My fear of needles for medical procedures started at an early age. My dad told me about the time I pulled a vaccination syringe out of my arm as a toddler. He remarked that I didn’t like needles — an understatement.
My avoidance of needles led me to bolt out of the doctor’s office during a vaccination appointment a few years later. I knew I was destined to be a runner when I sprinted down the hall to elude the nurse.
I know I’m not alone in my anxiety around needles. The Centers for Disease Control and Prevention (CDC) offers the following information on its website: “It has been estimated that up to 25 percent of adults have a fear of needles, with most needle fears developing during childhood. If not addressed, these fears can have long-term effects such as pre-procedural anxiety and avoidance of needed healthcare throughout a person’s lifetime.”
I still don’t like needles, but I’ve had to overcome that fear to receive the medical care I need to stay healthy: Every year I receive the flu shot in the fall, and I got my first dose of Moderna’s COVID-19 vaccine in early April. I went to the clinic lab a week later to get blood drawn for tests my doctors ordered.
Treating my psoriasis has also made me face my fear of needles.
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Psoriasis Treatment and Needles
I started receiving psoriasis treatment by injection in college. At first, I took methotrexate pills to treat my psoriasis as a 20-year-old student. Later, to bypass digestive side effects, a nurse injected the medication into my hip. It was an unpleasant experience that I dreaded, but it helped manage my psoriasis at the time.
Methotrexate treatment protocol back then required I undergo a liver biopsy after taking a specified cumulative dose of the medication. During that procedure I received anesthetic that made me groggy, but I have a faint memory of seeing the doctor with a large needle. Even though I didn’t feel anything, that image of the needle has stuck with me.
A couple of biologics I’ve taken required me to go to an infusion or dermatology clinic for a nurse to inject. I didn’t mind those nurse visits as much since I could look away as someone else gave me the shot.
Self-injecting, though, took my fear of needles to another level.
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My First Self-Injection Experiences
A friend once asked me, “Is it hard to inject yourself?” He had been told that one of his treatment options for a newly diagnosed condition involved self-injections. Knowing that I had experience injecting myself with biologic medications, he wanted my perspective. My reply was, “How much time do you have?”
A new class of medications called biologics emerged as a treatment for psoriasis in the early 2000s. I told my friend about the time when I was first prescribed Enbrel, which required twice weekly self-injections. My psoriasis was doing poorly on available treatments, so I felt I had no choice but to try it. First, though, I needed to learn how to inject myself subcutaneously (under the skin).
I appreciated how my doctor provided me with training and instructions. He had me practice injecting an orange, which he said was a technique used by medical students.
In the beginning I used a syringe that I prepared by swirling the medication with water. Soon after, the medication became available in a prefilled syringe, and I was relieved that I didn’t need to mix it myself or worry about tapping out bubbles from the syringe.
Then one day, my prescription came in an injectable pen. To take the medication, I pressed the pen down on my skin and pushed a button on the end. The pen provided convenience, but the loud noise of the spring shooting the needle into my skin left me a bit shaken.
Overcoming the fear of self-injecting took a lot of practice and nerve, but I did get used to it. Since Enbrel, I’ve injected myself hundreds of times, including with my current biologic, Skyrizi.
A Personal Treatment Choice
After sharing my injection experiences with my friend, I told him, “It’s really a choice between you and your doctor. But if that treatment is what you think is best, then you can get used to the needle.” When I checked with him later he was still weighing his options.
Recent medical innovations in targeting inflammation pathways on the molecular level have led to more treatment options than ever before. Unfortunately, many of these medications cannot be ingested like a pill and need to be injected. The way a medication is administered is certainly a consideration for each individual.
I wish I could say that overcoming my fear of needles led me to a psoriasis cure. The biologics need to be taken regularly to remain effective; some might work for one person but not another. Of the six biologics I’ve tried, none have cleared my skin the way I hoped they would. I’m now considering trying yet another. Still, overcoming my fear of needles allowed me to get some relief.
Tips on Self-Injecting
I found some general tips on overcoming the fear of needles on the Cedars-Sinai blog. It recommends strategies that I’ve used such as looking away, trying relaxation techniques, and reframing thoughts. “Instead of focusing on momentary discomfort, recognize that injection pain disappears quickly but the positive effects last much longer,” the advice goes.
If you’re looking at treatment options that require self-injections, here are some suggestions:
- Talk about your concerns with your healthcare provider. I’ve found doctors and nurses to be caring and understanding about my fears and anxieties.
- Take advantage of resources such as nurse’s visits, training videos, and medication instruction inserts to learn more. Being informed builds confidence and familiarity.
- Take a caregiver or friend with you to medical visits. They can help you remember details or answers to your questions. In some cases, they may be able to help you inject your medication.
- Develop a routine. On injection day, I set aside time in the evening in a quiet, well-lit corner of my house to administer my medicine. I keep my injection supplies — such as cotton balls, alcohol wipes, and a sharps container — conveniently nearby.
- Ask questions if you’re unsure about any part of the injection process or the medication itself. I’ve contacted healthcare providers and drug manufacturer help lines many times.
You can read more about my experiences on my blog for Everyday Health and on my website.