It started with a patch of red scaly skin on my upper cheek, the size of a small burn, during Christmas break my freshman year of college.

What I assumed to be a grossly misformed pimple spread down my neck and extremities over the next month, leaving me with the appearance of a child riddled with chicken pox. I initially dismissed the irritation as patches of dry skin associated with the colder weather in New York, where I went to school. After a few weeks of the red plaques rearing their head, I decided it was time to get a professional opinion on what was plaguing me.

The dermatologist, who couldn’t have been older than his mid-to-late 20s, gave a quick look-over of my body in his second week out of medical school.

He started to grill me on my sexual history.

“Have you ever slept with anyone who lives in or around the city?” he asked, referring to the area around Manhattan.

“I think the closest I’ve ever gotten is someone from Nassau county,” I said. “How is this relevant?”

“This looks like a textbook case of syphilis,” he said, with no hint of humor. “It’s one of the rarer STDs, but younger people are rife with it in the city.”

I told him I was much more inclined to think this was something closer to psoriasis or eczema. I remembered reading about syphilis and all of the facial deformities of people left untreated. I didn’t look like the elephant man, I just had a rash.

“People don’t get psoriasis on the palms of their hands and feet,” he said. “If you want, I’ll bring another doctor in here, but he’s going to tell you the same thing.” The tone was much more condescending than it was reassuring.

He brought in the second doctor, more than double his age. He looked me over with the same speed as Doogie Howser.

“Could be either,” he shrugged. “Why don’t you go ahead and test for both.”

I gave Doogie a raised eyebrow of self-satisfaction as he drew a vial of blood from the crook of my right arm, for the supposed syphilis.

The test for psoriasis involved a needle of anesthetic he warned would burn as he flicked the fat on my arm repeatedly (which did nothing but cause stinging in now two areas) and unsheathed a straight razor.

He pinched a plaque on my arm and sliced with the razor, revealing a quarter inch of milk white fat on the underside of my bicep where the skin was biopsied.

I spent the week waiting to get my results back with relative anxiety. Syphilis was nowhere on my mental map of WebMD before I went to the appointment. I started to relax when I went full google-fu on the condition. It turns out syphilis is really hard to get. There were exactly 19,999 cases of syphilis reported to the CDC in 2014 (for comparison, there were 1.4 million reported cases of chlamydia). In order to contract it, one needs sexual contact with someone in the primary stage of infection (normally within three months). This is because the point of contact for syphilis is the initial lesion called the chancre, usually found around the genitals. We’re not talking about a cute little herpes looking cold-sore. This is a huge open wet wound sore. Say you’ve somehow missed this on your partner (hey, maybe it’s dark), you then have to basically rub some broken skin all over that lesion, and bam, now you might have syphilis. The fact that my origin sore was on the top of my cheek means I either had a really weird night I couldn’t remember, or that I was in the clear.

I was feeling pretty confident when I went to my follow up appointment, as Doogie announced that I indeed did not have syphilis, and did indeed have psoriasis.

“You might be happier if you did have Syphilis though,” Neil Patrick Harris said, still gunning hard for the STDs. “At least then it’s a shot of penicillin and gone, this is much more complicated.”

He explained that my specific type of psoriasis, guttate, usually occurs as an immune response to acute stress within the body, such as a high grade fever or the flu. This made sense to me as I had spiked a 104 degree fever a few weeks before the first rash. The immune system starts to attack the skin, believing it to be a foreign body, creating new skin cells in the affected area at a rate hundreds of times faster than normal.

Normally, he said, he would prescribe a steroid cream first to get rid of the plaques, but since they were so widespread, he wanted to go full force. He first tried to convince me to go with a biologic, an immunosuppressive injection that causes the cycle to stop, but also increases your risk for leukemia and other cancers. I declined.

“The only other thing we could try is a light box,” he conceded.

