Can Stress Cause Psoriasis Flare-Ups?

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Psoriasis is an immune-mediated disease that causes inflammation. Visible signs of the disease include raised plaques and scales on the skin. Stress is one of the triggers for flare-ups of psoriasis.

In this condition, an overactive immune system speeds up skin growth. Typically, skin cells grow and shed within a one-month period, but if you’re affected with psoriasis, skin cells grow but don’t shed. They pile up on the skin’s surface, resulting in plaque formation and scaly skin.

The signs of psoriasis can appear anywhere on the body but are most often found on elbows, knees, and the scalp. Sometimes patients report symptoms of itchy, burning, and stinging skin.

Stress can trigger a psoriasis flare

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According to the National Psoriasis Foundation, 3% of the U.S. population is affected by psoriasis. Medical experts are unsure what causes psoriasis, but genetics and environmental triggers are believed to be involved.

Several triggers can cause symptoms to appear or worsen, including illnesses that affect the immune system. Cold weather can cause a flare-up, which may be due to little sunlight, low humidity, and overheated and dry spaces indoors.

Other triggers include environmental factors, allergies, certain medications, and alcohol. However, stress is the most common trigger for flare-ups of psoriasis, and aggravated symptoms may cause even further stress.

This article will discuss how stress affects psoriasis. To manage your stress, there are several relaxation techniques that may help minimize flare-ups.

The Research

Stress affects everyone. There are different types of stress that can involve physical and mental health risks. A 2020 survey by the American Psychological Association found that almost 78% of Americans said that the coronavirus pandemic was a significant source of stress, while three in five people stated that the number of issues in America has overwhelmed them. 

If you are affected by psoriasis, stress can aggravate flare-ups and make the itch worse, but also add more psychological discomfort. People with psoriasis experience stigma and may feel socially isolated, adding even more stress to their condition.

According to studies, people with psoriasis have an increased risk of mental disorders, including eating, sleep, sexual, and substance use disorders. 

How stress affects psoriasis is not fully understood, but chronic stress is associated with an increase in proinflammatory cytokines—messenger molecules produced by cells in the immune system that increase inflammation.

Inflammation may also play a part in neuropsychiatric disorders that alter the metabolism of norepinephrine, serotonin, and dopamine (molecules involved in nerve cell transmissions), which can lead to depression.

Studies also showed that administrating cytokines or cytokine inducers in healthy volunteers and laboratory animals induced symptoms of depression and anxiety, which increases cytokine levels. The use of anti-inflammatory therapies in patients with inflammatory disorders like psoriasis is linked with significant improvement in symptoms of depression.

Stress Management

There are several ways to reduce or manage your feelings of stress:

  • Relaxation techniques: Activities like deep belly breathing, guided imagery, a daily meditation practice, yoga asanas, or tai chi practice trigger the relaxation response. This helps lower your blood pressure, heart rate, and breathing rate, and decreases the levels of stress hormones like cortisol. 
  • Cognitive behavioral therapy (CBT): A therapist who practices CBT will help you identify negative and unhealthy thinking and replace it with healthy and positive thoughts. One common practice in CBT is keeping a gratitude journal. Studies show that gratitude is linked to happiness and helps improve health. 
  • Setting goals: When you set goals to achieve, it allows you to be in control. Make a goal to meditate daily for 10 minutes or start a hobby, like painting or a creative project, that allows you to move the focus away from the stress trigger.
  • Exercise: Spend at least 30 minutes a day moving. Go for a walk and surround yourself with nature; dance or do any type of activity that increases your heart rate as well as your endorphin levels (chemicals the body produces that relieve stress and pain). 

Find Support

If you need support from others who are affected with psoriasis, speak with your dermatologist and ask whether they know of any support groups within your area. The National Psoriasis Foundation has branches that provide support in several cities across the United States and also offer an online community.

Some social media platforms, like Facebook, also have dedicated psoriasis groups that offer support and personal tips. However, be aware that some of these groups may be open to the public and not private, or may offer products to sell.

Summary

Psoriasis is an autoimmune disorder in which inflammation leads to symptoms such as skin plaques and scaly areas. Stress is a trigger for flare-ups of psoriasis. Managing your stress may help prevent flares.

A Word From Verywell

Living with psoriasis can be uncomfortable and sometimes even painful—emotionally and physically. But it’s key to manage your stress so that it doesn’t trigger flare-ups. By managing your stress through cognitive behavioral therapy, meditation, yoga, or tai chi, you’ll be able to learn to avoid the triggers and enter into remission that may lead to no symptoms and clear skin.

Frequently Asked Questions

  • Is psoriasis curable?

    No, psoriasis is not curable. Psoriasis can come and go, but it can be kept under control as long as you keep up with your treatment plan and learn to avoid the triggers that may lead to flare-ups. Sometimes you may enter into remission that may lead to clear skin with no symptoms. 

  • What’s the difference between psoriasis and psoriatic arthritis?

    Psoriasis is an immune-mediated disease that causes inflammation in the body. Signs of the disease include patchy, red, scaly skin and raised plaques. The most common places where lesions appear are on the elbows, knees, and scalp. Psoriatic arthritis is an autoimmune disease and a form of arthritis that may affect some people with psoriasis. Symptoms include joint pain, stiffness, and swelling. 

  • What are other common flare-up triggers?

    Common flare-up triggers for psoriasis may include stress, skin injuries like scratches, sunburns, bug bites, and vaccinations. Other triggers include infections like ear infections, bronchitis, tonsillitis, or respiratory infections. The weather may trigger a flare-up if it’s too cold and very dry. Environmental factors, certain food allergies, and alcohol may also trigger a flare-up. 

  • What is plaque psoriasis?

    Plaque psoriasis is the most common type of psoriasis. It appears as raised scaly and inflamed patches of skin with a buildup of silvery-white skin cells or scales that can be itchy and painful. Plaque psoriasis can appear anywhere on the body, but appears more often on the knees, elbows, scalp, and torso.

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5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Tampa M, Sarbu MI, Mitran MI, Mitran CI, Matei C, Georgescu SR. The pathophysiological mechanisms and the quest for biomarkers in psoriasis, a stress-related skin disease. Dis Markers. 2018 Jan 28;2018:5823684. doi:10.1155/2018/5823684

  2. National Psoriasis Foundation. About psoriasis. Last Update May 6, 2021.

  3. Zeng J, Luo S, Huang Y, Lu Q. Critical role of environmental factors in the pathogenesis of psoriasis. J Dermatol. 2017;44(8):863-872. doi:10.1111/1346-8138.13806

  4. American Psychological Association. Stress in America™ 2020. October 2020.

  5. Harvard Health. Giving thanks can make you happier. August 14, 2021.