeply isolating, Like many people facing a chronic condition.
Speaker 1: For a while, she tried to hide what was going on,
Speaker 1: hoping that maybe someday things might change on their own.
Speaker 1: But when they did not, Rena hit a point where
Speaker 1: she couldn't get by on hope alone. Her symptoms had
Speaker 1: continued to intrude into her life for decades, and she
Speaker 1: knew it was time to find treatment. So that, of course,
Speaker 1: sounds really easy, go to a doctor, get a prescription
Speaker 1: treatment treatment, But just as a lot of syriasis is
Speaker 1: patients have experienced, the path to treatment for Rena was
Speaker 1: anything but easy. She found herself battling a reluctance to
Speaker 1: open up to her doctor and hesitancy from having used
Speaker 1: treatments in the past that just didn't work at all,
Speaker 1: or perhaps even exacerbated things. One of the sources of
Speaker 1: strength that Rena was able to draw upon during this
Speaker 1: difficult time. Was her mindfulness practice something that we're going
Speaker 1: to ask about for sure in our interview today. And
Speaker 1: she has also started sharing with others and putting her
Speaker 1: journey out there online and finding that her story empowers
Speaker 1: others as well as herself in the process. So eventually,
Speaker 1: Rena fortunately found a doctor that understood and her soriasis
Speaker 1: became more under control. So Rena had a new message
Speaker 1: to share with her followers. Open up to your doctor
Speaker 1: and you might be surprised what they're able to do
Speaker 1: to help. And your story, Rena ties in perfectly with
Speaker 1: the history that we're going to discuss today, which is
Speaker 1: going to take us on a step by step tour
Speaker 1: of the evolution of Sorias's Street from ancient times to
Speaker 1: our modern medicines. And I am so excited to talk
Speaker 1: to Rena today about her experience because there are a
Speaker 1: lot of barriers for people that seek treatment, from stigma
Speaker 1: and embarrassment to doctors who maybe aren't always that knowledgeable
Speaker 1: about skin conditions. It is a lot to take on
Speaker 1: as a patient and as a person. So Rena, welcome
Speaker 1: to our skin I'm so delighted that you're here.
Speaker 2: Thanks for that beautiful introduction, Holly, that was perfectly summarized.
Speaker 1: I'm glad. I never want a misstep. It's always that
Speaker 1: awkward thing when you're telling someone else's story while they're
Speaker 1: sitting there. So I'm glad it all vibed right. I
Speaker 1: would love it if you would take us back to
Speaker 1: your first inclinations when you were like, I might actually
Speaker 1: need to seek medical treatment for this skin condition. But
Speaker 1: first I want to ask how did your symptoms manifest initially?
Speaker 2: Yeah, they actually tie in perfectly together. So, like you mentioned,
Speaker 2: I was in high school. We were just about to
Speaker 2: go into high school. So it was like two months
Speaker 2: before the summer. I was in England seeing my family,
Speaker 2: living my best life, and all I just kept thinking
Speaker 2: about was I can't wait for the first day of
Speaker 2: grade nine.
Speaker 3: I'm going to meet all these new people.
Speaker 2: I'm so excited and thinking about all the boys and
Speaker 2: all the fun and all the things. But my skin
Speaker 2: had a different plan. So I just remember I was
Speaker 2: in England and I looked down at my stomach and
Speaker 2: I had these red dots.
Speaker 3: They look kind of like chicken pox. I didn't know
Speaker 3: what they were.
Speaker 2: I thought maybe bug bites, but as the weeks went on,
Speaker 2: the days went on, they were growing and kind of spreading,
Speaker 2: but they still look similar.
Speaker 3: So I ran to the.
Speaker 2: Doctor and I was like, you got to fix this.
Speaker 2: Like I'm about to start high school. I need to
Speaker 2: get rid of this now. So he's like, oh, you
Speaker 2: just have chicken pox. Like it's just chicken pox, right,
Speaker 2: he didn't know it kind of looked like it.
Speaker 3: I was happy. I went home, asked no questions.
Speaker 2: But again, as I mentioned, as the days went on,
Speaker 2: the weeks went on, it started growing even kind of
Speaker 2: and spreading, and the scales went from these like red
Speaker 2: dots to these silvery scales. And eventually I went back
Speaker 2: again and he said, oh, I think you may have psoriasis.
Speaker 3: I didn't know.
Speaker 2: There was no Google then, right. It sounded like a dinosaur.
