Beth Krietsch

There are various types of psoriasis, and each can come with its own set of challenges. Plaque psoriasis, the most common form of the skin condition, causes inflamed, localized rashes that are thick, scaly, and super itchy, for example. There’s also guttate psoriasis, inverse psoriasis, pustular psoriasis, and even nail psoriasis; all of them can cause life-disrupting symptoms that require thoughtful care. Erythrodermic psoriasis, however, is one you may be less familiar with. Unlike other types of psoriasis, erythrodermic psoriasis is a medical emergency and requires immediate treatment to avoid serious complications. Here’s what you need to know about this rare skin condition, including why it can be life-threatening.What are the symptoms of erythrodermic psoriasis?Erythrodermic psoriasis is not common: It affects around 1% to 2.25% of people with psoriasis, research suggests. This type of psoriasis is akin to an anaphylactic allergic reaction in someone who has significant food allergies, Lindsey Bordone, MD, an assistant professor of dermatology at NewYork-Presbyterian/Columbia University Irving Medical Center, tells SELF.The condition causes the majority of the skin’s surface to become highly inflamed, which makes the affected areas look like they’ve been badly burned, according to the American Academy of Dermatology (AAD). People with light-to-medium skin tones will typically see bright redness, while people with deeper skin tones may notice a purple, gray, or dark brown hue.And the symptoms go beyond the appearance of the skin. “People tend to feel that their skin is hot and uncomfortable, sometimes downright painful,” Peter Lio, MD, a clinical assistant professor of dermatology at Northwestern University’s Feinberg School of Medicine, tells SELF.Erythrodermic psoriasis also affects the body’s ability to sweat and regulate body temperature, which can lead to hypothermia or severe dehydration—both of which can be dangerous if not addressed quickly. These side effects can ultimately cause someone to experience uncontrollable shivering or feel feverish, almost like they have the flu.The condition can develop suddenly (over the course of just a few days) or gradually (over the course of a few months), and it often expands from an existing psoriasis plaque. Back to topWhat causes erythrodermic psoriasis?A majority of people who develop erythrodermic psoriasis have already been diagnosed with another form of moderate-to-severe psoriasis, typically plaque psoriasis, the AAD notes. Experts aren’t sure what, exactly, causes it, but they suspect it boils down to a trigger—like an infection or illness, allergic reaction, or even a gnarly sunburn—that sets off a cascade of worsening inflammation, Dr. Bordone says. Erythrodermic psoriasis may also be triggered by taking certain medications, oral steroid withdrawal, excessive alcohol consumption, or stress in people who are susceptible.Back to topWhat are the potential complications of erythrodermic psoriasis?“Erythrodermic psoriasis is serious and needs to be addressed by medical professionals as soon as possible,” Dr. Bordone says. That’s because, without swift treatment, dehydration, electrolyte imbalances, or hypothermia caused by the skin condition can be life-threatening. Erythrodermic psoriasis also increases a person’s risk of developing other serious complications like heart failure, pneumonia, or sepsis, per the Cleveland Clinic.Seeking medical care ASAP is the most important thing you can do to avoid these complications. “If someone has a fever or abnormally low body temperature to the point where he or she cannot stop shivering, then an emergency room evaluation is needed,” Dr. Bordone stresses. The same goes if a person has unstable vital signs, like a racing heart or dizziness, she says.“Because several [other] life-threatening conditions can also present with [these symptoms], including things like drug reactions, it is extremely important to get a firm diagnosis and start supportive treatment right away,” Dr. Lio says. A few other rare skin disorders and connective tissue disorders can also mimic the symptoms of erythrodermic psoriasis.

