Psoriasis is more sensitive to stress than any other
skin disease. The interesting part is that the disease itself may cause a
'reactive depression' in patients which could further exacerbate the whole
disease process, and in some cases even lengthen the time of disease clearance.
Psoriasis is a non-contagious skin condition that causes
rapid skin cell reproduction resulting in red and dry patches of thickened
skin. It commonly affects the skin of the elbows, knees, and scalp.
studies have confirmed that stress can trigger and worsen psoriasis and
increase itching. Additional, well-controlled studies are necessary to confirm
such a causal relationship, though a pathogenic association appears likely.
Psychological and physical stress can stimulate the release
of chemical messengers (neuropeptides), which can cause itching, pain, and
inflammation. One possible
underlying cause of stress-induced flares of psoriasis can be dysregulation of
the hypothalamus/pituitary/adrenal and sympathetic adrenomedullary systems.
Psoriasis can induce stress in a number of ways, such
as the stigma associated with the disease, embarrassment of the skin blemishes,
the financial strains of lifelong treatment, and many more.
Since the 'stress-prosiaris-stress' cycle has been
established, breaking this 'merry-go-round" is important to attain better
therapeutic outcomes. Stress management is an essential part of psoriasis
management. Stress reduction through psychotherapy and pharmacotherapy may be
useful in treating stress respondent psoriatic patients.