Speaker 2: To be honest, I had no clue how to even
Speaker 2: spell it. I didn't know what it was, never heard
Speaker 2: of it. All I cared about was ken you get
Speaker 2: rid of it. And that's kind of I think when
Speaker 2: my life changed, especially when it comes to my skin.
Speaker 2: So that was the moment, and the line you know
Speaker 2: that I always remember is I can't confirm for sure.
Speaker 2: You know you can try this cream, and there's no cure,
Speaker 2: but we can find a way to manage it, but
Speaker 2: we have to wait for the dermatologist.
Speaker 1: That's just what a fourteen year old wants to hear too.
Speaker 1: It's like we're gonna have a lot of guesswork ahead
Speaker 1: of us, no problem. I wonder at that age, especially,
Speaker 1: kids are not sharing the things that they're embarrassed or
Speaker 1: self conscious about. Did you know anyone else that was
Speaker 1: dealing with anything similar or did you feel like the
Speaker 1: only person on earth that had this condition?
Speaker 2: Yeah, what a good question. I thought I was the
Speaker 2: only person on earth with the condition. I kept hearing
Speaker 2: this story, and I still hear it to this day.
Speaker 2: Your aunt had it on her finger. She got rid
Speaker 2: of it by wrapping it up with this, this, and this.
Speaker 2: Your grandmother rather has eggzema as well as my father.
Speaker 2: But to be honest, no one was really talking about it.
Speaker 2: There was just that story about my aunt wrapping up
Speaker 2: her hands, which I said, like, I still here to
Speaker 2: this day, and she was able to get rid of it.
Speaker 2: I have brought myself up with everything and anything, and
Speaker 2: I still had it, So it.
Speaker 1: Did a Nobody knows if that was even what she
Speaker 1: was dealing with right, like she may have had an
Speaker 1: allergic reaction to something. There's no there's no actual science
Speaker 1: data to put.
Speaker 3: But it's brutal. Yeah, it truthfully all jokes aside. I
Speaker 3: just remember just thinking like what is this?
Speaker 2: And I did feel like I was the only one,
Speaker 2: and so there was so much that went into that. Again,
Speaker 2: like you mentioned, as a fourteen year old girl, I
Speaker 2: was really worried about my image and fitting in looking
Speaker 2: like everyone else. I didn't want to have this thing
Speaker 2: or this skin that made me quote unquote different.
Speaker 1: Right, you did not think you were turning into an
Speaker 1: X man. You just thought you were.
Speaker 3: I wish that's what happened, If I'm honest.
Speaker 1: By the way, I'm mistique now just funny exactly. I'm
Speaker 1: wondering too, though you mentioned like the words that were
Speaker 1: terrifying were like, we don't really know, we're gonna try
Speaker 1: some things. What challenges were there in those initial treatment stages.
Speaker 1: I know, even just like talking to a doctor as
Speaker 1: a teenager about anything is already tough, so then to
Speaker 1: be in this loop where you're having to give feedback
Speaker 1: and time about what doesn't doesn't work and what things
Speaker 1: feel like. What was that all like probably very scary.
Speaker 2: Absolutely, And I will say, although I've gotten better with
Speaker 2: having the conversations now, it still continues to be challenging,
Speaker 2: right to figure out what's gonna work, what's not gonna work,
Speaker 2: because treatments need reevaluation and change often, which I didn't
Speaker 2: know but in the beginning stages the first Okay, so
Speaker 2: after I actually got diagnosed with SIISIS, which in itself
Speaker 2: was a horrible experience because I was feeling so vulnerable
Speaker 2: and the doctor, the dermatologists at this point, came in,
Speaker 2: took a look at my skin, didn't really talk to me.
Speaker 2: I waited three months for this appointment. Side note, like
Speaker 2: three months, you know, I'm like, he's going to cure me,
Speaker 2: or they're going to cure me.
Speaker 3: Wherever it is. This person is going to cure me.
Speaker 2: And when I went to the actual office, like I said,
Speaker 2: he took a quick look, then brought all of his
Speaker 2: students in.
Speaker 3: And they also, I guess my mom must have given
Speaker 3: them permission.
Speaker 2: And I'm just sitting there right like a specimen on
Speaker 2: the table like it was.
Speaker 3: I just remember feeling humiliated, embarrassed.
Speaker 2: I was covered at this point as well, because it
Speaker 2: was all over my legs, now spread from my stomach
Speaker 2: to my back to my arms, and they're all kind
Speaker 2: of just looking at me.
Speaker 3: And eventually he gives.