It’s pretty well-known that chest pain is a possible sign of heart trouble—but it’s far from the only sign. Shortness of breath—which can feel like you’re exerting yourself more than you’re used to—is another big one to pay attention to, because it can signal heart valve disease, heart attack, and heart failure, among other cardiovascular issues.Shortness of breath, also called dyspnea, can be characterized in a bunch of different ways: You may have difficulty breathing, or feel “air hunger” (a.k.a. severe breathlessness), a sensation of suffocation, or intense tightening in your chest. According to the Mayo Clinic, most cases of shortness of breath can be linked to either a heart or lung issue. This is because the heart and lungs help carry oxygenated blood to tissues throughout the body, and also help remove carbon dioxide from your system. Problems with either function can impact your ability to breathe.Someone who’s generally healthy might feel short of breath while exercising or when spending time in extreme temperatures or high altitudes, especially if you haven’t been exercising much lately. Shortness of breath isn’t a symptom you should ignore, especially if it feels intense and comes on suddenly. Here’s what you should know.First, what types of heart problems cause shortness of breath?Heart valve diseaseThe heart has four valves, which help blood flow in the right direction within the heart and onward to other parts of the body. If one or more of the valves doesn’t work properly, this can cause problems with blood flow, per the US National Library of Medicine.Heart valve issues typically appear in one of two ways: one or more valves stiffen up and they don’t open correctly, or they don’t close correctly, Hal Skopicki, MD, PhD, chief of cardiology and co-director of the Stony Brook Heart Institute in New York, tells SELF. When the valves don’t operate as they should, blood can back up against the lungs and trigger shortness of breath. Over time, this puts strain on the heart, and can ultimately lead to heart failure, a condition in which the heart cannot pump a sufficient amount of blood to other vital organs.Heart muscle problems“Another way that the heart can cause a person to be short of breath is when the muscle itself is having problems ejecting blood out in the forward direction,” Dr. Skopicki says. People with heart muscle dysfunction, also known as cardiomyopathy, may experience a thickening, weakening, or stiffening of the heart muscle that can affect the organ’s ability to pump blood. A variety of health issues can set the stage for heart muscle problems, including heart disease, endocrine diseases, alcohol addiction, viral infections, and certain types of chemotherapy and radiation, among other factors, per the Centers for Disease Control and Prevention (CDC).Some pregnant people who are otherwise healthy may develop cardiomyopathy during or after pregnancy. “It’s important to not just assume that breathlessness is normal for pregnancy,” Stacy Rosen, MD, cardiologist and vice president of women’s health at the Katz Institute for Women’s Health at North Shore-LIJ Health System, tells SELF. Pre-existing heart issues can also become apparent for the first time during pregnancy, Dr. Rosen says.Issues with the heart’s electrical systemNormally, electrical signals help regulate your heartbeat. When these signals don’t fire properly, it can cause the heart to beat irregularly (arrhythmia), really quickly (tachycardia), or too slowly (bradycardia) without explanation, per the Mayo Clinic. Sometimes, an irregular heartbeat doesn’t cause any noticeable symptoms. Other times, it can make you feel short of breath, Dr. Skopicki says.Blockages in the arteriesCoronary artery disease, also known as coronary heart disease or ischemic disease, develops when the arteries—the major blood vessels that flow oxygen-rich blood to your whole body—can’t send enough blood, oxygen, and essential nutrients to your heart. It’s the most common form of heart disease in the US, per the CDC.

If your symptoms continue to flare even after you see a dermatologist, it’s important to keep using any treatments that your dermatologist has prescribed for you while you reach out to them about reassessing your regimen.2. Consider light therapy.Light therapy is one of the most common, effective psoriasis treatments for people with mild to moderate psoriasis. There are many different types of light therapy available, like narrow-band UVB therapy, broad-band UVB therapy, and laser treatments. Depending on your symptoms and what type of psoriasis you have, your doctor may recommend you try just one type of light therapy or a combination of them. The exact reason that light therapy effectively treats psoriasis is not very well understood, but researchers believe it suppresses cells in the skin related to the immune response, ultimately calming down inflammation. There are likely multiple intricate processes going on in the body that create this effect.If your doctor recommends light therapy, you’ll likely need to visit their office about three times each week, for 10 to 15 minutes per session, Dr. Ferris says. Over time, you probably won’t need to go in for treatment as frequently. “I have some patients who come maybe once a week, and that really maintains them,” Dr. Ferris says, adding that other people do well coming in just once every two weeks. 3. Try to keep stress levels low.