Why Your Psoriasis Treatment Regimen Should Include Mental Health Care

My Way to WellWhy Your Psoriasis Treatment Regimen Should Include Mental Health CareIncluding self-care — and therapy, if you have access — can be incredibly helpful, according to experts. Here’s what to know.

By Ashley Abramson

February 7, 2022

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Living with a chronic skin condition can be difficult, but you don’t have to navigate it alone. Psoriasis affects over 7.5 million people in the United States, so we at Allure have talked to some of the top experts in the field about how to get the best treatment there is for this confusing (but treatable!) condition, from inside out.

Taking care of your mental health is important for everyone. But if for those with a chronic health condition like psoriasis, self-care may also be a vital part of your treatment regimen. Prioritizing your mental well-being can help you cope with the symptoms of stress, anxiety, and depression that commonly come with chronic illness — and dermatologists say it could also help symptoms of psoriasis.

Psoriasis, a chronic skin disease that makes skin cells grow faster, also causes thick, itchy, and painful scales called plaques to develop on the skin. According to Michelle Henry, MD, a New York-based board-certified dermatologist, the condition can range in severity. Some people might have mild plaques on certain parts of their body, like their knees and elbows. For others, psoriasis is more severe and affects the whole body. In fact, a form of the disease called psoriatic arthritis can even cause joint pain and damage. 

In either scenario, psoriasis can be physically debilitating — which is one reason it’s so common for people with psoriasis to also suffer from depression. However, as with any type of chronic illness, physical symptoms are only one source of stress. Managing your discomfort, staying on top of your care routines to prevent flare-ups, and worrying about when the plaques will come back can take a major mental toll. Plus, psoriasis can keep people from participating in activities they’d otherwise enjoy, says Suzanne Friedler, MD, a New York-based board-certified dermatologist.

Maybe you’re worried about showing your plaques at the gym, or you avoid meeting new people because you don’t want to deal with their questions (or assume they’ll make silent judgments). Either way, the constant hypervigilance of a painful, visible health condition can quickly leave you feeling depleted. “When you have a chronic health issue like psoriasis, it’s hard for that condition not to color all your experiences,” says Grace Dowd, a therapist in Austin, TX.

The good news is, as you learn how to cope with your stress, it’s possible your psoriasis symptoms may improve, too. “Anything you do for your overall health and mental health can help with psoriasis,” explains Friedler. Of course, that’s easier said than done; this condition can be enough to manage on its own, so try to focus on simple-but-effective self-care routines that make you feel better, both physically and emotionally.

How to boost your mental health if you have psoriasis 

Psoriasis can feel like a roller-coaster ride, and one way to prevent the ups and downs is to follow the treatment plan recommended by the doctor you see for your psoriasis as closely as possible. It may seem obvious, but Henry emphasizes that using your medications per your doctor’s instructions and staying on top of your follow-up appointments can minimize the condition’s impact on your life, and in turn, support your mental well-being. 

Some of the most basic (but no less important) mental health tools also apply with psoriasis-related stressors. According to Friedler, it’s especially important for psoriasis patients to maintain a healthy sleep schedule. “Our body replenishes our cortisol levels in the middle of the night, and you need healthy cortisol levels to fight psoriasis,” she says. Plus, studies have shown inadequate sleep to contribute to mental distress.

Light exercise, if you’re able, can also make a big difference in how you feel, both mentally and physically — especially if you can make it outside on a sunny day. Friedler says sunlight can help stave off depression symptoms, and the UVB rays can help with psoriasis itself. (If you don’t want to or can’t go outside, she suggests asking your dermatologist about trying light therapy at their office.)

Any chronic illness can be isolating, so try to lean on trusted friends and family for support, and enlist a psychotherapist if you can access one. Any therapist can help you cope with the emotional and physical stress of psoriasis, but Dowd suggests looking for one who’s trained in (or at least interested in) supporting people with chronic health conditions. 

A doctor, like a pain specialist or psychiatrist, may have referrals; Henry says she keeps a running list of therapists to refer patients to if they’re struggling with depression or anxiety. It may also help to connect with others who share your condition, and therapists can often recommend chronic health support groups. You can download Kopa, a psoriasis support app recommended by the National Psoriasis Foundation.

When you feel alone or overwhelmed, you might be looking for a way to turn down the noise, but self-medicating with alcohol or other substances can worsen depression symptoms, and Henry says excessive alcohol use can actually worsen inflammation, which could affect your skin. Plus, alcohol can interfere with psoriasis medications and even limit how effective they are. 

When things get difficult, connect with your support system so you feel less alone. And, while it may not seem like it, remind yourself your chronic illness is only one part of who you are. Says Dowd: “Psoriasis might take up a lot of your life, but it’s not your identity.”

Visit SELF's My Way to Well information hub for more on Psoriasis.

Ashley Abramson is a freelancer journalist based in Minneapolis. Her work frequently covers the intersection of health, parenting, and culture and she has been published in The Cut, Washington Post, New York Times, and LongReads. To read more of her writing, check out her website, ashleyabramson.com.Contributor

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Keywordspsoriasismental health