How psoriasis can damage young people's quality of life
Victoria Sanderson was a 17-year-old model when her life was turned upside down by a serious skin condition.
First, she started to notice red blotches on her elbows. Then, within days, she was covered from head to toe in painful, itchy patches of red skin which would not go away.
"I had to stop modelling altogether because nobody could use me and I lost my job at a Chinese restaurant because the boss said I was putting people off their food."
Victoria's GP told her the problem would disappear in a week, so she was not prepared to cope with a devastating condition called psoriasis.
"I didn't understand what it was. I thought it was just a rash that would disappear. Nobody told me I would have it forever."
She started using cream to treat it, but her skin became increasingly dry, cracked and tight. Even brushing her hair was painful.
When she finally saw a dermatologist three months later, Victoria was in a terrible state.
"I couldn't stand up, I couldn't use my hands. Just wearing clothes, feeling them rubbing against my skin, was a nightmare."
The Psoriasis Association says the condition affects 2-3% of people in the UK and over a third of them develop psoriasis before they are 16.
As a result, it has launched a new website for young people with the condition, including information, practical tips and a place to get advice and support.
Christopher Griffiths, professor of dermatology at the University of Manchester and spokesman for the British Skin Foundation, says developing the condition as a teenager or young person is particularly difficult.
"It can often appear at this sensitive stage of life, around the same time as exams or first jobs and when young people are starting relationships. It can be life-ruining."
Although most patients have a genetic pre-disposition to the disease, it is also thought to be triggered by something like a sore throat or a stressful event.
Not only is it a sore and uncomfortable skin condition, it is also a visible problem which can have a major impact on patients' quality of life.
Victoria says it makes her self-conscious and nervous about meeting people for the first time and worried about people staring at her.
Now a 28-year-old marketing consultant, she is very aware of the pressure to look attractive when representing her client's brands.
She says: "It is a lonely disease which, at times, can make me want to hide away".
Prof Griffiths says that the general public still does not understand people with skin disease.
"People think psoriasis must be contagious, that it must be the result of eating the wrong things. Their first reaction is to take a step back. Imagine how that affects people with the condition."
Psoriasis is caused by a speeding up of the usual skin replacement process. Normally skin cells take about 21-28 days to replace themselves. In psoriasis, skin cells can be replaced every two to six days.
This results in a build-up of skin cells on the surface of the skin. The redness of the skin is due to the increase in blood vessels required to support the increase in cell production.
In recent years, new and more effective treatments for psoriasis have improved the lives of many sufferers.
Topical therapies and vitamin D creams are now available for more limited cases of psoriasis, while biologic therapies - in the form of injections which target the immune system - are now used to treat severe psoriasis which has not responded to any other treatment.
"None are cures, but they can cause considerable improvement and can bring social functioning back to normal," says Prof Griffiths.
Victoria found light therapy to be her salvation. After eight weeks of intensive UVB treatment, she was clear of the red patches which had covered her skin.
They slowly came back, however, and now she undergoes treatment with ultraviolet light every six months to keep the condition at bay.
"It's hard to avoid talking about my skin problem," Victoria says.
"People ask if it's HIV; sometimes they ask if I have had a car crash. I try to explain that it's an auto-immune disease and it's not contagious.
"Suddenly it's not this hideous, disgusting thing..."