Speaker 2: Me this crude cold tar and it's exactly what it
Speaker 2: sounds like. It's like this green, kind of dark brown,
Speaker 2: slimy paste that smells like mothballs. So you slather it
Speaker 2: on at night. It stains everything and then you wake
Speaker 2: up in the morning and you wipe it off with towels.
Speaker 2: My mother had to help me, and it really smelled
Speaker 2: number one, but number two, the skin didn't really clear.
Speaker 2: I still had like so I'm you know, South Asian,
Speaker 2: so I have more melanated, darker skin. And then I
Speaker 2: ended up with these like light patches where the psoriasis
Speaker 2: was everywhere. The hyperpigmentation was brutal, but it never went away.
Speaker 2: It was still itchy all day under my clothes. All
Speaker 2: I remember is just wanting to scratch my skin off.
Speaker 2: And so the beginning parts of treatment included, you know,
Speaker 2: something like that. I went for like light treatment like
Speaker 2: a lot of people do. I did cortisone creams and
Speaker 2: it was always sticky fingerprints everywhere, you know, smelling not
Speaker 2: very good and Also I was in these clothes that
Speaker 2: just covered every part of my body, like where this
Speaker 2: risees showed, so that I didn't want to do gym class.
Speaker 3: I was.
Speaker 2: People are like, aren't you hot? Like I just remember
Speaker 2: that question, aren't you feeling hot? Like no, I'm fine,
Speaker 2: I'm fine, I'm always cold. Meanwhile, yeah, sweltery link sweltering.
Speaker 2: It was like my favorite time of day was coming
Speaker 2: home after school, taking off everything and going for like
Speaker 2: a scratch fest and like it was so bad for
Speaker 2: the skin, but I was just it was the only
Speaker 2: relief I had.
Speaker 3: So I lived a lot of that.
Speaker 2: First part of my journey with just creams and potions
Speaker 2: and anything. Nothing took it away because work for me,
Speaker 2: I guess it's different for everyone. For me, it meant
Speaker 2: clearing the skin completely and nothing was working.
Speaker 1: You have also talked before about how transformative it was
Speaker 1: when you finally found a doctor who actually understood How
Speaker 1: did you know? Because I think this is whether you're
Speaker 1: dealing with a chronic condition or not. Finding that right
Speaker 1: doctor that you click with is really really hard. How
Speaker 1: did you know when you had found the doctor that
Speaker 1: was right for you? What were the green flags where
Speaker 1: you're like this one's different.
Speaker 2: Yes, that's a really good question. It's really ideal to
Speaker 2: find the right doctor. But depending on where people live,
Speaker 2: depending on the access they have, it might not be
Speaker 2: possible to find the right doctor because there might not
Speaker 2: be a choice of people around. You know, I live
Speaker 2: in an urban center. We have dermatologists everywhere, so I
Speaker 2: do have choices. But how I knew doctor yadav is
Speaker 2: my doctor here in Toronto.
Speaker 3: She was different.
Speaker 2: She was very, very confident. So first of all we
Speaker 2: had like an offline conversation. We were like creating a
Speaker 2: piece together and then kind of when we finish the work,
Speaker 2: she said to me, you know, Rena, you don't have
Speaker 2: to live like this, Because I was like, I am
Speaker 2: happy in my skin. I am here for it. I'm
Speaker 2: taking care of myself. But if I have some risis,
Speaker 2: it's fine. But I was uncomfortable, like I didn't have
Speaker 2: a goal for clear skin. At that point, I had
Speaker 2: given up. And she when she said I can help you,
Speaker 2: something in me was like, what you can help me?
Speaker 3: What like are you?
Speaker 2: And she was so confident And that's the part of it.
Speaker 2: I think that really worked and clicked for me. There
Speaker 2: was that her ability to say like I want to
Speaker 2: help you, like we will find something that works and
Speaker 2: you don't have to feel this way, like, yes, you
Speaker 2: found a way through, and yes you feel empowered and
Speaker 2: okay with the way your skin is, but there's hope.
Speaker 1: It sounds almost like this is the first time you
Speaker 1: really felt like taken care of by a doctor. Like
Speaker 1: doctors are always there to take care of you, but
Speaker 1: it's a different thing when you're like I feel taken
Speaker 1: care of.
Speaker 3: Yes, that's like on the money.
Speaker 2: There absolutely when someone gives you that feeling of self assuredness,
Speaker 2: she really does want to make her patients feel better
Speaker 2: and give them a better quality of life. She takes
Speaker 2: that extra step, And I think that is the person
Speaker 2: I fell cared for. And yeah, scene and she understood
Speaker 2: like it was tough, like I was having a rough time.
