After three doses of the second biologic I’ve used, I have finally achieved upwards of 90 percent skin clearance from psoriasis. This is a huge win, and I am so thankful to have come so far from where my body was six months ago. I still have a few stubborn patches on my legs as well as some remaining scalp and ear psoriasis, but I am, for the most part, lesion free. The skin discoloration remains throughout my body in the areas where lesions once were, but I am hoping this will fade over time.

I want to celebrate finding a medication that works for me without overly attaching to my currently clear skin. I know that, at some point, this medication could stop working and that I will likely experience another psoriasis flare in my life. So, I’m somewhere in between jumping for joy and trying not to place too much value on my current condition.

Now, when I look at pictures from when my body was covered, I’m honestly not sure how I made it through that time. This seems like a dangerous way of thinking, and I want to believe that even if it gets that bad again, that I could tolerate the discomfort and love myself through it.

Psoriasis lesions and, later, healed skin. (Katya Meltaus)

In addition to being both excited and wary of too much excitement, I am struggling with the new invisibility of my disease. It somehow feels invalidating to a part of my experience that no one can physically see the struggle anymore. I am also immunocompromised now, which too goes unseen.

The need to feel seen is universal, but I’m learning that I can meet this need on my own by being compassionate with myself. Instead of feeling shame or guilt around feelings of self-pity or medical anxiety, I can tell myself: “Ouch! That was really hard when your body was covered with psoriasis. It is really scary to think about being back in that place, and it is stressful to be coping with fears about your treatment.” I can honor that I am still managing something difficult and be OK with the fact that it is unknown to others.

The anxiety of maintaining clearance is something I am also now dealing with. I worry about what will happen if my shots don’t come on time or if I store them improperly. I am worried about if and when the medication will no longer work for me, a challenge many on biological treatment have experienced.

Moreover, I have never really made peace with the fact that I am modifying my immune system. I am not a researcher, and I don’t fully understand the impact this medication is having on me. I am happy to be clear, but I am scared that it is coming at a potential cost; that someday I will learn that this medication has negatively affected me in some way or that I will get extremely sick at some point because of it.

My skin is clear, but it doesn’t feel like I’m out of the woods, and it doesn’t feel like psoriasis is no longer affecting my life. I want to appreciate the wins while acknowledging that I am very much still on this journey.

MyPsoriasisTeam columnists discuss psoriasis from a specific point of view. Columnists' articles don’t reflect the opinions of MyPsoriasisTeam staff, medical experts, partners, advertisers, or sponsors. MyPsoriasisTeam content isn't intended as a substitute for professional medical advice, diagnosis, or treatment.