If you have psoriasis, you’re likely trying hard to do everything you can to manage your condition. While medication can help minimize flare-ups, so can finding healthy ways to cope with known triggers — including psychological stress.
Psoriasis and stress are strongly linked. Although psoriasis is thought to be influenced by genetics, environmental factors, such as traumatic life events, contribute and can make symptoms worse. It’s therefore crucial to find effective ways to manage stress.
Doctors and researchers don’t yet fully understand what causes psoriasis, but the condition is thought to occur when the immune system attacks healthy cells, causing skin cells to grow rapidly. Because stress can impact the immune system, experts warn that it can also cause psoriasis symptoms.
Of course, it isn’t possible to avoid stress altogether. And psoriasis itself can cause stress, which can make managing the condition more difficult.
“Psoriasis is a stigmatizing disease for many people because it’s so visible,” says Vesna Petronic-Rosic, MD, the head of dermatology at the John H. Stroger Jr. Hospital of Cook County in Chicago. 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 the first step in helping patients feel less stressed about their psoriasis is to provide them with treatment that works.
“You can’t just tell a patient, ‘Don’t stress and the psoriasis will improve,’” says Dr. 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.”
Stress management techniques can help you better manage psoriasis, and there are many effective methods to consider. Take exercise: It’s a great stress reliever with innumerable other health benefits, such as weight loss, which is also known to alleviate psoriasis symptoms in people who are overweight or have obesity.
“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. Virtually any type of exercise can relieve stress, whether it’s cardio, like running or tennis, or something more relaxing, such as yoga, qigong, or Pilates.
Exercise is a stress buster for many reasons: It releases feel-good neurotransmitters called endorphins, helps you stay present in the moment, and can improve sleep.
Always check with your doctor before beginning a new exercise routine. And walk before you run — literally. 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.
Another scientifically proven stress reduction technique is mindfulness meditation, in which you focus your awareness on the present moment and observe the bodily sensations and emotions you’re experiencing, without judgment.
One research review found that mindfulness meditation led to an improvement in psoriasis severity and how much skin surface was affected in five of six randomized controlled trials, and two studies reported significant improvement in quality of life. Its authors said that results suggest that mindfulness and meditation can be used as a tool to improve both disease severity and quality of life, at least in the short-term, but that more high-quality research is needed.
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. What’s more, one study suggests that alcohol use can make psoriasis symptoms worse by increasing production of a pro-inflammatory chemical, and that higher levels of alcohol consumption reduce response to treatment.
“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.”
One study found that smoking is a significant risk factor in the development of moderate to severe psoriasis.
It’s helpful to identify your main sources of stress, so you can avoid them when possible, and to have a strong support system that includes family members who understand your illness, Petronic-Rosic says. Therapy can also help you manage stress levels when other approaches aren’t enough.
You can also find peer support through the National Psoriasis Foundation (NPF). The NPF’s One to One program matches you with another person living and thriving with psoriasis to act as your mentor. The program is run by volunteers who commit to offering encouragement and support to their peer mentee. Finding connection with someone who’s also living with this illness can help you manage your stress, Petronic-Rosic says.
If you’re looking for a broader range of perspectives on life with psoriasis, you might consider joining a community-focused psoriasis Facebook group, or posting on Reddit psoriasis communities to commiserate with others and share coping tips.
“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.
It’s true that psoriasis is known to be a lifelong, relapsing-remitting illness, and that can be difficult for many reasons. People living with psoriasis should strive to develop healthy coping mechanisms, Petronic-Rosic says, so they’re not “constantly stressing themselves out because they have this disease.”
Research backs the importance of healthy coping mechanisms. One study found that participants with moderately severe psoriasis who were more accepting of their condition also reported more satisfaction with their lives.
None of this is surprising. A previous randomized controlled trial also connected acceptance to reduced stress. The study, which asked a group of stressed participants to observe their present-moment experience through a lens of acceptance, found that they had reduced stress hormone levels and lower systolic blood pressure than participants in observation-only and control groups.
Psoriasis can be triggered by a variety of environmental factors, including stress, but healthy coping mechanisms can minimize its impact.
Healthy coping mechanisms like exercise and mindfulness meditation can improve symptom severity and quality of life, research suggests, while unhealthy ways of coping, such as smoking and drinking, can make both symptoms and stress levels worse.
Emotional support is also crucial to reducing stress, whether it’s via family, friends, therapy, or online communities.
While psoriasis may be a lifelong condition, you can improve your symptoms and quality of life by taking measures to lessen your exposure and response to triggers.
