If you have psoriasis, it’s no secret that a flare-up can have you stressing. With that stress can come even more signs of psoriasis, leading to a seemingly never-ending cycle of the two.
Learn how stress can cause a flare-up — and what to do about it.
Even though researchers aren’t totally sure what causes psoriasis, the general understanding is that it comes from issues with the immune system and genetics. And stress can screw around with your immune system too.
According to the National Psoriasis Foundation, psoriasis is an immune-mediated disease that triggers body-wide bouts of inflammation. That inflammation can cause plaques or scales that can be itchy or painful (but different types of psoriasis trigger different effects on the skin).
Stress isn’t just in your head — when it kicks in, your body immediately reacts. A 2015 review suggests that when stress happens, we humans enter “fight or flight” mode. It’s the body’s way of prepping us for an injury or infection by releasing cells that increase inflammation — the immune system’s way of saying “Nope, not today.”
When the stress becomes chronic, hanging around for days to years, these inflammatory cells can wreak havoc on your immune system. If psoriasis is already messing around with your immune health, a flare-up of plaques and scales might be the way your body starts responding to stress.
Research suggests that 31 to 88 percent of people with psoriasis have dealt with stress-triggered symptoms. And folks who have experienced a stressful event in the last year are more likely to experience psoriasis flares as a result. (TBH, it’s 2021. Who hasn’t been stressed?)
This backs up the idea that stress can trigger psoriasis flares. And while stress is not likely to be the *cause* of your psoriasis (because researchers still don’t really know what kicks it off), your first flare-up might happen as a reaction to stressful events in your life.
If you’re dealing with a lot of stress and notice new dry, thick patches on your skin, chances are you’re dealing with stress-induced psoriasis. Along with these patches, other common symptoms of psoriasis include:
- dry, cracked skin
- itching, burning, and soreness
- swollen or stiff joints
But not all psoriasis is the same, and symptoms can vary from person to person. There are actually various types of psoriasis that look different and affect different parts of the body.
- Plaque psoriasis. If you’ve got psoriasis, it’s probably this type that occurs in 80–90 percent of folks with the condition. The scalp, elbows, knees, and lower back are its main areas of interest. The plaques look like patches of thick, raised skin with scales covering some of them.
- Guttate psoriasis. Flares of this type of psoriasis trigger small, pinkish bumps that usually cover your torso, legs, and arms.
- Inverse psoriasis. This type shows symptoms in skin folds like your armpits, genitals, and butt. The skin is usually sore and painful, and the psoriasis patches are smooth, red, and raw-looking.
- Pustular psoriasis. With this form of psoriasis, you’ll notice pus-filled bumps, typically on your hands and feet. Although rare, these bumps can spread across your body and leave you with a fever, headache, and muscle weakness.
- Erythrodermic psoriasis. This is one of the most severe types and causes burnt-looking skin along with fever, chills, and muscle weakness. It often develops when another type of psoriasis begins to get worse or doesn’t improve with treatment.
- Nail psoriasis. About half of people who live with psoriasis might also experience nail psoriasis. The symptoms often include white, yellow, or brown discoloration under one or several toenails or fingernails. The nail might also lift up or become rough and crumbly.
Stress will come for you, whether it’s through your job, your family life, or any other avenue. It’s inevitable. But you can prepare yourself to manage it.
These strategies won’t eradicate psoriasis symptoms — a healthcare professional will need to prescribe a treatment that works for you. But working through stress or distracting yourself might help you dodge a painful or irritating flare-up.
Give some of these stress-busting techniques a go and see what works best for you.
Whether you want to jog, swim, bike, or do yoga, physical activity can lead to a boost of feel-good hormones called endorphins. These can give you a sense of happiness and euphoria that may counter the stress.
A 2021 review of 26 studies found that mind-body physical activity interventions (in the form of yoga) helped reduce markers of stress in students. (But only 10 of these studies were of high quality, so more research is necessary — still promising, though.)
- being in a quiet location
- sitting, lying down, or walking — whatever helps you feel comfortable
- focusing your attention on your breath pattern or on an object while letting distractions run in and out of your mind without self-judgment
Who doesn’t like doing stuff they like? It might be crafts, reading, or gardening. Whatever your flavor of downtime, a 2015 study found that participants who took part in a leisure activity saw improved stress, better mood, and lower heart rate.
Time to whip out the crayons!
Sometimes, talking it out with a pro can help you sort through stressful feelings and thoughts.
Working through the stress in your life can help you prevent flares, but stress is not the only factor that can trigger psoriasis. You can’t always prevent the symptoms from showing up.
A dermatologist can help you set up a treatment plan tailored to you and your needs.
Common treatments include:
- medication applied directly to the skin, such as retinoids and corticosteroids
- UV light treatments like phototherapy
- oral or injected medication like methotrexate, cyclosporine, biologics, or oral retinoids
Treatment may vary, depending on the severity and location of your psoriasis patches. Topical treatments are usually the first approach for those dealing with mild-to-moderate psoriasis. For severe psoriasis, stronger treatments are often necessary.
Although stress definitely tops the list of possible psoriasis triggers, it can’t always take the blame. Other triggers include:
- skin injuries such as sunburn, bug bites, or scratches
- illnesses like strep throat, ear infections, or respiratory infections (since they also impact the immune system)
- cold weather (because it leads to drier air indoors)
- drinking alcohol
These factors may not always lead to a sudden flare-up of psoriasis. It might be worth keeping a journal to track what triggers your own symptoms. Then, you can more clearly pinpoint and avoid those triggers.
The effects of psoriasis are one of many health issues that can pop up after a bout of intense or long-term stress. Stress can affect every system in your body, including your:
- Musculoskeletal system. The tense muscles you experience during stress are your body’s way of putting its guard up against injury and pain. Somewhat counterproductively, this can trigger migraine episodes and tension headaches.
- Respiratory system. Asthma and panic attacks aren’t uncommon when dealing with stress, as it can constrict your airways.
- Cardiovascular system. Blood vessels actually get larger under stress. This pumps way more blood into important organs and may contribute to high blood pressure. Also, your heart works harder during stressful periods.
- Gastrointestinal system. Stress can disrupt communication between your gut and your brain, leading to digestive symptoms like bloating, nausea, and poopy problems. 💩
- Endocrine system. This is the part of your brain that chats with your hormone-pumping system to send cortisol all around your body during stress. If cortisol runs wild for too long, it can disrupt your hormonal balance, contributing to chronic fatigue, diabetes, obesity, depression, and immune system issues.
- Reproductive system. Looking to add a bébé to the family? Too much stress can make conceiving more difficult for both the male and female reproductive systems.
Chronic stress intermingles with psoriasis in a number of ways.
Combining stress-relief techniques and psoriasis treatments can help you reduce the frequency of psoriasis flare-ups and soothe the skin effects when they do happen.
Remember, if your psoriasis gets worse, it’s important to follow up with your doctor so that it doesn’t cause further complications.