For better or worse, Kim Kardashian’s appearance has come to signify a particular sort of physical perfection. Kardashian might be most famous for her internet-breaking rear end, but even the minute details of how she presents herself—her glowing skin, the thickness of her eyebrows, her wardrobe—have seeped into American culture. A few posts on her Instagram account, which has 131 million followers, are enough to sell a lot of perfume, makeup, and in-app purchases.
That’s why it was all the more striking to see a photo she posted earlier this week, which showed her face not flawlessly groomed as usual, but covered in red, puffy splotches. Kardashian has been occasionally candid about dealing with the chronic skin condition psoriasis in the past, mentioning it on her various reality shows and even posting on Instagram about the trendy detox routines she was trying in order to calm the incurable inflammatory illness. This was the first time she’s shown a severe flare-up on her face.
Itchy, scaly skin is psoriasis’s most well-known symptom, but it’s also the thing that makes Kardashian’s preferred platform an unlikely place to see it discussed. Instagram is often a place for people to show the best and most desirable parts of their life. Its culture is one that Kardashian and other highly influential users have been instrumental in shaping—and profited from greatly. Those who do a good job of selling their lifestyle can make millions of dollars showing other people how to live as they do.
But in shining a light on a common and poorly understood disease, Kardashian demonstrates one of the most underutilized ways the internet’s most-watched people might be able to do a little good, just by being less perfect versions of themselves.
Kim Kardashian’s ubiquitous internet presence is, perhaps more than anything, a social-media Rorschach test. She reveals something not only about the person viewing her, but also about what that person wants to discuss online. Kardashian posting a video of her kids inspired days of arguing about children and makeup. She and her sisters have made the debate over cultural appropriation something far more mainstream than it was just a few years ago by adopting hair and beauty practices historically used by black women. The term news peg is used by journalists to refer to a current event that makes a broad topic feel relevant to readers, but Kardashian, mostly seen through social media, acts as a news peg for people who post their thoughts online in any form.
That’s where the potentially enormous value of the psoriasis selfie comes in, says Evan Rieder, a dermatologist and psychiatrist at New York University Langone Health. “It’s a particularly effective way to raise awareness, and it can immediately reduce stigma,” he says. “[Social media] is an opportunity to educate people on a mass level and in a very digestible way, where people are actually tuned in.” These platforms are adept at reaching Millennials, he says, and because most people develop psoriasis in their 20s or 30s, it’s a demographic that needs the information.
Randy Beranek, the CEO of the National Psoriasis Foundation, thinks it’s particularly valuable when people well known for their beauty and wealth are candid about their health issues. “Most of the time, Kim’s fans see her looking like a million bucks,” he says. “The disease can cross all socioeconomic lines, and if someone as famous and visible as Kim Kardashian can have it, it doesn’t make your disease feel so isolating.”
That Kardashian posted a photo of her psoriasis instead of just mentioning it is bold. A significant rash is fairly unsightly by anyone’s standards, and for most of Instagram’s elite, the most relatable imperfections they display are still an expertly curated part of their highly photogenic public personas. Red, flaky facial skin is several orders of magnitude more socially unacceptable than carefully tousled bed head or an artfully messy dinner spread. As Kardashian’s selfie demonstrated, psoriasis has physical symptoms that can be difficult to conceal, even for people with a lot of resources.
More than 8 million Americans have psoriasis, but it’s still poorly understood by the public at large, which can lead to stigma that unnecessarily ostracizes those dealing with a flare-up. Rieder says that many people think they can get psoriasis by being in proximity to those with it. “A lot of us have heard stories about people moving their children away from them so they don’t catch it,” he says. “You hear of people getting out of the pool because someone’s in the pool with psoriasis.” That sense of isolation can be exacerbated when people avoid social situations because of flare-ups, a tactic both doctors mentioned as common. And this can contribute to emotional issues such as depression and anxiety, which Rieder says are more common among people with psoriasis than the population at large.
In reality, psoriasis isn’t contagious, and it’s a lot more than just a recurring rash. The skin-based symptoms of the disease can often be treated with over-the-counter creams, but the illness can affect multiple systems of the body, mostly unseen. “People with psoriasis have much higher rates than the general public of things like cardiovascular disease, metabolic syndrome, type 2 diabetes, liver and kidney disease, lymphomas—a whole host of chronic conditions,” Beranek says.
A selfie from one of the world’s most famous women can’t convey all of a disease’s complexity, but it doesn’t necessarily need to. More than 40 percent of Americans with psoriasis don’t realize that the condition is what’s causing their skin problems, according to an estimate from the American Academy of Dermatology. Seeing Kardashian’s photo might help them realize that what they have is a diagnosable problem that can be helped. “In the last 20 years, there’s been a revolution in the way we treat psoriasis,” Rieder says. He points specifically to new biologic medications, which can clear up to 90 percent of the disease’s visible symptoms. Seeing a doctor if at all possible, Beranek notes, is also the best way to start examining the less noticeable ramifications of chronic inflammation.
It’s not clear if Kardashian intended the photo of her psoriasis to be helpful, or if it was just a frustrated outburst (she did not respond to a request for comment). Either way, it demonstrates a potentially beneficial way that modern media’s new class of influencers can use their massive platform. Many of them are already keen to share health and wellness misinformation to an apparently interested audience, and Kardashian herself has shilled prescription drugs and mentioned trying “natural” cures for psoriasis based on sketchy or nonexistent science. Celebrities aren’t the people we should be looking to for information on cures, but when it comes to stigma, they have enormous power to provide a little bit of relief, instead of information about yet another juice cleanse.