From healthcentral.com
Life is full of unavoidable drama—but a few changes to your routine can help curb stressors and calm your PsO symptoms
If you have psoriasis (PsO)—a chronic, autoimmune condition that causes itchy, painful plaques on your skin—chances are, your doctor has already told you how stress can make your symptoms worse.
Whether it’s from a major ordeal (such as moving to a new house or getting divorced) or a minor one (like the customer service call that puts you into an endless loop of automated options), emotional pressure of all kinds can build up and have physical consequences. In fact, “stress is a trigger for many inflammatory diseases,” points out Christopher Sayed, M.D., a board-certified dermatologist, in Chapel Hill, NC. Which can set you up for vicious circle of symptoms and your reaction to them, since experiencing a PsO flare also causes stress. So, how do you escape the maddening disease-stress loop?
You’re not powerless, says Aaron Farberg, M.D., a double board-certified dermatologist and dermatologic surgeon, in Dallas, TX. Managing your stress levels can help you get the upper hand on your PsO, and slow or even stop its progression. “If you can decrease or better control your stress, you have a great opportunity to really help control your disease state,” he adds.
Now, you’re probably thinking: Let’s do this, sign me up! Here’s all you need to know about the stress-inflammation connection—and how specific lifestyle changes throughout your day can help you stave off the next psoriasis flare and even slow (or stop) the progression of your disease.
How Stress Makes PsO Worse
According to research, there’s a well-established connection between how someone responds to stress and their genetic makeup and environment. However, people with PsO seem to be particularly sensitive to stress. Scientists aren’t exactly sure why, but studies suggest that people with psoriasis secrete less cortisol, a hormone that regulates the body’s response to stress, plus more epinephrine (or adrenaline), a stress hormone, and norepinephrine, a neurotransmitter and hormone that plays a role in the body’s fight-or-flight response, than people without the disease. As a result, the production of PsO-initiating mast cells and inflammation-promoting cytokines increase and trigger flares, as well as contribute to the progression of the disease.
What’s more, another study published in May 2024 further supports an association between chronic stress and PsO and a related condition, psoriatic arthritis (PsA, which affects the joints of roughly 30% of people with psoriasis). Researchers psychologically tested and tracked 1.6 million Swedish men who’d enlisted in military service between 1968 and 2005. The study showed that young men who didn’t handle stress well were 1.3 to 1.7% more likely to develop PsO and 1.2% to 1.5% more likely to develop PsA.
Managing Stress Through Diet and Exercise
Stress is unavoidable, and it’s a normal part of life—we all know that. But controlling your response to it may help you minimise PsO flares and its progression, says Allison K. Truong, M.D., a board-certified dermatologist specialising in psoriasis at Cedars Sinai in Los Angeles.
Besides being a top skin specialist, Dr. Truong also happens to have PsO. After experimenting on herself with holistic therapies and Western medicine, this expert says she has dramatically reduced her own symptoms—which included thick psoriatic plaques on her scalp and nail psoriasis so severe, her nails were crumbling off.
During this self-discovery process, Dr. Truong learned that she could relieve her stress best by focusing on what she can control: her diet and the amount of exercise she gets. She does her best to let go of everything else, she adds.
Eating a healthy diet is one way to prevent the physical stress of being overweight, which studies show can exacerbates PsO. Dr. Truong says she avoids processed foods (think: French fries, chips, and cookies), which have a high glycemic index and can therefore increase inflammation in the body, per The Cleveland Clinic. Instead, she loads her plate with plenty of healthy fats (such as nuts, seeds, and avocado), plus lean meats such as chicken and fish, and lots of vegetables.
Additionally, she runs and practices yoga to relieve mental stress. Aerobic exercise including swimming and walking is particularly helpful for reducing stress, she notes. And yoga helps loosen your joints and reduces inflammation. “Exercise will also help people reduce risk of heart attack and stroke, since psoriasis is a whole-body inflammatory disease,” she adds.
Meditate on the Regular, Too
This mind-body wellness technique has been scientifically proven to lower stress, according to the American Psychological Association. It also helps increase pain tolerance, per The Cleveland Clinic, which can help those with PsO better cope with flares. And you don’t have to sit for hours and chant “om” to yourself. There are free, guided meditation apps such as Insight Timer and Healthy Minds, which offer short meditations for beginners, as well as longer meditations for those already practiced in the art of quieting the mind. These meditations can take place in a quiet room, or when you’re on the go—so they’re easy to fit into your day, whatever it holds.
Get 7 Hours of Sleep Each Night
Research has found that being deprived of consistent, uninterrupted sleep is associated with an increase in inflammation in the body, per Harvard Health—and there is a well-established connection between sleep disorders and PsO, most recently confirmed in a 2022 study. If you suspect you may have a sleep disorder, seeking treatment for it can dramatically improve your sleep quality, which will naturally reduce stress levels in the body and can reduce your PsO symptoms and progression, says Dr. Truong.
Build a Solid Support System
A 2022 study found that people with PsO are 1.5 times more likely to have depression and anxiety than those without the skin condition. Joining a support group for those with PsO, or building a trusted network of loved ones that will support you, can help minimize stress levels and any feelings of isolation that many people experience while trying to cope with a chronic illness, says Dr. Sayad. Engaging on such platforms also connects you with others with whom you'll likely relate, he adds.
Consider Cognitive Behavioural Therapy (CBT)
A 2019 study demonstrated that CBT—in which a therapist will teach you how to restructure inaccurate of helpful thoughts and behaviour, as well as better coping techniques—helped reduce the severity of symptoms of those with moderate and severe PsO, whereas non CBT-based therapy was not effective in helping to combat the skin condition.
Focus on Self-Care
Get a massage, take a walk, grab some coffee with a friend—whatever it is that helps you relax and de-stress, Dr. Sayed suggests. Self-care is linked to improved mental health and optimism, according to Psychology Today, both of which can help you minimize PsO flares and cope with them when they do occur.
Remember, minimising stress may improve your PsO symptoms or slow their progression—and Dr. Truong is living proof. “In medical school, stress was a leading factor of my psoriasis flares,” she shares. “Nowadays, I believe that despite my stressful schedule as a dermatologist and mother of two young children, my psoriasis is managed better with my healthy diet and exercise regimen. Psoriasis is a part of me but does not affect me day-to-day anymore.”
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