Questions and Answers
Questions and AnswersDate: 12 May 1997 10:45:49 -0400
969 PSORIASIS AND STRESS I am interested in any information regarding stress and psoriasis, especially, but not limited to, how stress affects treatment. Any references would be appreciated. ANSWER BY AASE MARIT, CERTIFIED SOCIAL WORKER, NORWAY Psoriasis is a skin disease which appears in 2-4% of the population. The cause of this chronic skin disease is unknown. Research has proven that psoriasis is an auto-immune disease, and not long ago the psoriasis gene(s) was found. The disease, or the tendency to get it, is inherited. It is possible to have psoriasis without any visible symptoms. This makes research on it quite complicated. If a person develops psoriasis, depends on if something actually "provokes" it to outbreak. Several different factors can act as triggers. Common triggers are strep throat infections, trauma to the skin (e.g. a graze or a cut), certain medications, systemic steroids or as you mention, stress. The same factors can later cause flare ups of the symptoms. There is little scientific evidence of foods as triggers, which has led to the conclusion that there is no scientific reason to use diet as psoriasis treatment. But, it is a fact that many psoriatics experience that certain foods increase their skin problems. Which foods to avoid, if any, varies a lot from person to person. Consulting with an educated nutritionist could be wise if you suspect that foods may be a contributing factor in your psoriasis. The nutritionist can advice you on how to go through with an elemination diet to find your triggers. Stress has impact on several diseases, including several skin diseases. Eitinger, Retterstol and Dahl (1991) use a table on skin diseases which show an established correlation to psycho-social factors (from Koblenzer 1987). The table differs between diseases where psychological factors normally are central, diseases where psychological factors have a significant importance and diseases where genetic/other factors are necessary, but where psychology often is of some importance. Psoriasis (and also atopic eczema) is listed in the last group. Psoriasis is not caused by stress. But, stress can exaggerbate the condition. This varies a lot from individual to individual. Most psoriatics who have a disease that reacts badly to stress, know it very well. Others cannot pinpoint any reactions to stress at all, they even experience remission during stressful periods or a worsening of symptoms during peaceful times. The bottom line is, if you have experienced that your condition worsen when you are dealing with stress, this is something you should address. All of us have to deal with stress in our lives, in one way or another. But, we can look at the way we deal with the stress. Try to look at your every day life. E.g. are you one of those who say yes to everybody? I have met many psoriatics over the years who have had a lot of psoriasis, and no time to sit down at all. Running from one thing to another all day, all evening. Barely time to sleep. In the end, you are the one who have the answer to these questions. Stop and think about how you can take care of yourself in order to reduce the stress. Other stressful situations is not that easy to control. We get into life situations that are more or less out of our control sometimes. Losing somebody close to you, experiencing marrital problems or other types of life crisis' can exaggerbate psoriasis, even to the point where extensive treatment of the skin disease is necessary. This often becomes a visious cycle where the psoriasis increases the stress even more, which leads to even more psoriasis etc. There is different types of psoriasis treatment available. Most cases are treated by topical ointments/creams of different types and/or light treatments. The most severe cases are treated with systemic drugs if other options have been tried unsuccessfully. But, if you feel that your psoriasis is first and foremost triggered by stress, most treatments will be pretty useless unless you at the same time try to do something to reduce the stress in your life. That can include looking at the situation at work, at home, how you spend your spare time and how you deal with it all. Some also find relaxation techniques useful. If you don`t adress this, all treatments will most likely give very temporary relief only. You could also experience that you donīt get the expected results of the treatment. The symtoms will most likely return quickly after you return to the same stressful life. If that is the case, you certainly need to brake the cycle in order to make your situation better. Please visit my homepage at http://home.newmedia.no/flaker/ for more information on psoriasis, psoriasis treatment etc. The National Psoriasis Foundation in USA also have a very informative web page with lots of useful information at http://www.psoriasis.org. NPF has several booklets and brochures on different subjects which you can order without any cost. I also recommend that you try to meet others with psoriasis, for support and to share experience. The newsgroup alt.support.skin-diseases.psoriasis is the place on the net where you can meet others. Your local chapter of the psoriasis association or foundation can also be of help. If you have more questions, please feel free to e-mail me at flaker@newmedia.no. PLEASE NOTE: The information contained on this system is not intended to supplant individual professional consultation. It is offered solely as a community education service. Advice on individual problems should be obtained directly from a professional. FOLLOW-UP: We would appreciate a follow-up note to let us know how things worked out for you. Submit it in the same way you submit your question.