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Psoriasis and Stress

By Maureen Salamon

Updated July 04, 2008

(LifeWire) - How can someone whose skin is chronically marked with scaly, red patches or lesions not feel stressed? They can't, which explains why the usually lifelong skin disease psoriasis is inextricably linked with stress.

But stress isn't just a by-product of psoriasis -- it's also one of its principal triggers. For anyone who has psoriasis, the circular relationship between the two significantly complicates matters. However, there are steps to help break the cycle.

Psoriasis-related stress can come from many sources:  the individual's own self-consciousness about visible lesions, the reactions of others, pain and itching, and even the treatments themselves, which can be time-consuming and costly with no guarantee of effectiveness. Some patients report that their first psoriasis outbreak came during a period of great stress, and others report that the condition is aggravated the same way.

For Leah Bird, a 55-year-old Newton, Mass., resident who developed the condition at age 12, psoriasis has affected all aspects of her life.

"I've had it on my palms and on the soles of my feet, and it's horrible because it cracks. It makes cooking or working for hours at the computer difficult because my hands are sore and they flake," Bird says.

"The big issue with psoriasis is that it's so demoralizing," she adds. "You always have to be aware of it."

Scientists have found that the hormone cortisol, which alters the immune system responses and is released at times of physical or emotional stress, tends to be found at higher levels in people with psoriasis. Conversely, a 2008 study in the International Journal of Dermatology reported that three-quarters of those with psoriasis experience significant drops in cortisol levels during remissions of the disease.

Clearly, reducing stress is a high priority for anyone with psoriasis. Here are some tried-and-true methods to help you do so:
  • Counseling or Support Groups
    Support from others who understand your concerns has been proven to reduce stress. Speak with your doctor, another trained professional, or others with psoriasis. You can search for a National Psoriasis Foundation support group on the organization's website .
  • Exercise
    Another proven stress-buster, exercise has many forms. Yoga, for instance, has been long touted for its relaxation properties.

  • Simplifying Commitments
    Prioritizing your needs and cutting back on extraneous activities and commitments can also help.

  • Stress-management Skills
    Meditation, biofeedback, journal writing, guided imagery, massage therapy and deep-breathing exercises can all help lower your stress level.

Despite such efforts, you may find that your stress level is still too high. So when is it time to consult your doctor and consider medical treatments?

"When you feel that no matter what you do, you can't get ahead [of your stress] and when it's affecting the activities of daily living, it's time to see a doctor," says Doris J. Day, MD, assistant clinical professor of dermatology at New York University Medical School.

However, it's important to note that all medications have the possibility of side effects that can interact with other medications you may be taking, so it makes sense to try the non-drug approaches first.


Bird, Leah, Newton, MA. Phone interview. 15 April 2008. 

Day, Doris J., MD. Assistant clinical professor of dermatology, NYU Medical School. Phone interview. 16 May 2008.

"Stress Management Tips." Psoriasis.org.. Oct 2005. National Psoriasis Foundation. 4 Jun 2008 <http://www.psoriasis.org/PATH/approach/stress>.

Weigl, Bea. "The Significance of Stress Hormones for Eruptions and Spontaneous Remission Phases in Psoriasis." International Journal of Dermatology 39.9. Sep 2000 678-688. 4 Jun 2008 <http://www.blackwell-synergy.com/doi/abs/10.1046/j.1365-4362.20>.

Zachariae, R. "Self-reported Stress Reactivity and Psoriasis-Related Stress of Nordic Psoriasis Sufferers." Journal of the European Academy of Dermatology and Venereology 18.1Jan 2004 27-36. 4 Jun 2008 <http://blackwell-synergy.com/doi/abs/10.1111/j.1468-3083.20>.    

LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Maureen Salamon is a New Jersey-based freelance writer who has written for newspapers, websites and hospitals. She has suffered from psoriasis for nearly three decades.

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