Theresa Tierney Bugler, a psychiatric nurse from Co Clare who lives in Cork, has had psoriasis since she was 11. Now 29, she feels she is coming to terms with having the skin condition.

“I was covered with it when it broke out first. It was so bad that you couldn’t actually see my back between the ages of 11 and 12,” she says.

“The GP and dermatologist prescribed creams for me to use and I eventually got clear, on and off during my teens. It came back badly, though, the year of my Leaving Cert but it’s always more likely to come back at times of stress.”

While no one knows the exact trigger for psoriasis, Theresa was told that it may have been a combination of puberty and the fact that she was genetically predisposed to it.

“It wasn’t too bad at college,” she says, “and I had a pretty good run of it through my 20s but last year it came back. I was doing final exams for another degree and getting married and my father had a triple by-pass after a heart attack – all in the space of three months – so there was a lot going on.”

Theresa stayed clear for her wedding, she says, but about a month after coming back from honeymoon she had a flare-up.

“I was covered from head to toe. It was in my eyebrows, in my ears and around my nose – it wasn’t the easiest time, to say the least.”

So what does Theresa do when she has a bad flare-up?

“It’s a case of exfoliating every day in the shower then putting on creams – one kind on my face and different kinds on my body.

“On my day off I would do extra. I would also coat my hair in baby oil or a thick Vaseline-type substance and leave it on all night. Next morning I’d use a fine comb to comb all the scales out – I find that a huge help.

“I wash it after that with the proper shampoos and then put the cream on again then rewash it again a couple of hours later. That night I would shower and exfoliate again and put on the creams and wrap my arms and back in cling film. Doing that is brilliant as the cream doesn’t get on the bedclothes. You might look like a mummy but it locks in the creams and you really get the benefit. That’s my routine when it’s very bad.”

Theresa has had ultraviolet light therapy since and it cleared the psoriasis for a long time, she says, and she is glad to know that she could have that again in the future if she has a serious flare-up.

CENTRAL HEATING

“Winter tends to bring it back too because of the cold,” she says. “I’d be the coldest person in Ireland and it’s hard to do the routine when you’re cold. I find my skin is very dry in the winter as well and having central heating on all the time can also aggravate it.”

Theresa loves the sun and finds it helps her psoriasis. “It’s great. I just soak it up. Not everyone with psoriasis likes the heat but, for me, it fades the psoriasis. I always wear factor 50 and a hat, though, or my head would get very itchy.”

Learning how to use the creams properly has been key to managing her psoriasis better, she believes.

“I went to specialist clinic in Cork where they teach you that and it really made a difference. No one told people with psoriasis years ago how to exfoliate, to take off the white scale first.

We were just rubbing the cream on, on top of the scale and getting no real benefit from it.”

Since Theresa became pregnant she has been relatively clear.

“It’s something to do with your immune system, I think, but I do expect to have a flare-up after the baby is born so I’m prepared for that and I have all the creams ready,” she says.

Theresa is a member of the Psoriasis Association of Ireland and regularly fundraises. “We had a fashion show where all the models had psoriasis so that’s very positive.

“We have set up more support groups too which help a lot of people. Younger people chat on the Facebook page but older people prefer the face-to-face meetings.”

Theresa’s advice for anyone newly diagnosed with psoriasis or who needs support is to make contact with the Psoriasis Association of Ireland.

“There’s phone and Facebook support and lots of information booklets. You often learn more from other people who have psoriasis. I got the cling film tip on the Psoriasis Association of Ireland Facebook page and it’s made a big difference to me.”

Theresa admits to her teens being difficult with the condition. “I used to think it was the worst thing in the world to have. Now I think ‘God there’s more to worry about than having psoriasis’ but when you’re younger it’s very hard because you become so self- conscious. Luckily it didn’t stop me doing sport – I just used to wear leggings rather than shorts.

“I did get negative comments about it at school and in camogie but now if I catch people looking at my skin I say straight up ‘I’ve psoriasis by the way’. Nowadays there is more awareness and some people will say ‘Oh, I can’t help noticing that you have psoriasis. What do you use for it? I know someone who has it.’ I don’t mind that at all. How you tell people about it has a lot to do with it, I think. In the last few years I have come to terms with it a lot more than before.”

TYPES

• Plaque psoriasis – most common

• Guttate – red scaly dots

• Nummular – round plaques

• Pustular – affects hands and feet

• Erythrodermic psoriasis – most severe kind, plaque and pustules

• Flexural psoriasis – affects skin folds and creases

TRIGGERS

• Triggers can be different for different people but can include the following:

• Stress

• Medication

• Hormonal change

• Injury to skin or surgical wound

• Smoking

• Infection e.g. sore throat

See www.underthespotlight.ie and www.psoriasisireland.ie for more info.

Note: Theresa is now the proud mum of baby girl, Andrea, born on 14 December, weighing 8lb 5oz. Congratulations Theresa!