Psoriasis is a skin condition that causes red, thick, irritated patches that often look silvery and scaley. It most commonly affects the elbows, knees, and scalp but can occur 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 might have periodic flare-ups, which are times when symptoms are active.
One common psoriasis flare-up trigger is stress. Stress worsens symptoms and increases the risk of a psoriasis flare-up. The experience of psoriasis itself can also induce stress, causing a looping cycle of stress and psoriasis flare-ups.
Experts aren’t sure what causes psoriasis, but it likely includes genetic and environmental factors as well as an immune system overreaction. Experts know that certain factors can cause psoriasis to flare.
One of the leading causes of a psoriasis flare-up is stress. Experts are unsure why stress causes psoriasis to flare up, but there are several theories about why this occurs.
The potential reasons why stress causes psoriasis flare-ups include:
- Psychological stress can trigger inflammation in the body, which may worsen psoriasis.
- Chronic stress may disrupt the endocrine system (hormone system), causing abnormal function of your organs, including your skin.
- Chronic stress affects your immune system, and immune system overreactions may be involved in psoriasis.
Whatever the cause, the connection between stress and psoriasis is clear. Research has found that psychological stress occurs before psoriasis onset in about 44% of people. In 88% of people, stress causes intensification of psoriasis symptoms.
If you have psoriasis, you are likely well aware of the stress the condition can cause. This stress can cause psoriasis to flare up, which can lead to more stress, which can lead to more flares—and the cycle goes on.
Research has shown that people with psoriasis score lower on quality-of-life measures than people without psoriasis. Contributing factors include the severity of psoriasis and whether they also experience arthritis symptoms along with their psoriasis.
Having a poor quality of life can significantly increase your stress levels, but there are other reasons stress levels tend to be high among 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 may cause feelings of shame and decreased self-esteem.
- Some people with psoriasis socialize less during flare-ups because of shame or discomfort, leading to increased loneliness.
- Psoriasis can increase your risk of mental health issues like depression and anxiety, which can increase stress.
Psoriasis is also linked to issues like sleep disorders and sexual dysfunction, which can increase stress levels and potentially cause flare-ups.
If you have psoriasis, there are many ways to manage your stress so that your symptoms don’t flare or your symptoms go away. You might 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 their impact on 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 may also help keep flare-ups under control. Research has shown that CBT effectively reduces psoriasis symptoms, especially among people with moderate or severe psoriasis.
Practice Mindfulness and Meditation
Mindfulness and meditation can help you manage feelings like stress that may develop when you have psoriasis. Mindfulness means being aware of and not judging your feelings immediately. Meditation is a set of practices focusing on the connection between the mind and body to calm the mind.
Mindfulness and meditation can also improve psoriasis symptoms and severity.
Make Lifestyle Changes
There are lifestyle changes you can implement to help decrease psoriasis symptoms. Many of these interventions also help manage your mental health and decrease stress. These tips include:
- Take baths in lukewarm waters and with mild soaps
- Keep your skin adequately moisturized, 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 alcohol consumption
- Avoid triggers like cold weather, skin injuries, infections, and medications that cause your flare-ups
- Join psoriasis support groups to feel less alone and to learn ways to cope with symptoms, increase self-esteem, and boost mental health
Stick To Your Treatment Plan
If you have psoriasis, your dermatologist (a specialist in skin, nail, and hair conditions) will help you manage it. Managing psoriasis helps decrease your symptoms and keeps your stress at bay.
Your provider may prescribe different types of medications. Topical creams, lotions, ointments, and foams are applied directly to the skin. Many of these contain corticosteroids to help with inflammation.
Oral medications and medications, like biologics, that are injected subcutaneously (in fatty tissue just below skin level) are also common.
Medications given through a vein (intravenously, IV) are not common aside from Remicade (infliximab). These may work to suppress the immune system.
Another promising treatment for psoriasis is phototherapy, which involves exposing your skin to ultraviolet (UV) light at a healthcare provider’s office. The provider may sometimes prescribe an at-home UV light treatment kit.
If you are experiencing psoriasis symptoms for the first time, you should see a healthcare provider. They can properly diagnose the issue and develop a treatment plan that’s best for you.
If you are already seeing a dermatologist for care, you should contact them in cases where:
- Your psoriasis symptoms continue, even with treatment
- Your symptoms are getting worse
- You are experiencing joint pain or fever in addition to psoriasis symptoms
Seek emergency medical care if you have skin symptoms, such as a rash, covering your whole body.
If you are experiencing serious stress or mental health issues related to your psoriasis, don’t hesitate to reach out for support from a mental health professional. Your dermatologist may be able to recommend someone to you.
Many factors can cause psoriasis to flare up. One common cause is stress.
Stress can increase inflammation, disrupt the endocrine system, and exacerbate immune issues, all of which contribute to psoriasis flare-ups. Psoriasis is also stressful in itself, which can cause increased stress levels and psoriasis symptoms.
Managing psoriasis involves medical and lifestyle interventions, but it also involves managing stress. Your healthcare provider can help you determine how to manage your psoriasis and stress levels, including options like cognitive behavioral therapy and mindfulness meditation.