“Managing stress as much as possible is always ideal,” Dr. Burris says. This is true for anyone, but especially for someone with psoriasis. “We don’t really know why stress causes [psoriasis and other] skin diseases to flare, but it really does,” Dr. Ferris says.2If you’re not sure how to relieve stress, consider yoga, meditation, journaling, exercise, sharing your feelings with a friend, or making an appointment with a therapist or other mental health professional. These stress-relieving activities and grounding exercises are a good place to start too.4. Steer clear of hot showers.A hot shower or bath in the winter might feel great at the time, but in the long run, it isn’t doing you any favors. In fact, hot water can seriously dry out your skin and strip it of nourishing oils.  The AAD recommends keeping showers and baths to 10 minutes or less and showering or bathing in warm water rather than hot water. 5. Moisturize, moisturize, moisturize.Dry skin is rampant in the winter, and all the more so if you have psoriasis. The Mayo Clinic recommends that people with psoriasis use a moisturizer every day—or even more than once a day if it helps your skin symptoms. Get in the habit of moisturizing right after you shower, and reapply lotion during the day if your skin feels dry and uncomfortable. The AAD also recommends sticking to fragrance-free creams and ointments to avoid irritating sensitive skin.Dr. Ferris says that over-the-counter moisturizers containing salicylic acid can be helpful because they help get rid of dry skin and thin or soften psoriasis plaques, making it easier for topical medications to access the skin, which could make them more effective. Dr. Ferris notes that most over-the-counter moisturizers and shampoos with salicylic acid contain such low concentrations (2–6%) that it’s not typically irritating, especially when it’s in a cream or ointment.6. Sleep with a humidifier.A humidifier adds moisture back into the air, which can be helpful if your skin tends to be dry, cracked, or painful during the winter. Dr. Burris recommends using a humidifier at night during the cold, dry winter months to reduce dryness and the urge to scratch—which just makes things worse. “Dry skin is itchy skin, and the less one scratches, the less likely they will experience a flare in their underlying psoriasis or even eczema,” she says.7. Take precautions to avoid getting sick.As we know, infections and illnesses can trigger psoriasis flares. That becomes a much bigger risk during cold and flu (and COVID and RSV) season, when viral illnesses are more common, Dr. Burris says.

If you have painful skin symptoms that just won’t quit—you know, dryness that leads to obvious cracks, inflammation that just feels awful, or intense itchiness—and you’ve traveled down a rabbit hole via Dr. Google, then you’ve probably come across information on either eczema or psoriasis.These skin conditions are different and complex in unique ways, but their respective lists of symptoms can overlap quite a bit, making them difficult for the average person (read: anyone who’s not a trained dermatologist) to tell apart.If you think that suspicious rash could be a sign of eczema, psoriasis, or maybe even both, here’s some information to help you navigate what you’re experiencing, straight from dermatologists.First, a little bit about how psoriasis is defined.At its core, psoriasis is an autoimmune condition, meaning it’s caused by a glitch in the immune system that causes the body to mistakenly attack healthy skin cells. Because of this immune malfunction, the body overproduces skin cells, which then accumulate and pile up on the skin’s surface, according to the American Academy of Dermatology (AAD).Plaque psoriasis, the most common form of the condition, causes raised lesions—often with a scaly appearance with a silver-to-gray plaque, depending on your skin tone—that can manifest anywhere on the body and feel itchy, tender, or even painful.There are various forms of psoriasis, so the symptoms can vary widely. But plaque psoriasis often appears on areas like the elbows, knees, trunk, and scalp, Esther Kim, MD, an assistant professor of dermatology at Columbia University Medical Center, tells SELF. You may even start to feel pain in your joints: When inflammatory arthritis occurs alongside psoriasis, it’s called psoriatic arthritis, Dr. Kim says.Many people with psoriasis experience flare-ups, or periods of time when symptoms become more active. These flares can last anywhere from weeks to months, and there is a range of triggers that can set them off, from infections and illnesses to skin stressors (like cuts and scratches) to changes in weather and stress levels, per the AAD.Like other autoimmune conditions, the root causes of psoriasis aren’t well understood, but researchers believe that both environmental and genetic factors are at play, Dr. Kim says.…and here’s a little eczema 101.Eczema is an umbrella term for a group of skin conditions in which the skin barrier (the outermost protective layer) is damaged, leading to itchy, dry, and inflamed skin, per the AAD. Eczema is broadly referred to as atopic dermatitis, the most common form of the condition, but there are various types of eczema that have different triggers. An eczema rash can look and feel different from person to person but may include small raised bumps, dry or cracked skin, itchiness, and oozing or crusting, among other symptoms that generally signal irritation. “Intense itch is a hallmark of eczema,” Dr. Kim notes. “Because of the itch, patients often suffer from a persistent itch-scratch cycle that can lead to thickening of skin and scratches that render the skin prone to superficial skin infections.”

