For those who live with psoriasis—an incurable autoimmune skin condition that affects nearly 8 million Americans and 125 million people worldwide—the potential impacts don’t end with just the physical symptoms.

According to new research from the UMD Department of Sociology, the judgmental and stereotypical responses that can greet sufferers with the condition’s scaly, itchy skin patches are stressful, too, and can make them feel “disgusting,” “filthy” and “broken.”

“Skin is an important part of one’s appearance and plays a critical role in establishing interpersonal relationships,” said Dr. Alex Parkhouse, a medical sociologist whose study was recently published in the American Journal of Health Behavior. “Television commercials and other advertisements contribute to the visibility of psoriasis, but often inadequately characterize life with the condition and neglect to highlight hidden burdens, like stigma, affecting daily life.”

For the study, Parkhouse conducted in-depth interviews with 23 people living with psoriasis in the United States. Many participants said they felt others viewed them as “different,” a perception that resulted in everything from skipping school and family-related functions to sexual and intimacy issues and shaping career goals.

“You know, when your elbows and ears and face and legs are all red and scaly and gross, people don’t see you as being attractive,” Alan, a 36-year-old service worker from New York, said in the study. “They don’t see you as being normal. It influences your popularity, how people interact with you.”

Participants also revealed how personal and social resources such as friends, family, health care professionals and support groups can help them cope with and manage the effects of stigma-stress.

“It’s just nice to tell people about it, just someone to talk to, really,” Laura, a 19-year-old college sophomore from New Hampshire, said in the study. “It’s nice to have that because they (friends and family) don’t get grossed out or anything. They’ll listen to me.”

Parkhouse hopes his research contributes to a better understanding of psoriasis and other chronic illness-related stigma-stress.