Psoriasis and stress are intricately linked. Although psoriasis is a genetic condition, environmental factors, such as traumatic life events, can make symptoms worse, according to the American Academy of Dermatology. That’s why it’s crucial to make stress management a key component of your psoriasis treatment plan. Doctors and researchers do not yet fully understand what causes psoriasis, but the disease 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 it may impact psoriasis, and recent research supports this 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, a dermatologist in Chicago. Many people with psoriasis even recall their first flare happening during a difficult time in their lives, she says. A research review published in October 2018 in the International Journal of Dermatology found that a large number of patients — anywhere from 31 to 88 percent — reported their psoriasis started within a year of a very stressful event. The authors of the study say the patients’ claims clearly suggest that stress may trigger the autoimmune disease in those who are predisposed to it. RELATED: 5 Tips to Recognize and Manage Psoriasis Triggers Psoriasis itself can cause stress, and that can make managing the condition more difficult. “Psoriasis is a stigmatizing disease for many people because it’s so visible,” says Dr. Petronic-Rosic. For example, you may be anxious about exposing psoriasis plaques and choose to wear long sleeves on a hot day. Feeling self-conscious or worried about signs of disease increases stress, which can cause psoriasis to flare even more — a vicious cycle. Doctors believe that that the first step in helping patients feel less stressed about their psoriasis is providing them with treatment that works. “You can’t just tell a patient, ‘Don’t stress and the 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.” RELATED: Mind-Body Therapies to Sooth Psoriasis
Stress Management Skills Help Minimize Psoriasis Flare-Ups
Stress management techniques can help you manage psoriasis, and there are many effective methods to consider. For one, try exercise: It’s a great stress reliever with innumerable other health benefits, such as weight loss, which is also known to alleviate psoriasis symptoms. “I will very often tell patients to take up an exercise or a hobby — something that they will enjoy doing that will help alleviate the stress,” says Petronic-Rosic. Some ideas include yoga, meditation, and Pilates. Exercise can be a stress buster because it releases feel-good neurotransmitters called endorphins, according to the Mayo Clinic. Exercise also helps you sleep better, which can help lower stress levels, the scientists at the clinic say. Always check with your doctor before beginning a new exercise routine, the National Psoriasis Foundation (NPF) advises. And walk before you run. You’re more likely to stick with a new exercise plan if you don’t try to do too much too soon. Plus, increasing your exercise level in increments will help you avoid injury. RELATED: How Yoga Can Help Psoriasis — and How to Get Started
Unhealthy Coping Mechanisms Can Make Psoriasis Worse
People with psoriasis also should limit behaviors that can amp up stress. Alcohol and recreational drugs, for instance, may intensify rather than relieve stress, Petronic-Rosic says. A study published online in August 2019 in Psoriasis Auckland suggests that alcohol might make psoriasis 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.” A study published in January 2019 in Expert Review of Clinical Immunology found that smoking can make psoriasis treatments less effective and suggested that people with psoriasis be encouraged to enroll in smoking-cessation programs.
Emotional Support Can Help Reduce Stress
Identifying your main sources of stress can help you keep levels in check, and so is having a strong support system, including involved family members, Petronic-Rosic says. Counseling could also help you manage stress levels when other approaches aren’t enough. You can find peer support through the National Psoriasis Foundation. The NPF’s One to One program matches you with someone who has been through what you are going through. The program is run by volunteers who commit to offering inspiration, encouragement, and support for at least six months to a year. Finding you’re not the only one with this disease can help you manage your stress, Petronic-Rosic says. RELATED: Overcoming a Psoriasis Flare
Learning to Manage Stress Has Long-Term Benefits
“Psoriasis will get better or worse, go into remission or flare, but it’s probably going to be there for the rest of your life,” says Petronic-Rosic. Psoriasis patients should strive to develop healthy coping mechanisms, she says, so they’re not “constantly stressing themselves out because they have this disease.” Additional reporting by Beth W. Orenstein.
