Psoriasis, a common dermatosis, is a multifactorial disease involving genetic predispositions, among other factors. Many patients report that stress exacerbates their psoriasis flare-ups. But what is the reality? Is there a link between stress and psoriasis?
Can stress cause psoriasis?
Summary
Published on September 29, 2022, updated on August 2, 2024, by Sandrine, Scientific Editor — 3 min of reading
Themes:
Reviewed and validated version by dermatologist, Dr. B. LEVY GAREL (France).
Stress and Psoriasis: Is there a connection?
As previously mentioned, intrinsic factors can trigger the onset of psoriasis. In 31 to 88% of cases, patients report that stress triggers their psoriasis. Furthermore, the incidence of psoriasis is significantly higher in individuals who have experienced a stressful event in the previous year. This raises a question: is stress a contributing factor to psoriasis? Is there a scientific link?
Firstly, it is important to understand how the brain responds to stress. Upon perceiving stress, the autonomic nervous system is activated within seconds. This leads to the secretion of catecholamines, namely adrenaline and noradrenaline. These induce the degranulation of mast cells, which are immune cells, resulting in the release of pro-inflammatory molecules that are responsible for the exacerbation of psoriasis.
In another instance, the hypothalamic-pituitary system is activated. Following a cascade of reactions, cortisol, the stress molecule, is secreted by the adrenal cortex. Cortisol is responsible for inhibiting the barrier function of the skin.
Stress is also believed to be a cause of changes in epidermal permeability, promoting inflammation. Additionally, stress could inhibit the synthesis of epidermal lipids, potentially leading to an increase in the proliferation of keratinocytes. In response to stress, the brain secretes substance P, which causes an increase in the proliferation of keratinocytes as well as an inflammatory response. Therefore, there appears to be a close link between stress and the onset of psoriasis.
Dermatologist Dr. B. LEVY GAREL clarifies on this matter: "Psoriasis is the only skin disease where the role of stress as a contributing factor to the onset of lesions is clearly demonstrated."
Furthermore, research proves that patients suffering from psoriasis perceive certain challenging situations as more stressful than those not affected.
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Psoriasis: A stigmatizing disease that causes stress.
Psoriasis is also a source of stress and anxiety. Due to a lack of understanding of the disease, psoriasis is a highly stigmatized disease. Indeed, individuals suffering from psoriasis may face discriminatory behaviors. This leads to feelings of rejection and shame, which exacerbate stress. Stress triggers or worsens psoriasis lesions, but conversely, psoriasis is a disease that promotes stress: it's a real vicious cycle.
Some solutions to reduce your stress.
Some techniques, such as yoga, acupuncture, massages, can help manage stress during challenging daily situations. The physical exercise is particularly recommended, as it allows the release of endorphins, which are molecules responsible for the feeling of well-being.
Sources:
KALLNER A. & al. Stress and psoriasis : psychoendocrine and metabolic reactions in psoriatic patients during strandardized stressor exposure. Psychosomatic Medicine (1985).
HALIOUA B. & al. Stress and psoriasis. The International Society of Dermatology (2018).