Speaker 1: One of the things that you talk about, it's like
Speaker 1: the animating idea of all of your work is you
Speaker 1: deserve to feel good. And it's such a simple and
Speaker 1: basic concept, but I think for a lot of people
Speaker 1: that's very hard to really internalize, especially when they're dealing
Speaker 1: with a chronic condition. There's all of this weird mental
Speaker 1: and emotional baggage that comes with it. Sometimes there's whether
Speaker 1: you're conscious of it or not. People will think there's
Speaker 1: something bad or wrong about them, or that they did
Speaker 1: something wrong in their skincare or in their health care.
Speaker 1: But this idea, if they could just get it into
Speaker 1: their minds, is something to embrace, deserve to feel good.
Speaker 1: But I want to know how that has shaped your
Speaker 1: particular brand of activism.
Speaker 3: Ugh.
Speaker 2: I also found it to be such a powerful line,
Speaker 2: hence why I put it on the website, because it
Speaker 2: was something I didn't believe. I thought, because I was
Speaker 2: sick and I had this skin condition, that feeling good
Speaker 2: was beyond my reach. It was beyond what was possible
Speaker 2: for me, and that I didn't deserve it.
Speaker 3: I didn't deserve this.
Speaker 2: Feeling of peace of ease in my body, regardless of
Speaker 2: what my skin looked like. And so as I started
Speaker 2: taking care of myself and opening up more about my
Speaker 2: story online, I started to challenge what I believed what
Speaker 2: was possible for me as an individual and as a human.
Speaker 2: So it was really important for me to take care
Speaker 2: of myself and learn how to do that.
Speaker 3: Even if my skin.
Speaker 2: Was flared, I was still deserving of a massage.
Speaker 3: I was still deserving going to a beach. That was
Speaker 3: something that I wouldn't do.
Speaker 2: You know, if someone had a pool party or we
Speaker 2: went on a vacation, I would go tan on the
Speaker 2: other side of the beach because I didn't want anyone
Speaker 2: to see me. And I had to learn to tell myself,
Speaker 2: you deserve to be here, You deserve to be part
Speaker 2: of this as well. You deserve to dance, you deserve
Speaker 2: to wear these clothes like you are deserving of these
Speaker 2: things as well. Your skin doesn't make you unworthy. Your
Speaker 2: skin doesn't make you less than. What are the things
Speaker 2: that somebody who cares about themselves, who gives a damn
Speaker 2: about themselves would do?
Speaker 3: What does that look like?
Speaker 2: And so that started as me putting out these challenges
Speaker 2: when I first started my page. You know a lot
Speaker 2: of people and I don't think this is just with skin.
Speaker 2: Will say when my skin is clear, then I will
Speaker 2: dot dot dot, wear the shorts, go to the beach,
Speaker 2: go to the wedding, and sandals. These like tiny little
Speaker 2: things that maybe a lot of people don't think about.
Speaker 2: I was thinking about them all the time, and so
Speaker 2: it was starting to challenge myself. And then as I
Speaker 2: started to feel good and see that a lot of
Speaker 2: these barriers were only built up in my mind. Like
Speaker 2: most people were receiving me in a good way. This
Speaker 2: was an evolution, and so feeling good or feeling better
Speaker 2: and giving myself the opportunity to challenge what I thought
Speaker 2: I didn't deserve really helped me break into Yeah, starting
Speaker 2: to feel good and giving myself things that would help
Speaker 2: me feel whole and content.
Speaker 1: I also wonder because with any medical condition, it's for
Speaker 1: the most part, especially something like this, that can progress
Speaker 1: and shift. It's not like it all happens at once.
Speaker 1: It's something that's slowly growing over time. So your brain
Speaker 1: is sort of adjusting to you. I guess this is
Speaker 1: the new normal, and you're not really cognizant of how
Speaker 1: much you've given up until you like have one great
Speaker 1: day and then you're like, what it could be like
Speaker 1: this all the time. So I think that's also important
Speaker 1: for people to remember, right, this is kind of a
Speaker 1: mantra you need to maintain.
Speaker 2: Yes, like you said, there was this feeling when I
Speaker 2: found the right treatment and my skin started to clear.
Speaker 2: I didn't know it was possible to feel this way,
Speaker 2: And I'm so grateful that for me that I was
Speaker 2: open to treatment and that I was open to trying
Speaker 2: something new, because it really has made all the difference.
Speaker 1: Rina, thank you so much for sharing your story with us.
