Does your psoriasis flare up every time you're under a deadline, worrying about your kids or having a spat with your husband? You're not alone. Stress is a trigger for a lot of psoriasis sufferers. Since stress is a part of life, focus on controlling your emotional reactions—it may help improve your psoriasis. Ted Grossbart, Ph.D., author of Skin Deep: A Mind/Body Program for Healthy Skin and assistant clinical professor of psychology at Harvard Medical School, explains how.
Q: Why does psoriasis worsen during times of stress?
A: The exact physiology isn't clear. Psoriasis is affected by changes to the immune system, which can be compromised by stress. Different emotions can cause the body to release hormones that affect the skin, but we are not yet at a point where we can say, "Emotions push this button, and that's what pushes the psoriasis button." Studies have shown that 40 to 80 percent of people who have psoriasis are "stress responders," meaning their symptoms worsen as a reaction to stress. Anecdotally, doctors have noted that people who have psoriasis often fall into a common personality pattern—they are always on the run, in overdrive. Their skin may be doing exactly the same thing: turning over too fast, which causes flaking, redness and other symptoms.
Q: Are there ways to minimize the effects emotions have on psoriasis?
A: Identifying your triggers is the first step. One British study found that people who were able to connect their triggers to the ups and downs of their disease improved more with the same treatment than people who didn't make those connections. Study the "why now?" of your disease by reflecting on the first time you experienced psoriasis symptoms. What was going on in your life at that time? Then, start keeping a record of events surrounding even minor fluctuations in symptoms. Once you have identified your triggers, look at them honestly. If your skin flares up every time you are angry, discover what is making you angry. If you can feel your emotions in your heart, you don't have to feel them in your skin. People with stress-triggered skin disorders tend to be very nice; they don't give other people grief; they give themselves grief. If you're not angry in situations that would make most people angry, try to spot the conspicuous absence of the emotion, and learn to feel and express it.
Q: What strategies are worth trying?
A: Consider joining a psoriasis support group, which may help you learn to feel your emotions in your heart, not in your skin… a group can be an excellent resource, especially if you have developed a pattern of suppressing your emotions. Just sharing the way you feel, and learning that other people have dealt with the same feelings, can be key to getting better. Therapy can help you get in touch with your feelings, too. Certain mind-body exercises can also be beneficial. In one study, psoriasis patients who were not improving on medication alone received weekly hypnosis and relaxation treatments as well as the daily use of a relaxation and imagery tape: They experienced both significant relief from their psoriasis and improvements in their self-image. Some therapists can customize visualization and relaxation tapes to your particular problem, so that through guided imagery, you might visualize your skin getting clearer and smoother.