Imagining a futuristic box shooting “Toxic” music video-style lasers at my skin, he told me it was much more akin to a tanning bed, except it only used UV-B rays and cost about $5,000 pre-insurance. Sunlight apparently keeps psoriatic conditions at bay, and having lived under the Florida sun my entire life, it wasn’t unusual to experience my first occurance up north. I would be required to take an hour in the afternoon, three days a week, to drive another hour away and back for the treatments. Tempting, but I told him I would get back to him in a month for a follow-up after trying some lotions and hoping it would disappear on its own.

The medical tanning bed idea took root in my mind as I started to scan the psoriasis forums to see what had worked for other people. I repeatedly saw posts where some sufferer would suggest that instead of spending obscene amounts of money to sit in a modified tanning bed, they would sit in a regular tanning bed with the same results for a monthly membership fee of around $30 at a salon. Some lurking medical professional would inevitably fight back, calling the suggestion dangerous and ill-informed while the rest of the board collectively rolled their eyes.

I found the closest salon, Beach Bum Tanning (an apparent favorite of the Jersey Shore reality elite, according to their website press), in the same town as my university.

I walked into Beach Bum for the first time on a cold, dreary, snowy February afternoon to greet Pauly D’s cousin manning the front desk. He signed me up for a package that included the bed that I wanted (the one with the most UV-B), and then tried to sell me on all of the lotions they had. After going through such options as SOLID BLACK, BLACK 20X, FLASH BLACK, BLACK IS BACK, and BLACK CHOCOLATE, I asked him if there was anything for people who just didn’t want their skin to dry out in the beds. His summarized response was no, they only sold lotions for white people who wanted to experience racial discrimination, so I went for the least offensive option of Black Hemp (might actually be more offensive).

I truly didn’t expect to enjoy the experience. Laying in a hard plastic tube surrounded by light bulbs with only a sock to cover your jingle-jangle didn’t seem like my idea of fifteen minutes well spent, but I would be lying if I said I didn’t find the entire thing euphoric.

I don’t think I can explain the psychology behind it, but after living through months of cold winter days with seven hours of sunlight, being enveloped in this warm light while nice Caribbean music is pumped through the speakers was like a little vacation in the middle of the day. I always climbed out of the bed feeling charged up and ready to tackle the world, only to step into the snow-slushed parking lot and slowly deflate into emotional baseline. When I started, I told myself that I would go three times a week, as frequent as the therapy would have been through the dermatologist. The excitement of my plaques receding and darkening along with my skin proved to be too much and soon, other than to slap on underwear after the third day with badly burned buns, my routine was set in stone. I climbed into a tanning bed at 2pm every day for thirty days.

The red plaques against normal skin tone What a difference one month makes. Ignore the face, the tanning fried my motor control as well as my skin.

A side effect of this regimen was that I started to get really dark. BLACK 20X dark. This normally wouldn’t be a problem in my native Florida. It could be explained away that you spent a little too much time doing yardwork or you had a really good weekend at the beach. Against the background of a snow-covered New York winter however, my transformation was anything but natural and did not go unnoticed. My self-consciousness of resembling an oompa loompa was no match for the warmth of the human toaster oven and I continued to go until my month was up.

I went back to Doogie for my follow-up a few days after my last tanning session. His eyes immediately turned to daggers as he entered the exam room.

“What did you do?” he scolded me, as if he’d discovered his dog chewed up the living room furniture.

“I know, I know,” I said, trying to placate him. “This wasn’t the medically prescribed treatment…”

“This wasn’t a treatment, period,” he cut me off, his face growing red.

“But they’re gone,” I finished on a sing-songy note. He wasn’t satisfied.

“They may be gone now, but they’re going to come roaring back and worse than before,” he started to stammer. “Sitting in a tanning bed like that is the same as… as… the damage of shooting heroin but to your skin.”

Okay, Dr. Syphilis.

The psoriasis did not come back, at least for another three years, but my adventures in Beach Bum did not go unpunished (still no syphilis, though).

If moles were like pests, my body would be categorized as an infestation. I’ve had hundreds of them since as early as I can remember and they seem to multiply. Dermatologists love to call these original ones “birth marks,” but they’re indistinguishable from the others, which makes them moles. About a month after my psoriasis cleared, my skin had returned to its normal shade, but every day I noticed a new mole sprouting in a different place. I started to go to the dermatologist annually for a mole check to make sure no malignancies were forming on the melanoma incubator that is me.

