5 Important Facts About Psoriasis Doctors Don't Always Cover
And not because they don't want to! Treating and preventing psoriasis flares likely takes up most of your appointment, right? Here are the things derms wish they had more time to discuss. by Dori Price Health Writer
While we’d like to think psoriasis is all about treating and preventing flare-ups, there’s a lot more to it than that. “On the surface, psoriasis is a red flaky rash that tends to show up in adulthood,” says Roy Seidenberg, M.D., a clinical assistant professor of dermatology at New York University. “However, it is actually a systemic disease that can affect overall health.”
It’s easy to get bogged down with managing your physical symptoms—plaques, flakes, and redness—because they are the most visibly obvious. Unfortunately, many other factors may be playing a role in your condition, or vice versa, your psoriasis could be impacting them. Psoriasis is a super complex condition and all the intricate parts deserve a bit of your attention. Here are a few things your doctor might not have mentioned at your last appointment.
#1: Stress is One of the Biggest Triggers
Psoriasis and stress go hand in hand, says Sapna Palep, M.D., a clinical instructor of dermatology at Mount Sinai Hospital in New York City. Our body deals with stress, whether it be physical stress like infection or mental stress like anxiety, by releasing small molecules called chemokines and cytokines. In patients with psoriasis, they overreact to stressors by sending out too many of these small molecules. Parts of their immune system are in overdrive. This may contribute to the development or worsening of psoriasis. And it can be a vicious cycle of one causing the other—stress causing psoriasis—that goes back and forth.
Nava Greenfield, M.D., a board-certified dermatologist at Schweiger Dermatology Group in Brooklyn, NY, agrees. She has seen numerous studies that show that uncontrolled psoriasis contributes to stress in life, and that stress can be improved when the psoriasis is under control. One study from the National Psoriasis Foundation found that psoriasis interferes with enjoyment of life in 82% of the cases. The moral of the story: Do whatever you can to control your stress. Whether that is meditation, listening to calming music, reading, or another hobby, anything that can calm and relax your mind may help prevent flares.
#2: You’re Prone to Getting Another Chronic Condition
Psoriasis is associated with several other comorbidities (a.k.a. co-existing health conditions), including fatty-liver disease, metabolic syndrome (high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels) and cardiovascular disease, says Dr. Greenfield. Likely related to inflammation, it can most commonly affect your nails and joints in the form of psoriatic arthritis, which can be chronic, irreversible and debilitating. If you notice any pain, soreness or different feelings in these areas, don’t hesitate to reach out to your doctor.
There are correlations with mental health struggles as well. Psoriasis can negatively affect someone's mood, confidence and self-esteem, he said. Some studies suggest a multidisciplinary approach to treatment, which includes treating the mental illness and psoriasis together as a connected unit.
#3: Nutrition and Exercise Play a HUGE Role
We know everyone should avoid processed foods whenever possible, but this is especially important for those with psoriasis. Sticking to an anti- inflammatory diet can help alleviate symptoms, says Dr. Palep. Steer clear of fatty red meats and dairy, which are known to cause inflammation, and instead eat lots of fruits and veggies and antioxidant-rich foods, like kale, dark chocolate, and berries. Other good options include fish rich in omega-3 fatty acids, and heart healthy sources of fat like olive oil, avocado, whole eggs and nuts.
Whether it’s to reduce stress, burn calories or just to stay healthy, make sure to keep exercise high on your priority list. Working out can have a positive effect on controlling your condition. Activities such as running, aerobic exercise, or calisthenics were linked to a reduced risk of psoriasis, says Dr. Sapna. Pick your favorite physical activity and get moving—your skin will thank you. Just be mindful of sweat-exacerbated irritation and redness and opt for moisture-wicking workout gear.
Studies show that even small amounts of weight loss can help alleviate the symptoms and severity of psoriasis, says Dr. Greenfield. Dr. Seidenberg also noted multiple studies where an elevated body mass index (BMI) has been connected to increased severity of psoriasis. Theories suggested that obese individuals are also carrying around extra oxidative stress that boosts inflammation in the body.
#4: Sex Might Help Reduce Flares
Sex can facilitate chemical and hormonal changes. For many people, sex is associated with stress release and can theoretically contribute to lower inflammatory cytokines in a way that can control psoriatic outbreaks. However, there is a lack of data to be able to definitively state whether sex has a direct impact on psoriasis control or severity. But experts agree, if it doesn’t irritate psoriasis plaques it can’t hurt.
#5: You Probably Know Someone Else With Psoriasis
Don’t let this chronic condition make you feel isolated and alone. Because you aren’t. In fact, 8 million Americans currently have the chronic skin condition. There are lots of support groups with people who are living with psoriasis day in and day out. Here are a couple of our favorite places to find your psoriasis tribe:
The National Psoriasis Foundation. This non-profit has dedicated itself to the 8 million Americans living with psoriasis and psoriatic arthritis for more than five decades. And when we say dedicated, we mean dedicated. It hosts a robust online community, offers one-on-one counseling, and puts its money where its mouth is—the foundation has invested $19 million dollars in clinical research to help find a cure for psoriatic disease.
Overcoming Psoriasis on Facebook (@PSOWHAT). Consider this group of more than 19,000 psoriasis warriors your sounding board, there to support anyone looking for answers to life with psoriasis.
Stress and Psoriasis: Maedica. (2019). “ Psychological Stress and Depression in Psoriasis Patients—a Deramatologit’s Perspective.” ncbi.nlm.nih.gov/pmc/articles/PMC6861725/
Weightloss and Psoriasis: Cureus. (2018). “Effects of Weight Loss on Psoriasis: A Review of Clinical Trials.” ncbi.nlm.nih.gov/pubmed/30648033