An Exploration of Life With a Chronic Skin Condition

Despite considerable prevalence and clinical impact, chronic skin conditions have received little sociological attention. This research examines the social implications of living with a chronic skin condition, based on the thematic analysis of in-depth interviews featuring 24 adults with experiences of eczema, psoriasis or acne. Drawing on Bourdieusian field theory and corporeal phenomenology, this thesis brings new insight to the disembodying experiences of disordered skin, strategies enacted for their management, and the wider implications of disordered skin on social participation. Illustrating experiences of social dys-appearance, individuals are found to negotiate stigma, both enacted and perceived, based on normative expectations of bodily presentation. Employing the notion of aesthetic capital, disordered skin is shown to impair possibilities for aesthetic distinction and undermine a sense of capability in personal and working roles. Faced with disabling spatialities and difficulties surrounding disclosure, individuals develop anticipatory dispositions and a range of time-space tactics. The corporeal dys-appearance of disordered skin demands that individuals respond through laborious practices which often take on Sisyphean attributes. A novel concept of “containing” is introduced as a type of skin work reflecting how managing disordered skin requires attention to clearing up exudations of “dirty” bodily substances, such as skin flakes, blood, pus, and the remnants of topical treatments, to avoid soiling external environments. Pharmaceutical treatments are found to be a source of deep ambivalence. Moreover, individuals value agency in their treatment protocols and, where capital resources allow, enact resistance to medical authority through experimentation with alternative strategies and practices of self-medication. This study highlights a need to accommodate the additional labour demands of life with chronic skin conditions, and the desire for agency in treatment, through policy and practice measures. Further efforts are needed to address the impact of inequalities of access to resources on the burden of managing chronic illness.