Speaker 1: When we come back, I have some history I'm going
Speaker 1: to share with you, some of which is going to
Speaker 1: sound very familiar. After this break, we will take a
Speaker 1: look at siasis treatment throughout our history, starting with Hippocrates
Speaker 1: in ancient times, running all the way through to advanced
Speaker 1: treatments that are available today. We've covered in previous episodes.
Speaker 1: Ciriasis has always been with us. The ancient Greeks were
Speaker 1: well aware of it, although they did not call it
Speaker 1: psoriasis for quite a while. The physician Hippocrates, who lived
Speaker 1: around four sixty to three seventy BCE, is often credited
Speaker 1: with being one of the first to document treatments for
Speaker 1: skin condition that we now recognize as psoriasis. One of
Speaker 1: his go to remedies was pine tar. That's right, thick, sticky,
Speaker 1: and pungent pine tar. Pine tar has actually been used
Speaker 1: for centuries as a topical treatment because of its supposed
Speaker 1: ability to reduce inflammation and relieve itching. So over the
Speaker 1: centuries it's been applied to the scalp the trunk, the limbs,
Speaker 1: pretty much anywhere of those suffering from psoriasis, and while
Speaker 1: in some cases it actually could provide some relief, it
Speaker 1: obviously comes with some downsides. The heavy, dark substance could
Speaker 1: also irritate some people's skin, so that is the opposite
Speaker 1: of the desired effect, and there's that strong, lingering odor
Speaker 1: not super pleasant. With the advent of the Industrial Revolution,
Speaker 1: pine tar's cousin which Rina mentioned, coal tar, came into
Speaker 1: the picture, and coal tar is of course thick, heavy
Speaker 1: oil that's derived from coal. It emerged as a ciasis
Speaker 1: treatment due to its similar anti inflammatory and anti itch properties,
Speaker 1: and by the early twentieth century, coal tar had become
Speaker 1: a staple in the dermatologist toolkit. So each of these
Speaker 1: types of tars are distilled the same way from their
Speaker 1: origin substances using extreme heat. Basically, if coal or wood
Speaker 1: is burned at really really high temperatures in an absence
Speaker 1: of oxygen, the result is a tar that can be
Speaker 1: put into soaps, lotions, foams, other kinds of topical applications.
Speaker 1: And actually why tars sometimes work on poriasis is not
Speaker 1: still super well understood. But coal tar, as we know
Speaker 1: from Rena's story is still recommended today by the American
Speaker 1: Academy of Dermatologists, and the best that we can tell
Speaker 1: is that these tars slow down skin cell growth, which
Speaker 1: can reduce the severity of the plaques that often accompany pariasis.
Speaker 1: But these are, after all products that also have industrial uses,
Speaker 1: so they are not necessarily gentle. Side effects can be
Speaker 1: very serious, including in some people an increased risk of
Speaker 1: certain cancers, and some people, such as anyone who's pregnant,
Speaker 1: is not recommended to use these kinds of treatments. So Rena,
Speaker 1: I was a little bit shocked that the ancient Greeks
Speaker 1: were like, yes, let's put pine tar on people. I
Speaker 1: didn't know until working on this show that people were
Speaker 1: still using col tar, and you are an example of
Speaker 1: that today. Did you know that pine tar was in
Speaker 1: the mix?
Speaker 3: I had no clue.
Speaker 2: I am I'm shocked, but I have used pine tar,
Speaker 2: which is interesting.
Speaker 3: I feel like someone gave it to me because I
Speaker 3: did have it. You know what, people are always like, hey,
Speaker 3: if you tried, does have you tried?
Speaker 1: That's I'm shocked, like an old wives remedy that they're like,
Speaker 1: I prepared some Yeah, apparently they're going all the way
Speaker 1: back to Hippocrates. With that, you also mentioned some light
Speaker 1: therapies That goes back to nineteen twenty five, when an
Speaker 1: American dermatologist named William Gekerman discovered that combining coal tar
Speaker 1: with ultraviolet light therapy was particularly effective in treating pariasis.
