Psoriasis is a skin condition that causes red, thick, irritated patches that often appear silvery and scaly. It most commonly affects the elbows, knees and scalp, but it can appear anywhere on the body.
Psoriasis is a chronic condition, meaning you have it for life. The severity of the condition usually ebbs and flows; you may have periodic attacks, which is a period when symptoms are active.
One common trigger for psoriasis flare-ups is stress. Stress worsens symptoms and increases the risk of psoriasis flare-ups. The experience of psoriasis itself can also cause stress, triggering a cycle of stress and psoriasis flare-ups.
Experts aren’t sure what causes psoriasis, but it likely involves genetic and environmental factors, as well as an overreaction of the immune system. Experts know that certain factors can trigger psoriasis.
One of the leading causes of psoriasis flare-ups is stress. Experts aren’t sure why stress causes psoriasis to flare up, but there are several theories as to why it happens.
Potential reasons why stress triggers psoriasis flare-ups include:
- Psychological stress can cause inflammation in the body, which can make psoriasis worse.
- Chronic stress can disrupt the endocrine system (hormonal system), causing your organs, including your skin, to function abnormally.
- Chronic stress affects your immune system, and overreactions of the immune system can be involved in psoriasis.
Regardless of the cause, the link between stress and psoriasis is clear. Research has shown that psychological stress occurs before the onset of psoriasis in about 44% of people. In 88% of people, stress causes an intensification of psoriasis symptoms.
If you have psoriasis, you’re probably well aware of the stress the condition can cause. This stress can cause the psoriasis to flare up, which can lead to more stress, which can lead to more breakouts—and the cycle continues.
Research has shown that people with psoriasis score lower on measures of quality of life than people without psoriasis. Contributing factors include the severity of the psoriasis and whether they also have arthritis symptoms along with their psoriasis.
A poor quality of life can significantly increase stress levels, but there are other reasons why stress levels are high in people with psoriasis. These reasons include:
- The symptoms of psoriasis itself — itching, irritated skin, and arthritis-like symptoms such as joint swelling — can cause discomfort and distress.
- The appearance of your skin can cause feelings of shame and lowered self-esteem.
- Some people with psoriasis become less social during an attack due to embarrassment or discomfort, leading to increased loneliness.
- Psoriasis can increase the risk of mental problems such as depression and anxiety, which can increase stress.
Psoriasis is also associated with problems such as sleep disturbances and sexual dysfunction, which can increase stress levels and potentially trigger flare-ups.
If you have psoriasis, there are many ways to manage stress so that your symptoms don’t flare up or go away. You may find that a combination of addressing the stress itself and managing the condition works best.
Try cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is a talk therapy that teaches you to be more aware of your thought patterns and how they affect your emotions. You also learn techniques to manage your thoughts and feelings.
CBT can help you manage your challenging thoughts and feelings about living with psoriasis. It can also help keep flare-ups under control. Research has shown that CBT is effective in reducing psoriasis symptoms, especially in people with moderate to severe psoriasis.
Practice mindfulness and meditation
Mindfulness and meditation can help you manage feelings like stress that can develop when you have psoriasis. Mindfulness means being aware and not judging your feelings immediately. Meditation is a set of practices that focus on the mind-body connection to quiet the mind.
Mindfulness and meditation can also improve the symptoms and severity of psoriasis.
Make lifestyle changes
There are lifestyle changes you can make to reduce psoriasis symptoms. Many of these interventions also help manage your mental health and reduce stress. These tips include:
- Bathe in lukewarm water and with mild soaps
- Keep skin adequately hydrated, including after bathing
- Eat a nutritious, well-balanced diet
- Try the Mediterranean diet, which is known to help with psoriasis symptoms
- Maintain a weight that you and your healthcare provider decide is optimal for you
- Avoid or quit smoking
- Reduce your alcohol consumption
- Avoid triggers such as cold weather, skin injuries, infections, and medications that cause your inflammation
- Join psoriasis support groups to feel less alone and learn how to manage symptoms, boost confidence and improve mental health
Stick to your treatment plan
If you have psoriasis, your dermatologist (a skin, nail and hair specialist) will help you manage it. Treating psoriasis helps reduce symptoms and keep stress at bay.
Your doctor may prescribe different types of medication. Topical creams, lotions, ointments and foams are applied directly to the skin. Many of them contain corticosteroids that help with inflammation.
Oral medications and medications, such as biologics, that are injected subcutaneously (into the fatty tissue just below the skin level) are also common.
Medicines given through a vein (intravenous, IV) are not common except for Remicade (infliximab). They can act to suppress the immune system.
Another promising treatment for psoriasis is phototherapy, which involves exposing your skin to ultraviolet (UV) light in a doctor’s office. A provider may sometimes prescribe a home UV light treatment kit.
If you have psoriasis symptoms for the first time, you should see a doctor. They can properly diagnose the problem and develop a treatment plan that is best for you.
If you are already seeing a dermatologist for care, you should contact him in cases where:
- Your psoriasis symptoms continue, even with treatment
- Your symptoms are getting worse
- In addition to psoriasis symptoms, you have joint pain or a fever
Get emergency medical help if you have skin symptoms, such as a rash, that covers the whole body.
If you’re experiencing severe stress or mental health issues related to your psoriasis, don’t hesitate to seek support from a mental health professional. Your dermatologist may be able to recommend one.
Many factors can cause psoriasis to appear. One common cause is stress.
Stress can increase inflammation, disrupt the endocrine system, and worsen immune problems, all of which contribute to psoriasis flare-ups. Psoriasis is also stressful in itself, which can cause increased stress levels and psoriasis symptoms.
Psoriasis treatment includes medical and lifestyle interventions, but it also includes stress management. Your healthcare provider can help you determine how to manage your psoriasis and stress levels, including options such as cognitive behavioral therapy and mindfulness meditation.