These days, most of us spend a ton of time staring at screens. We’re working from our computers all day, streaming from our tablets and televisions in the evenings, and constantly glancing at our phones for anything and everything. Screens are so ubiquitous that they’re hard to avoid, which is pretty problematic if staring at a screen is a migraine trigger for you.Migraine is a neurological disease that causes all sorts of symptoms, one of the most common being light sensitivity. This means you are extremely sensitive to things like bright light, natural light, and changes in light, as they all intensify migraine pain and discomfort.As you might have guessed, screens can aggravate this light sensitivity, Dawn Buse, PhD, clinical professor of neurology at the Albert Einstein College of Medicine in New York City, tells SELF. “Someone with migraine may have a hypersensitive nervous system that finds the light painful,” she says, and that can extend beyond migraine attacks. You might be extremely sensitive to light all the time, which can make all this screen time a huge challenge.In the hyper-digital world we live in, most people can’t just ditch their electronic devices altogether—so we need to go for the next best option: finding ways to deal with it. Here, migraine experts share their tips for managing when staring at screens all day tends to trigger or exacerbate your symptoms.1. Filter out blue light.Research shows that blue light can intensify migraine pain compared to green or white light. This means that if you’re already experiencing migraine symptoms, staring at a computer, phone, or any other device that emits blue light might leave you feeling even worse.1 Dr. Buse recommends trying blue light glasses, which filter out some wavelengths of light that contribute to eye strain. She suggests one brand called TheraSpecs that makes blue light glasses specifically for people with migraine.If blue light glasses aren’t your thing, you still have another option. Dr. Buse suggests swapping your phone over to “Night Shift” mode, which alters its display to use warmer tones and emit less blue light. You may also be able to do the same thing on your computer, depending on the type you have.2. Ditch the harsh overhead lighting.One helpful adjustment you can make in your home is to ditch bright overhead lights. Fluorescent lights in particular are typically too bright and harsh and can exacerbate someone’s headaches, Emad Estemalik, MD, section head for headache and facial pain at Cleveland Clinic’s Neurological Institute and assistant professor of neurology at the Lerner School of Medicine of Case Western Reserve University, tells SELF.So, what lights should you choose? Generally, incandescent bulbs are a better option than fluorescent and LED bulbs, and lights with a warm yellow or golden tone will probably be more comfortable for you than those with cooler tones like white or blue, Dr. Buse says. You can also try dimming the lights or using a desk lamp so you don’t even need to turn on those harsh overhead lights. This can also help if you work in an office and have your own space where you can control the lighting to some extent.3. Look away from your screen every once in a while.Periodic breaks from all these screens give your eyes time to rest. Dr. Estemalik suggests taking about five minutes away from your computer or phone every 45 minutes or so. “If you’ve been in a Zoom meeting for an hour, and then you have a break, don’t go to your phone to read unnecessary stuff,” he says. “Just stand up and walk and maybe do other things.”

Having these conversations can also help strengthen relationships and build trust, she adds. They can also clue in your coworkers to any simple adjustments they can make in your work setting to avoid triggering migraines. For example, de los Santos is a teacher, and one time the cameras were right outside her classroom door on school picture day. The flashing lights triggered a severe migraine attack and she had to go to the emergency room. “This was a new trigger for me and I didn’t realize how badly I would respond,” she says. “Once my admin and staff were aware, they were amazing—I have great support.”3. Take a break. Actually, take lots of breaks.Susan K. Shaffer, 53, has been living with migraine for about 15 years. Her tip for managing migraine while working is to truly take breaks when you need them, rather than trying to push through. “​​Save time by taking time,” she tells SELF. “When I feel a migraine coming on, my hack is to literally leave my desk for 20 to 30 minutes, give myself everything I need, and let it pass.”During these breaks, she heads to a quiet room away from people, dims the lights, takes her migraine medication, and lays down (occasionally with an ice pack). Usually, a half hour is enough time to let the feeling subside so that she can return to work.“If I try to fight it, it will only exacerbate the migraine and I’ll be out of commission the whole day,” Shaffer says. “When it comes to your health, give yourself what you need, and you’ll save valuable time in the long run.”4. Don’t forget to dim the lights if you need to.For Marla White, 58, bright light can trigger significant migraine pain. She has a few strategies for managing her exposure, whether she’s inside or out. “I keep my office slightly darker than the rest of the house,” she tells SELF. She also has tinted windows in her home and car, uses black shutters in her office, and never leaves home without sunglasses.Since looking at bright screens, in particular, can be painful for White, she always turns the brightness of her laptop and phone way down. “It really helps to keep the lights as low as possible,” she says.5. Plan ahead for moments when you’re not feeling your best.One of the many potential symptoms of migraine is brain fog, which can cause memory issues and trouble focusing—all things that can really interfere with getting your work done. “It took me years to learn to accept the high brain fog days and be kind to myself about it,” Lindsay Weitzel, 46, tells SELF.Beyond accepting that some days you simply may not feel your greatest, one way to manage the cognitive effects of migraine is by saving some easier work for times when you’re not feeling 100%. “I try to keep a ‘brain fog task’ on the back burner to do on days that I’m mentally not at my best,” Weitzel says.6. Try to make time for regular exercise.Lots of people with migraine swear it helps keep attacks at bay. Exercise definitely helps to reduce stress, which could be part of it, but the research is mixed and some people find heavy exercise to be a trigger—so listen to your body.

