"Ur skin is the thing that everyone sees and you cant change it!": exploring the appearance-related concerns of young people with psoriasis.

Purpose: The failure of research to capture the qualitative experiences of young people who have chronic skin conditions means that their psychosocial needs are poorly understood. Using a grounded theory approach, this study facilitated group discussions between adolescents with psoriasis in order to rapidly identify themes about their support needs.

Methods: Three online focus groups were hosted in a real time forum. In total, 8 young people aged 11-18 years were recruited through the websites of psoriasis support organizations. Focus groups lasted an average of 1 hour and data was analysed using grounded theory techniques.

Results: Appearance-related concerns are central to the experiences of young people with psoriasis. Participants constructed their individual struggle (It and Me) in physical, emotional, motivational and intellectual terms. A strong sense of Us developed as participants recognized the value of meeting peers with psoriasis. This enabled groups to blame Them for their negative social experiences.

Discussion: The findings are discussed in the context of literature around adolescence and appearance. It is suggested that the experience of negative social encounters in adolescence may have long-term implications for appearance anxiety specifically and self-esteem generally. The potential of peer support to improve these outcomes is considered.