The psoriasis-stress connection
“There are some people for whom stress is clearly a trigger [for psoriasis outbreaks],” says Mark Lebwohl, MD, chairman of the medical board of the National Psoriasis Foundation. In a 2004 survey conducted by Scandinavian researchers, more than two-thirds of the respondents reported that their psoriasis was exacerbated by stress, and 35% said that the onset of the disease had occurred during a time of worry and stress.
Though there is no research definitively showing that lowering stress can improve your psoriasis, many patients swear by the strategy. Lori Leyden, PhD, who has had psoriasis for 30 years and is the author of The Stress Management Handbook: Strategies for Health and Inner Peace, is one of them. “[My psoriasis] has been under control for the last 20 years, every since I started practicing stress management.”
Try these techniques to see if reducing stress will reduce your flare-ups.
In a 1998 study at the University of Massachusetts Medical Center, psoriasis patients who listened to stress-reducing meditation tapes during phototherapy had their lesions clear up more quickly than patients who didn’t.
There are lots of resources to help you get started, says Leyden, who recommends meditating for 15 to 20 minutes every day. You can find classes at Buddhist centers and some YMCAs and yoga studios; you can also look for audiotapes and DVDs, and even listen to guided meditations online.
Whether it’s running, biking, swimming, yoga, or just plain walking, exercise is good for overall stress reduction.
“I try to run every day for about 40 minutes, and I find that if I'm really consistent, my skin stays pretty clear,” says Liz Salemme , 24, who’s had psoriasis for the past six years. In fact, she got her first outbreak during her freshman year of college—when she had stopped being active for the first time in her life.
Learn to say no
If your to-do list is longer than your day, you may want to readjust your priorities. “If you don’t have time for yourself, something needs to be attended to,” Leyden says. “If you decide your health is your focus, rearrange your priorities accordingly.” So take another look at your schedule and responsibilities and drop (or delegate) things that are less important.
A 1991 study in Clinical and Experimental Dermatology found that patients with psoriasis can feel extremely vulnerable and experience social isolation; however, it discovered that a support group improved their psychological well-being.
“Support groups can be very valuable,” says Neil Korman, MD, PhD, clinical director of the Murdough Family Center for Psoriasis and professor of dermatology at the Case Western Reserve University School of Medicine in Cleveland. “They allow you to share your experiences, which can be very cathartic, and learn coping strategies from others.”
Get professional help
A 2007 study at the Johns Hopkins Bloomberg School of Public Health evaluated 265 people with psoriasis and found that 32% of them screened positive for depression. Many psoriasis patients benefit from psychotherapy to deal with the stress, anxiety, and depression associated with the disease, says Dr. Korman. Psychotherapy can help you develop coping skills to manage them. Your dermatologist may be able to refer you to a therapist who has experience with psoriasis patients.