Rita Tennyson, 51, realized something wasn’t quite right with her health when she experienced a string of abnormal and mostly unexplained symptoms in her early twenties. Among them: numbness, muscle weakness, nausea, vertigo, and facial paralysis. At one point she was given an ear infection diagnosis—a doctor said she likely had a virus enter her ear while visiting SeaWorld on a windy day. Over the years, Tennyson had no idea what was going on with her body, but she had a strong feeling that something really wasn’t right.It turns out Tennyson didn’t have an ear infection; she has multiple sclerosis (M.S.), a chronic neurological condition that affects the central nervous system, which includes the brain and spinal cord. M.S. symptoms can vary from person to person, but some of its early signs can include vision problems, numbness and tingling, arm or leg weakness, changes in balance and coordination, and sensitivity to heat. One important thing to understand about M.S. is that it can’t be diagnosed using a single test. Instead, an M.S. diagnosis is made through a combination of things, including a person’s medical history, neurological exam, tests like an MRI and a lumbar puncture (spinal tap), blood tests to rule out other illnesses, and a physical exam. Tennyson’s experience isn’t exactly unique; an M.S. diagnosis can be challenging, and many M.S. symptoms overlap with those of other conditions. This is her story, as told to health writer Beth Krietsch.I learned I have M.S. when I was 26, but the road to an accurate diagnosis was a long one. My symptoms first started the summer after I graduated from college, when I was working as a waitress and randomly dropped something. I had also been experiencing a bit of numbness in my arms, so I went to the doctor and they scheduled me for nerve testing. The results didn’t show that anything was wrong, so they basically just said to let them know if similar symptoms popped up again.The next year I started getting really dizzy and nauseated, and I also had vertigo. I would lie down and not be able to move. If I got up, I would throw up. It got so bad that I went to the E.R., where a doctor told me I must have an inner ear infection. They flushed my ears and sent me on my way, but the relief didn’t last too long.Soon after, I headed back to my hometown for a wedding and brought my boyfriend at the time, who is now my husband. While there, the nausea and vomiting returned, and my mom assumed I was pregnant. But I knew that couldn’t be the case—this was the same nausea I’d been experiencing for a while.The next year I experienced paralysis on one side of my face. It was so bad that I couldn’t even smile or clear my nostril on that side. I was diagnosed with Bell’s palsy, which is a condition that causes temporary paralysis or weakness of the facial muscles, making it look like half your face is drooping. It may sound strange, but I was actually so relieved because it meant I had a concrete diagnosis that people could actually see. Previously so many of my “invisible” symptoms were things I could only feel. Bell’s palsy is something other people could see with their own eyes, so, in a way, I was happy about that.

