Psoriasis is a long-term, itchy, and uncomfortable skin condition. Stress can trigger or worsen psoriasis flare-ups, and living with the condition can have a detrimental effect on a person’s overall mental health.

When someone has psoriasis, their immune system speeds up the production of skin cells, which build up in raised plaques covered with scales. Psoriasis can also cause inflammation throughout the body.

This article explores the relationship between psoriasis and stress and considers how people with psoriasis can manage their triggers.

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Immune system dysfunction causes excessive skin cell growth that is characteristic of psoriasis. However, researchers do not yet understand the underlying causes of this immune response.

Psoriasis is a long-term condition and does not currently have a cure.

Psychological stress can trigger flare-ups. When a person experiences reduced stress levels, their psoriasis symptoms may also improve.

Research in a 2019 article suggests stressful events may trigger or worsen psoriasis for 27% of people. Perceived stress may contribute to debuting psoriasis in 35% of cases and relapsing psoriasis in up to 71% of cases.

Researchers do not know precisely why stress can worsen psoriasis, but some believe it may relate to the effects of stress on inflammation.

A 2021 review highlights how stress can activate the autonomic nervous system, triggering inflammatory cytokine production and worsening inflammation for some people.

The authors suggest that activating mast cells — a type of white blood cell — is a key mechanism of inflammatory skin conditions that stress can trigger or worsen, including psoriasis.

Psoriasis, inflammation, and depression

A 2022 article lists depression as a potential comorbidity of psoriasis, affecting 9–55% of people with psoriasis, and is more likely in those with severe symptoms.

The authors suggest that systemic inflammation may be a part of depression and may explain the association between these conditions.

While researchers are still exploring the relationship between depression and inflammation, their connection may be influential in future psoriasis treatments.

While avoiding stress is not always possible, people can take steps to reduce the effects it has on the body and mind.

The following activities may help reduce the effect stress has on a person with psoriasis and make flare-ups less likely:

  • Exercise: Even just a brisk walk can help release endorphins. These “happy” chemicals can help reduce stress and promote well-being.
  • Yoga, meditation, and mindfulness: These activities can help reduce stress and anxiety. Yoga is particularly beneficial as it may have the stress-relieving benefit of releasing endorphins in a similar way to other forms of exercise.
  • Tai chi: This is another physical exercise that incorporates mindfulness. It involves slow, deliberate movements that a person guides using their breath, which may help reduce stress levels.
  • Massage: Having a massage can help reduce stress and muscle tension and promote a sense of well-being.

Avoiding smoking, limiting alcohol, and eating a balanced diet can also benefit stress management.

However, some people may find it challenging to manage stress levels despite making lifestyle changes. If a person finds stress difficult to manage, a doctor may refer them to a specialist for further help.

A 2016 study suggests early referral access to psychological intervention may be an important way to help manage psoriasis.

Stress may trigger psoriasis flare-ups, which may affect a person’s mental health. This can result in a cycle of stress and psoriasis flares.

Psoriasis is a long-term condition that can be itchy and painful and cause a lot of discomfort. It may also be visible and cause a person to feel unhappy or uncomfortable about their appearance.

The combined effects of physical discomfort and self-consciousness may profoundly affect a person’s mental well-being.

A 2023 narrative review suggests that stress is one factor that can affect the health-related quality of life in people with psoriasis.

A 2020 systematic review suggests cognitive behavioral therapy (CBT) can be effective alongside skin treatments to improve quality of life, psoriasis symptoms, and certain mental health comorbidities such as anxiety and depression.

However, another 2019 systematic review highlights that CBT may only benefit some people with psoriasis since it is tailored to the individual and may vary in delivery method.

Psoriasis is a long-term skin condition, but treatments are available to help manage its symptoms, including light therapy and topical medications.

Stress is a trigger for psoriasis flare-ups because of how it relates to the immune system and inflammation. Engaging in activities to manage stress may help people with psoriasis reduce flare-ups.

Understanding how to reduce the effects of triggers, such as stress, can reduce the negative effect of psoriasis on a person’s life. Following a treatment plan may also help keep symptoms under control.

If a person with psoriasis experiences anxiety or depression, they need to speak with a doctor. A doctor can refer them to a specialist offering cognitive behavioral therapy or similar therapies.