Speaker 1: That method, still known as gekermann therapy, involves applying coal
Speaker 1: tar to the skin and then exposing it to UVB light,
Speaker 1: and that combination helps slow down rapid skin cell turnover,
Speaker 1: which is what characterizes psoriasis. It provides significant relief to
Speaker 1: a lot of patients, but we can't pat ourselves on
Speaker 1: the back too much. Long before Geckerman's discovery, sunlight itself
Speaker 1: was already recognized as a valuable ally in the fight
Speaker 1: against sariasis. Ancient physicians noted that exposure to sunlight could
Speaker 1: help alleviate the symptoms, especially if it was used in
Speaker 1: conjunction with topical treatments. However, not everyone could afford to
Speaker 1: spend hour sunbathing, and of course we know excessive sun
Speaker 1: exposure has its own set of risks, including skin damage
Speaker 1: and an increased risk of skin cancer. Light therapy, which
Speaker 1: I want to ask you about because you've done It
Speaker 1: can be used alone or in combination with topical medications
Speaker 1: or tablets that will increase your sensitivity to UVB or
Speaker 1: UVA light. The latter of those is prescribed for young
Speaker 1: or more sensitive patients, and those sessions, according to our
Speaker 1: research I've never done one can last just a few minutes,
Speaker 1: and they're typically given two or three times a week
Speaker 1: for like a six to eight week run. But the
Speaker 1: effectiveness and options depend on a wide range of factors,
Speaker 1: including the type of severity of psoriasis, other health conditions,
Speaker 1: as well as any medication. So you mentioned light therapy.
Speaker 1: Tell us about that. It sounds in theory to someone
Speaker 1: that's not done it very nice, like, oh, you need
Speaker 1: a sunbath, let's do light therapy. But what is it
Speaker 1: actually like?
Speaker 3: I know, imagine, yeah, you go into this beautiful zen spot. No,
Speaker 3: actually it's like that at all.
Speaker 2: So, like you mentioned, in addition to the coal tar
Speaker 2: that I was putting on every night, now three times
Speaker 2: a week, we were going to this light therapy. So
Speaker 2: it's a chamber essentially, and you're in there for like
Speaker 2: ten seconds, but I remember, to get there it would
Speaker 2: take an hour, and to get back it would take
Speaker 2: an hour because it was so far. So it's just
Speaker 2: like going into a tanning booth, but a standing up
Speaker 2: tanning booth. You kind of do this for ten fifteen seconds.
Speaker 2: It wasn't a few minutes. It was very quick, and
Speaker 2: that was that, and it works. It worked for me
Speaker 2: at least, and it's worked for people who I've talked to.
Speaker 2: But eventually you're just like, I don't this seems a
Speaker 2: bit odd just to drive for a ten second stand
Speaker 2: up session and come home.
Speaker 3: Some people bring them into their house, right, thousands of dollars,
Speaker 3: you know.
Speaker 2: So for me it did help, but I got really
Speaker 2: tired very quickly, so after the first stint I was done.
Speaker 3: Well.
Speaker 1: It's good that you mentioned that, though, because it is
Speaker 1: a cool therapy. It does work for a lot of people,
Speaker 1: but it doesn't mean that it's easily accessible for everybody.
Speaker 1: You know, if you're not in a metro area, your
Speaker 1: odds of finding one in driving distance are probably pretty low.
Speaker 1: And the other option is to go to great personal
Speaker 1: expense to build one.
Speaker 2: It's true, and not to go to the tanning booth.
Speaker 2: Because a lot of people are going to the tanning booth.
Speaker 2: I think it's not the same thing. It's that like
Speaker 2: you mentioned UVB versus UVA, So right, yes.
Speaker 1: Don't do that, that's not your treatment. I do want
Speaker 1: to shock you with more things, because moving into the
Speaker 1: Victorian era, there were some very alarming treatments going on,
Speaker 1: including diluted tinctures of arsenic and mercury that were used
Speaker 1: to treat various skin conditions, including psoriasis. These are obviously
Speaker 1: incredibly toxic and their use usually did more harm than good.
Speaker 1: In some cases, people were even advised to inject these
Speaker 1: very dangerous chemicals directly into their bodies. That's a stark
Speaker 1: reminder though, of how desperate people have been over the
Speaker 1: ages to get some relief and how limited medical knowledge
Speaker 1: was at the time, and that combination was brutal and
Speaker 1: probably deadly for some people. We don't really have any
Speaker 1: hard data on how many people died from injecting our
Speaker 1: snack to treat skin conditions, but I bet you it happened.
Speaker 1: And then in the early nineteen hundreds, there was another
Speaker 1: topical treatment that came into play called dithronol. This compound
Speaker 1: is derived from the bark of the aerobatry and it's
Speaker 1: found to be effective in slowing down skin cell production.
Speaker 1: And therefore reducing the severity of plaques that develop. However,
Speaker 1: it was not widely used in the United States because,
Speaker 1: like other treatments, it could discolor the skin and stain
Speaker 1: clothing and bedding. That's not super practical for everyday use.