My most recent visit to the dermatologist was at a new practice, having moved home after graduation. Her office was connected to a plastic surgeon’s, a decision I found only so convenient and nefarious as the deeply-accented Polish intake nurse started asking me questions in the exam room.

“I see here you’ve come in for a mole check,” she said. “Is there anything else you’d like the doctor to have a look at while you’re here? We could map the moles that you already have, or maybe take care of that thing on your face.”

“What thing on my face?’

She scooted her rolling chair a little closer to me.

“You know, this,” she said, arbitrarily brushing her hand over the air where my entire face was.

A silence prompted her to explain further.

“You know those little broken blood vessels on the bridge of your nose?” I did.

“How it kind of spreads out across your face?” I did not.

“We have a laser for that,” she explained. “We just zap it over your nose, it breaks apart all of the blood vessels. Your face will be bruised for a few days, but then it’s gone.”

“I’ll talk to the doctor about it,” I said, already dismissing the idea of the face-punching derm-laser.

Right on cue, the doctor, a cute compact middle-eastern woman entered the exam room. She looked over my entire body with what looked like a compact telescope, intermittently clucking terms I did not know to Polish nurse who started drawing circles on a male dummy on her tablet. The doctor stopped at an area in-between my shoulder blades.

“This doesn’t look great,” she said to the nurse. “Let’s do a full shave on this one.”

She finished looking me over and turned to face me.

“You know, we can fix that thing on your face,” she said.

“I know, I’ve been told, the blood vessels, the laser.”

“No, well there’s that too, but I was talking about that thing on your cheek.”

I rubbed the left side of my face.

“No, other cheek, looks like you have some enlarged sebaceous glands. We could just burn those off.”

Why did it feel like everyone in this office was trying to mutilate me?

“Wouldn’t that just leave a scar the same size in the same place?”

“It might, but it would probably be less noticeable,” she snapped off her gloves and turned to the nurse again. “Shave that mole and send over to pathology at Shands.” She excused herself from the room.

The nurse made me lie on my stomach as she unpackaged the shave kit, which was just another round of anesthetic and straight razor. She didn’t flick my skin as she injected the bee sting, for which I was thankful, but she looked nervous when she grabbed the razor.

“You’ve done this before, right?” I asked.

“Oh, once maybe twice,” she said. I was unable to perceive if the shakiness in her voice was real or if I was still trying to hear through the accent.

“I’m not sure I’m numb yet,” I said loudly as I saw her arm reach for my back in my peripheral.

“I guess you were, I’m done,” she laughed nervously, holding a piece of brown tissue with forceps in front of me.

I left the office feeling good that barring any bad pathology reports, I at least had one less mole covering my body.

When I returned for my follow-up two weeks later, a different doctor greeted me in the exam room.

“I’ve got good news and bad news,” she said, sitting on a stool in front of me.

“Pathology report came back negative, but there were a lot of abnormal cells in the tissue and they reached the edge of the sample meaning we didn’t get all of the mole off of your back.”

Damn Poland, you failed me.

“By abnormal cells, you mean…?”

“I don’t believe in the term pre-cancer, so I won’t use it, but that’s what other doctors might call it.”

So pre-cancer, essentially.

“It’s not a huge deal, but I’d like to go in there and cut away the remaining tissue just to be safe.”

Since they had already done a shave, she explained that a surgeon would have to use a scalpel to cut a football shape deep into my back and stitch it up at some considerable cost.

“Recovery time is usually less than two weeks,” she said. “Just no strenuous activity and I wouldn’t raise your arms above your head.”

“Say I didn’t do that and just left it alone?” I asked.

“Probably nothing,” she said. “By the way, we can totally fix that thing on your face if you want.”

I left the office, never to return, pre-cancer intact.

Next time on NewcomerWrites, another enthralling medical tale, Wisdom Teeth are the Foreskin of the Mouth; or, Why I Will Never See an Oral Surgeon.