The Psoriasis-Stress Connection — and What You Can Do to Manage Stress
Stress plays a crucial role in psoriasis: Having psoriasis can be stressful, and stress itself can trigger flare-ups. Here's how to make stress management a valuable part of your psoriasis treatment plan.
Medically reviewed by Lindsey Marcellin, MD, MPH
People with psoriasis want to do everything they can to keep their condition under control. Taking medication and avoiding known triggers — including psychological stress — can help you minimize flare-ups.
That’s because psoriasis and stress are intricately linked. Although psoriasis is a genetic condition, environmental triggers such as stressful life event often trigger it, according to the American Academy of Dermatology. And having psoriasis is stressful in itself, which can trigger future flare-ups. That’s why it’s crucial to make stress management a key component of your psoriasis treatment plan.
Psoriasis, Stress, and Your Immune System
Psoriasis is an inflammatory skin condition. Doctors and researchers do not yet fully understand what causes this condition, but it is thought to occur when the immune system turns on the body, causing skin cells to grow abnormally and rapidly. Because stress can have an impact on the immune system, doctors have long suspected a link between stress and psoriasis, and recent research supports the theory.
"Psoriasis is very stress-dependent. It flares very easily when patients are under stress, and it tends to improve when they're relaxed," says Vesna Petronic-Rosic, MD, MSc, a dermatologist and associate professor of medicine at the University of Chicago Medical Center. Many people with psoriasis even recall their first outbreak happening during a difficult time in their lives.
Psoriasis-Related Stress
Psoriasis itself can be a stressful thing to deal with, and that can make psoriasis management more difficult.
People with psoriasis may be uncomfortable exposing areas of their skin that show signs of the condition. "Psoriasis is a stigmatizing disease for many people because it's so visible," says Dr. Petronic-Rosic. Someone with psoriasis might avoid wearing warm-weather clothing, instead choosing to sweat in long sleeves and pants because they want to hide their skin. Feeling self-conscious or worried about these physical symptoms increases emotional stress, which can cause psoriasis to flareeven more.
Before focusing on stress management, however, you should address the symptoms of the disease itself. "You can't just tell a patient, 'Don't stress and your psoriasis will improve,'" says Petronic-Rosic. "First try to get the disease under control. When the skin feels and looks better, then move on to doing other things that are beneficial for well-being."
Psoriasis Treatment: Stress Management
Stress management techniques can help you keep psoriasis under control, and there are many effective methods to try. For one, exercise: It's a great stress reliever with innumerable other health benefits. "I will very often tell patients to take up an exercise hobby — something that they will enjoy doing that will help alleviate the stress," says Petronic-Rosic. Ideas include yoga, meditation, and Pilates.
People with psoriasis also should limit other behaviors related to stress. Alcohol and drugs, which people may use to reduce stress, actually make stress worse. "There's a lot to be said about managing these addictive behaviors," says Petronic-Rosic. "Stress-induced behaviors, such as alcoholism and smoking, aggravate psoriasis and correlate directly to the severity of the psoriasis."
Identifying your main sources of stress can help you keep them in check — but stress management doesn't have to be done alone. Having a strong support system, including involved family members, is important for coping with a chronic condition. Counseling could also help bring stress levels under control when other techniques are not enough.
Psoriasis is a chronic condition and often requires an effective method to continually manage associated stress. "Psoriasis will get better or worse, go into remission or flare, but it's probably going to be there for the rest of their life," says Petronic-Rosic. Psoriasis patients need to develop a coping mechanism so that they're not "constantly stressing themselves out because they have this disease." Doing so will benefit emotional health, and may positively impact psoriasis symptoms as well.
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