Speaker 1: As recently as nineteen fifty six, medical literature still mentioned
Speaker 1: using mercury in topical ointments for psoriasis. We know now
Speaker 1: that mercury is highly toxic and can cause serious health issues,
Speaker 1: but even in the mid twentieth century it was one
Speaker 1: of the few options that was really available to doctors
Speaker 1: and patients. So throughout history there have been various unorthodox treatments,
Speaker 1: herbal concoctions, and then my favorite, snake oil, which were
Speaker 1: often touted as miracle cures. We use the term snake
Speaker 1: oil today to talk about something that is a fake
Speaker 1: medicine or like something a carpetbagger would sell you that's
Speaker 1: not going to do any good and might in fact
Speaker 1: harm you. But there are actual snake oils that work.
Speaker 1: The snake oil concept derives from an old Chinese remedy
Speaker 1: that made use of the black banded secret it's also
Speaker 1: known as a Chinese water snake, and that had legit
Speaker 1: anti inflammatory effects because Chinese water snakes have a very
Speaker 1: high concentration of omega three fatty acids. But when that
Speaker 1: remedy made its way to North America via immigration, there
Speaker 1: were a lot of Charlatans that picked up on it,
Speaker 1: particularly in the American West, and they started making their
Speaker 1: own version of the Chinese cure. But they used just
Speaker 1: about any snake they could find, including rattlesnakes. Those do
Speaker 1: not have the same beneficial omega threes, and that is
Speaker 1: how that term transitioned to become snake oil in our
Speaker 1: lexicon as something that's worthless and possibly dangerous in terms
Speaker 1: of health treatments. There are also, of course, indigenous tribes
Speaker 1: that have had their own remedies, including the use of
Speaker 1: buds from the balsam poplar that has been used to
Speaker 1: treat soriasis in other skin conditions. And of course, today,
Speaker 1: as Rena knows, there are a lot of changes in
Speaker 1: our understanding of psoriasis. We know it's not just a
Speaker 1: skin condition, which is how it used to be treated.
Speaker 1: It is an autoimmune disease. This means that the body's
Speaker 1: immune system is mistakenly attacking healthy skin cells. That's what
Speaker 1: leads to that rapid skin cell turnover we've been talking about,
Speaker 1: and that's what causes those characteristic red and scaly patches.
Speaker 1: Here's what I wonder as I'm talking about all of this, rena.
Speaker 1: There are so many treatments now for psoriasis that I
Speaker 1: imagine even that becomes its own. While it's like they're
Speaker 1: an array of things we can try. That is probably
Speaker 1: intimidating in and of itself. Since you have a community
Speaker 1: around this, do you find that a lot of people
Speaker 1: are going through trial and error? And what is that
Speaker 1: like again mentally in emotion? Is there a point where
Speaker 1: some patients are just like I'm done, I'm not going
Speaker 1: to deal with this anymore.
Speaker 3: Yes, I found that with myself and with others.
Speaker 2: It is exhausting, especially when something doesn't work and you
Speaker 2: have so much hope. You're trying everything, You're hoping it's
Speaker 2: going to work, and it doesn't, and then you're like,
Speaker 2: should I bother going through the whole process of getting
Speaker 2: something else? So, yes, people get tired, And I always say,
Speaker 2: you know, it's okay to take a break, but don't quit, Like,
Speaker 2: just try as much as you can. And I would
Speaker 2: give that same advice to myself who went through years
Speaker 2: and years of just giving up completely and my skin
Speaker 2: going wild. I was like, nothing's going to work, So
Speaker 2: what's the point. So I think people do get tired,
Speaker 2: and there is trial and error, but take a break, rest,
Speaker 2: give yourself a moment, and then get back on that horse,
Speaker 2: because as I've said, for me, I've found something that works.
Speaker 2: And the science is so much more sophisticated than it was,
Speaker 2: you know, years ago. So as you educated me with today,
Speaker 2: I was like, I'm still happy I wasn't born in
Speaker 2: the twenties.
Speaker 1: Yeah, right, And the thing is too we mentioned and
Speaker 1: we know topical treatments don't address the root cause of psoriasis, right.
Speaker 1: They may help with your skin, but you're still having
Speaker 1: an autoimmune system. This is where, of course, a much
Speaker 1: newer treatment comes in, which is biologics. Biologics are a
Speaker 1: class of drugs that was first approved in the US
Speaker 1: by the FDA in the early two thousands, and they
Speaker 1: target specific parts of the immune system involved in the
Speaker 1: inflammatory process, and by inhibiting certain immune responses, biologics can
Speaker 1: significantly reduce the symptoms of psoriasis and improve quality of
Speaker 1: life for a whole lot of patients. Biologics have obviously
Speaker 1: revolutionized the entire treatment possibilities for moderate and severe psoriasis.