Bhuta suggests asking your doctor about physical therapy, including water therapy, which research shows can help control pain and improve symptoms and quality of life among people with M.S.1 “I go to physical therapy more often than normal and it has helped me stay off the muscle relaxers,” Bhuta says.Cubero says speech therapy, cognitive behavioral therapy, and occupational therapy have all been tremendously helpful in managing her fatigue and cognitive symptoms, but she says these therapies weren’t offered until she asked about them. “I’ve learned that in order to take control over my medical care, I had to advocate for myself,” she says.Azure Antoinette, 39, says one of the most important things she’s learned in the past decade of living with M.S. is the importance of approaching symptom management holistically, factoring in things like exercise and diet, on top of choosing the right medication.“I encourage newly diagnosed M.S. warriors to speak up—not only to discuss what medication may be best for you but also ask your doctor for tips and resources to help with everything else that comes with living with a chronic illness,” Antoinette tells SELF.4. Can I exercise?Staying active was a top concern for dancer Courtney Platt, 34, after her M.S. diagnosis. “Anyone going through this journey should ask whether they can stay active, if there are limitations they should consider, and the benefits of staying active for their health,” she tells SELF. Platt’s neurologist let her know she could continue dancing, and movement has played an important role in keeping her body, mind, and soul strong since her diagnosis.Research shows that exercise benefits people living with M.S. in many ways, including helping with symptom management and improving quality of life.2 Exercise can help build strength, improve flexibility and mobility, and increase cardiovascular fitness, but you may need to adjust your exercise habits depending on your goals, abilities, and how you’re feeling on any given day.3Platt encourages working with your health care team to determine how much movement makes sense for you, and to listen when your body tells you to rest. “Know when you need to push through and know when you need to pause,” she says.5. Will anything make my symptoms worse?Sometimes M.S. symptoms can be triggered by seemingly simple things like stress and heat. Bhuta used to be able to spend tons of time in the sun but now loses energy if she gets too hot. Knowing that heat is a big trigger for her, she now uses cooling towels and wears a big hat to block the sun and prevent overheating. “Ask your doctor about what is likely to trigger your symptoms and what you can do to alleviate them,” Bhuta says.At the time of Bordelon’s diagnosis, her job as a medical surgery coder required long hours and a ton of computer time. But she had no idea that all that screen time (and the eyestrain that comes along with it) and the increased stress of working long hours would make her M.S. symptoms worse. “Had I known that staring at the computer screen would cause additional stress on my body and ultimately worsen my symptoms, I would have scaled back on my workload while I was finding the right treatment to manage my M.S.,” she says.6. Is there anything I can do to feel more prepared to deal with my symptoms on a day-to-day basis?You’re not alone if you feel worried and overwhelmed after an M.S. diagnosis. To alleviate some of that anxiousness, ask your doctor what you can do to prepare for symptom flares and to manage your condition on a daily basis. “Are there ‘just in case’ medicines they can prescribe? Is there support equipment that you can have in your house, like shower chairs and handles, canes, and walkers? Whatever you need, ask for it,” Bhuta says. If you find certain tasks have become more difficult, let your doctor know, and ask them what might help.7. How can I connect with others who have multiple sclerosis?You may feel alone and isolated after being diagnosed with M.S., but there are many other people out there feeling the exact same way who are also looking for some support. Ask your doctor how and where you can connect with people who have M.S. There may be a support group in your area, or you can connect with people on social media or join an online support group.“I highly recommend getting involved with the M.S. community because it will help you feel more normal and give you the comfort you need,” Bhuta says. “I spent a lot of time on the MS Society forums, and they will even pair you up with someone who has been diagnosed that you can talk to about your journey.”Bottom line: Know that it’s completely acceptable to advocate for yourself and ask lots of questions. “You’re not in this alone and the only way people know how to help you is if you speak up,” Bhuta says. “You allow people to see what you’re experiencing only by vocalizing it. Speak up often—it will be your greatest ally.”Sources:Evidence-based Complementary and Alternative Medicine, Hydrotherapy for the Treatment of Pain in People With Multiple Sclerosis: A Randomized Controlled TrialThe Lancet Neurology, Exercise in Patients With Multiple SclerosisSports Medicine, Exercise and Multiple SclerosisRelated:

Selina Ferragamo, 27, first started experiencing hidradenitis suppurativa symptoms in high school, but she wasn’t diagnosed with the condition until she was 22. Hidradenitis suppurativa (H.S.) is a chronic, inflammatory condition that causes painful bumps under the skin, often in sensitive areas like the armpits, groin, and beneath the breasts. The bumps and lesions can burst, releasing pus and blood and causing a lot of pain. Sometimes, the condition causes tiny tunnels beneath the skin connecting lesions, and it can also cause scarring.H.S. is a very visible and uncomfortable condition, so along with the physical pain, it can also impact emotional well-being. Self-inflicted body shaming and a lack of self-confidence are common. Ferragamo personally felt a lot of shame about the boils, cysts, and lumps brought about by her H.S., as well as the scars left behind by the condition and the surgeries she’s had to treat it. She says these negative feelings can make it hard to wear sleeveless shirts and bathing suits, or even just to get ready to go out to a party.When in a flare, shaving can irritate H.S. bumps and lesions, worsening the condition and making it more painful. But having hairy armpits adds another layer of shame, Ferragamo says. After a boil ruptures, she’ll often place gauze under her armpits, which people sometimes comment on. She also says that people—and even doctors—who didn’t understand H.S. made her feel like it was her fault: that she wasn’t showering enough, that it was due to her weight, that she wasn’t hygienic, that she wasn’t changing her razor blades enough. All of this blame really impacted how she viewed herself.Over the past few years, Ferragamo has managed to overcome a lot of her body shame and embarrassment related to H.S. Here is her story, as told to health reporter Beth Krietsch.Between May 2017 and August 2018, I had three surgeries on my armpits—my hidradenitis suppurativa flares were getting so big and painful that I wasn’t able to move without excruciating pain anymore. After my surgeries, it took me a long time to be comfortable wearing tank tops. If I lift my arms, my surgery scars are pretty noticeable, and you can also see the scars from the back of my arm because of how I was stitched up. It gets really hard sometimes, especially if I’m trying to find an outfit for a party or event. When I was getting fitted for my sister’s wedding, the tailor saw the scars underneath my armpits and she asked if I had cancer. I was kind of taken aback because I wasn’t really expecting anyone to say anything about it. I was like, “Oh no, it’s just surgery scars,” but it was really uncomfortable.Sometimes comments like that really get to me and make me feel self-conscious. I used to get really embarrassed talking about H.S. because it’s not the most pleasant thing to describe. I get nervous that people will judge me and think I’m disgusting, and then those thoughts spiral in a negative way. So it bothers me when people draw attention to my insecurities. But I try to remember this is not my fault—that this is an uncontrollable disease that I have to live with. I saw a meme that said something like, “those scars are showing the history of everything that you’ve been through.” So I try to see it that way.

Shoshana Lipson, 56, has lived with migraine for as long as she can remember. Many people think of a migraine as a bad headache, but Lipson and others with the condition know that it’s actually way more involved than that. Migraine is a complex neurological disorder that can cause intense head pain and other symptoms like nausea, weakness, and sensitivity to sound, light, and smells.1 A migraine attack can strike at any time, disrupting so many aspects of your life, from work to time with family and friends. People with migraine may need to cancel plans at the last minute or avoid certain activities that trigger an attack such as going to the movies, which can strain relationships. Lipson talks to SELF about how she’s learned to get to a place where her relationships are thriving.Migraine impacts my relationships in a big way because everything has to revolve around the condition. Migraine dictates where I can go and what I can do, and my plans always need to be flexible. Sometimes I can’t be available to my partner or my children. Some people think I can just take an over-the-counter pill and be fine, or that I am faking my condition. My first marriage was very challenging because my spouse really did not understand my condition. I was pushed to work a 9 to 5 job on top of caring for three young children and assisting my husband in his own business, which healthwise I wasn’t really able to do. I was pushed into doing things that I couldn’t do. The marriage didn’t survive the strain—it was just too much.When I eventually started dating again, I was pretty open about the disease with other people. But I was also so afraid of starting a relationship, wondering if the next person I met would be understanding. I did meet a partner who is incredibly supportive, and we’ve been married for nearly eight years now, but we had a challenging start. Around the time we decided to get married, my migraine attacks were out of control to the point where they didn’t respond to medication.My fiance knew I had migraine, but he didn’t see me in a full-blown attack until the night we got engaged. I spent the evening in the bathroom in excruciating pain and was unable to stop throwing up. When my migraine attacks happen they are completely and utterly debilitating and bring my life to a grinding halt, regardless of my responsibilities or plans. Within a month of getting engaged, I was no longer able to work and my health basically just crashed and burned. We expected to have a longer engagement so we could merge our lives together slowly. But because I was no longer able to financially support my family, we got married much sooner than planned.My fiance was understanding and really supportive of my condition. I think it helps that I constantly educate him about migraine, and he does his own research too. Still, in the beginning, I didn’t know if we were gonna make it. The strain in our marriage at the time was due to three things. First, we had full custody of five teenagers between us, so there were normal challenges to work out in a blended family. For example, fragrances can trigger a migraine attack and my stepdaughters didn’t understand why they couldn’t wear perfume or body spray as their friends did. Secondly, I was not able to work at all at that time, which caused a lot of financial strain. Thirdly, my health was so bad I had trouble doing basic housekeeping and being there for our children as needed.