“It was around fifth grade when I started to hide it and cover it up,” says Alisha. “It affected how I viewed myself, how I felt about myself, my quality of life, and my willingness to participate in events or activities.” This overwhelming feeling of anxiety showed up time and time again for Alisha. If she was invited to a pool party, would she wear a swimsuit and get stares and questions from the other kids, or go fully dressed and risk being made fun of because of that? For a track race, the uniform was shorts and a tank top — Alisha would pace, palms sweating, breath heavy, overwhelmed at the thought of wearing such an outfit in front of her teammates. Then at drama club, the director wouldn’t let her use the makeup used by the other members. Picking out a dress for a pageant, going to a nail salon, even a trip to the grocery store — all of these could bring on anxiety. From her diagnosis onward, Alisha was seeing doctors and trying various treatments for her psoriasis, but no one talked to her about this effect it was having on her life. “I always feel like the emotional component was missed, “ she says. “I don’t think it was missed on purpose. I just don’t think they realized how much it affected me mentally and emotionally. Now I realize that I was dealing with anxiety and panic attacks.” From there, Alisha got in touch with the National Psoriasis Foundation, and during a volunteer conference, she attended a workshop on how to share about the disease through blogging. She was inspired and thought, “That’s something that I can do. “I started writing about my psoriasis journey — everything that I had been through,” says Alisha. “I didn’t think that it really was going to resonate with people the way it has. But it has gone to a place that I did not imagine. So many people read the blog. So many people can relate.” Aside from being an outlet where she could share her story, her blog opened up doors for advocacy. “It’s grown into me speaking out about the disease at conferences,” Alisha says, “to doctors and researchers, to other people dealing with the condition to let them know that they can thrive with the disease.” She’s even advocated for psoriasis research before Congress. “Every year,” she says, “the National Psoriasis Foundation takes a group of patients to Capitol Hill to talk to our Congress members about psoriasis research and legislation. We talk about how the disease affects us, and why money for research is important.” Alisha also explains that scalp psoriasis can be a problem for African Americans because treatment usually involves the use of a special shampoo that requires washing your hair every day or two, and she says, “we don’t wash our hair that often.” This leads to treatment adherence issues and affects how well the medication works. She also says that these treatments can even damage certain types of hair. “I always strive to make sure that I’m the voice for people of color,” Alisha says, “to make sure that we’re included and to make sure that our wants and needs and concerns and challenges are known.” “The difference,” she says, “is that I can post a picture online with a caption that says ‘psoriasis,’ but you don’t have that advantage when I’m out in public. If I’m at the grocery store, I don’t have a comic bubble over my head that says, ‘Hey, it’s just psoriasis,’ so it leaves those around me to just assume whatever it is that they want to assume and sometimes that’s difficult and uncomfortable.” Almost 10 years after that “suicide” letter, Alisha is taking control of her anxiety over psoriasis once again: One of her 2019 resolutions was to strive to be more confident in public. “This summer, I’ve been going to the beach and exposing my legs, regardless of my psoriasis,” Alisha says. “That’s huge for me. It’s definitely not something I would have done 10 years ago — not even one year ago.” “For me, at this point,” she says, “it’s not an issue of being embarrassed by my plaques. Sometimes, I just don’t want to be a walking billboard for psoriasis — I don’t want to explain it. So I cover up when I don’t feel like being bothered with the attention.” On such days, Alisha gets creative with her clothing. “One thing I have control over is how I dress,” she says. “Since I have control over that, I’m going to be as fashionable as I possibly can be.” In the end, it’s all about doing what makes you feel confident — whether that’s covering up your psoriasis, or exposing it for the world to see. “Some people feel as though if you’re trying to cover up or if you wear body makeup, that that’s not promoting body positivity,” Alisha says. ”But people have to do what they’re comfortable with, and that is what is most important.”