Speaker 1: They are typically administered by injection or intravenous infusion, and
Speaker 1: they can actually provide some very long lasting relief. And
Speaker 1: as we reflect on the h of soriasis treatments, it
Speaker 1: is clear we have come a very long way from
Speaker 1: the days of pine tar and arsenic thankfully, and other
Speaker 1: toxic chemicals. Our understanding of the condition has deepened and
Speaker 1: with it our ability to manage it effectively. And while
Speaker 1: there is still no cure, advances in medical research continue
Speaker 1: to bring hope to millions of people living with this
Speaker 1: challenging condition. So I think the most important takeaway from
Speaker 1: all of this is that we really have come very
Speaker 1: very far right. Treatment is way more effective than it
Speaker 1: was in the early days, no more arsenic. So if
Speaker 1: someone has been reluctant to open up to a doctor
Speaker 1: and see what treatments are available, now is a great
Speaker 1: time treating a chronic skin condition. I know we've said
Speaker 1: it a million times, but it bears repeating. It's not
Speaker 1: a straight line, as our dip into history shows, but
Speaker 1: it is really amazing to know that there's a lot
Speaker 1: that's been done to make living with poriasis so much
Speaker 1: more doable and so that people can embrace the idea
Speaker 1: that they deserve to feel good. There are things you
Speaker 1: can do every day to feel better emotionally and physically,
Speaker 1: and you just had to find what works for you.
Speaker 1: So I want to come back to that idea arena
Speaker 1: of you deserve to feel good, because we all deserve that.
Speaker 1: But that is also not a straight line. What got
Speaker 1: you through those times where treatment wasn't working or you
Speaker 1: just weren't feeling good about the whole.
Speaker 2: Journey, you know, I just went through that phase in
Speaker 2: December recently, on New Year's Eve. I yeah, my treatment
Speaker 2: just wasn't working and I had to And now again
Speaker 2: I've found good treatment because I went back. I didn't
Speaker 2: give up. But during that really hard time, I noticed
Speaker 2: how everything I intellectually knew just went out the window.
Speaker 2: I didn't follow any of my own advice. I just
Speaker 2: felt hopeless. I laid in bed, I was swollen, I
Speaker 2: was sad, and what helped me was asking for help,
Speaker 2: going to my therapist, which I'm lucky enough to have,
Speaker 2: asking my family for support, telling my friends I'm struggling.
Speaker 3: I really need someone here with me, and.
Speaker 2: Then also telling myself it's okay, like having some self compassion.
Speaker 2: It's okay that you're here and you're having a hard time.
Speaker 2: You're not doing the quote unquote things you should be
Speaker 2: doing or could be doing.
Speaker 3: It's okay to.
Speaker 2: Have a moment and be sad and grieve the pain
Speaker 2: and give yourself what you need. But I said to myself,
Speaker 2: you know, after a week of this, you're not going
Speaker 2: to pack your bags and move into the space. It's
Speaker 2: time to get back on the horse, like get the
Speaker 2: support that you need, like I said, and also go
Speaker 2: back to the doctor and talk to her about what
Speaker 2: is possible. And we were able to find something that worked.
Speaker 2: I was nervous because I'm like, oh, I'm going to
Speaker 2: go right back to where I was. But yes, it's
Speaker 2: it's truly learning to ask for help and support and
Speaker 2: knowing that I don't have to do it alone. That's
Speaker 2: changed my life.
Speaker 1: Rina, you are an angel and your story is so powerful.
Speaker 1: If you could send one mess to listeners who might
Speaker 1: be grappling with their own diagnosis, what would that be.
Speaker 2: I think everything that we've said through this, but it
Speaker 2: would be that there is a hope and that there
Speaker 2: is change, and although right now you may not know
Speaker 2: what direction you need to go, it is possible to
Speaker 2: find the care. Just don't give up and be open
Speaker 2: to what might be possible for you.
Speaker 1: I love it. Thank you again so much. You're such
Speaker 1: a delight.
Speaker 3: Thanks Hollie, love to convo.
Speaker 1: Our Skin is hosted by myself, Holly Frye, and executive
Speaker 1: produced and engineered by Ryan Martz. Our senior producer and
Speaker 1: writer is Meredith Barnes. If you enjoy the show, share
Speaker 1: it with your friends. You can also listen and follow
Speaker 1: on the iHeartRadio app, Apple Podcasts, or wherever you get
Speaker 1: your podcasts.