Psoriasis and Mental Health: How Stress and Emotions Affect Your Skin
Psoriasis is a skin condition with red, scaly patches of skin. The physical symptoms are unpleasant – but they also affect your mental health, and that should not be underestimated.
Skin and mind influence each other: on the one hand, stress can trigger a psoriasis flare-up; on the other, a flare-up weighs on your mental state. That in turn can make psoriasis worse – a vicious circle.
Many people affected suffer from social withdrawal, depression, anxiety or sleep problems, and some also from increased alcohol consumption or excess weight. In this article, you will find out how psoriasis and mental health are connected and what helps you break the cycle.
Can stress trigger psoriasis?
Stress alone does not cause psoriasis. The condition arises from a genetic predisposition and a misdirected immune system. Stress is, however, one of the best-known triggers for flare-ups: in people with this predisposition, it can set off a first outbreak or a new flare-up and make an existing one worse.
The reason: under stress, the body releases stress hormones and messenger substances that influence the immune system and can fuel inflammation in the skin. On top of that comes the itching, which often gets stronger under stress. Scratching injures the skin – and new plaques can develop at injured spots.
Is psoriasis psychological?
No. Psoriasis is not a "psychological" or purely psychosomatic illness, and it has no hidden "emotional meaning" either, as you sometimes read. What is true, however, is that the mind can have a significant influence on its course. That is why it is worth taking both seriously – your skin and your mind.
How psoriasis affects your mental health
Psoriasis and depression
People with psoriasis have an increased risk of depression. Studies show – depending on the study design and the size of the group studied – that between 9 and 55 % of people with psoriasis suffer from depression. Certain characteristics are associated with a higher risk:
- being female,
- the severity of the psoriasis,
- accompanying conditions such as psoriatic arthritis,
- the type of treatment.
Depression can impair self-esteem and weaken your ability to cope with stress. If you feel down, listless or hopeless over a longer period, please seek professional help. A paper in the Journal of the German Society of Dermatology even recommends asking specifically about depression at the dermatology practice – so feel free to raise it yourself.
Psoriasis and social withdrawal
Psoriasis can also lead to social isolation. Many people feel insecure because of their skin and are afraid of being labelled – for example at the swimming pool, when doing sport or in a relationship. One way to find your way out of isolation is a self-help group or an online community. There you can talk to people who know exactly what you are talking about.
Psoriasis and anxiety
Anxiety disorders are more common in people with psoriasis than in people without the condition. The anxiety can stem from the worry that others will reject you because of your skin. This can affect finding a partner, but also finding and keeping social contacts.
Psoriasis and stress
Losing your job, a break-up, upcoming exams, the death of someone close to you or conflicts – these are all stressful situations. Stress weighs on your mind and can trigger flare-ups or make an existing flare-up worse. If you know that your skin reacts to stress, you can take targeted countermeasures: consciously go easy on your mind and so lower the risk of stress-related flare-ups.
Psoriatic arthritis and mental health
Up to 30 % of people with psoriasis also develop joint problems over time, known as psoriatic arthritis. Constant pain, fatigue and limitations in everyday life add to the burden – which is why psoriatic arthritis is considered one of the factors that increase the risk of depression. You can read more about signs and treatment in our article on psoriatic arthritis.
The vicious circle of skin and mind
| Step | What happens |
|---|---|
| 1. Stress | Pressure at work, in the family or from the condition itself |
| 2. Flare-up | Inflammation in the skin increases, the patches itch and spread |
| 3. Strain | Shame, withdrawal, sleep problems, low mood |
| 4. More stress | The psychological strain intensifies the next flare-up |
The good news: you can intervene at any point in this cycle.
What is good for your mental health
Psoriasis affects everyone's mental health differently. When the symptoms on the skin are treated well, that is good for your mind too. Even so, it is important to reduce psychological strain in a targeted way. These strategies can help:
- Less stress: try to avoid situations that stress you a lot, or consciously plan breaks.
- Managing stress: treat yourself and try out different techniques to lower your stress level – for example meditation, yoga, breathing exercises or anything that relaxes you.
- Keeping a diary: keep a (skin) diary. This may help you spot connections between stressful phases and flare-ups.
- Staying active and sleeping well: regular exercise reduces stress hormones, and enough sleep strengthens your resilience.
- Becoming part of a community: talk to other people affected and get tips on how they deal with their psoriasis. The feeling of not being alone helps enormously. Places to turn to include, for example, the Deutscher Psoriasis Bund, Psonet, Psoriasis-Netz and Bitte berühren.
Seeking professional help
Getting psychological or psychotherapeutic support is not a weakness – it can be an important step towards coping better with the condition. This applies especially if you suffer a lot from your psoriasis – but not only then. Your first points of contact are your GP and your dermatologist. They can refer you on.
Taking good care of your skin
Because well-cared-for, calm skin also affects your mood, a good skincare routine is part of it – alongside your medical treatment. Our psoriasis care with the neem leaf extract NEEMAVERA® soothes irritated, scaly skin. You can read about other natural approaches that can help in 7 natural remedies for psoriasis. And we talk about how to feel comfortable in your skin again in Self-acceptance: feeling comfortable in your own skin.
Conclusion
Psoriasis has physical and psychological effects. It can impair self-esteem, social relationships, career opportunities and quality of life as a whole. But there are proven strategies for dealing with it: professional help, self-help groups and online communities, stress reduction and relaxation techniques. If you live with psoriasis, take the psychological side seriously – it is just as important a part of your treatment as caring for your skin.
Frequently asked questions
Can stress trigger psoriasis?
Stress does not cause psoriasis, but it is one of the most common triggers for flare-ups. In people with the relevant predisposition, it can set off a first outbreak or make an existing flare-up worse.
Is psoriasis psychological?
No. Psoriasis arises from a genetic predisposition and a misdirected immune system. The mind can, however, strongly influence its course, for example through stress.
How common is depression with psoriasis?
Depending on the study, between 9 and 55 % of people with psoriasis suffer from depression. The risk is particularly increased with severe psoriasis and with psoriatic arthritis.
What helps your mental health with psoriasis?
Reducing stress through relaxation techniques, exercise and sleep, talking to other people affected, a skin diary and, if needed, professional psychological support. Well-treated skin also takes pressure off your mind.