Psychosomatics and Psoriasis. Myths and Scientific Facts
Jan 09, 2020
“I just feel like an outcast. I can’t wear shorts or skirts because my calves are always covered with psoriatic plaques. I have to wear long sleeves. I constantly think that someone will notice the condition of my skin, start asking questions and grimace squeamishly. No, people, it’s not contagious! But I have no desire to explain. Because of this I have almost no friends, I do not meet men. It’s getting colder now and it’s easier for me. At least the people around do not stare because I am too warmly dressed in hot weather. And it seems to me that in winter the disease somehow releases its hold and the rashes are not so active. Could this be due to my emotional state? Most of all, I’m afraid that psoriasis will appear on my head due to psychosomatics. I’ll not be able to cover that with sleeves and pants.
– Anna, 31
Can an emotional state cause psoriasis and worsen the condition? This question cannot be answered unambiguously since the connection between emotions and disease is quite complex. We have tried, however, to answer the most important questions about the connection between psychosomatics and psoriasis.
- Can an emotional state cause a disease and influence its course?
- Why does psoriasis appear at all?
- Is it possible to permanently get rid of psoriasis?
- How then does psychosomatics affect psoriasis? Who is at risk of psychosomatic psoriasis?
- But what about the tables of psychosomatic causes of psoriasis? For example, those by Louise Hay?
- Why is non-medical psychosomatics so popular if it is not evidence-based?
- What should I do if it seems to me that I have psoriasis due to stress?
- What should I do if my child has psoriasis?
- How can a psychologist help treat psoriasis?
Can an emotional state cause a disease and affect its course?
“They say that all diseases are caused by nerves. But why then do we wash our hands? Can my mood really cause and affect diseases? How is such an influence possible?”
Yes, such an influence is possible. In such cases, we are talking about psychosomatics – this is a direction in medicine that studies the influence of psychological factors on the occurrence and development of bodily diseases.
But basically, the connection between our mental state and diseases is not direct – you haven’t developed a corn because you pressured someone into something, you simply wore shoes which were too tight.
It is not the emotions themselves that affect diseases, but the stress that they cause.
Fear, anxiety, anger, guilt, etc. – each of these can be the underlying cause of prolonged, chronic, and uncontrolled stress. For example, we regularly conflict with colleagues, and our anger towards them leads to chronic stress. We look after an elderly relative with dementia, constantly anticipating new problems associated with his/her illness –this can also lead to chronic stress. We have lost someone close and are sad and worried – this is also a chronic stress situation
The effects of stress on human health has been studied and proven. For example, it is known that chronic stress reduces immunity , and therefore increases the likelihood of getting sick. Stress “ages” the cells of our body.  Stress slows the rate of recovery.  And subjective dissatisfaction with one’s life increases the risk of premature death. 
It is important to understand that stress does not necessarily cause the development of any disease. The diseases you get will depend on what you have a predisposition for. Therefore, different people react differently to stress, even if it is based on similar emotions. For one person, stress may provoke a relapse of pyelonephritis, for another – depression, and for someone else – psoriasis.
Why does psoriasis appear at all?
“If everyone has stress, then why does psychosomatical psoriasis among adults occur only in a small percentage of people?”
Psoriasis is a skin disease accompanied by the formation of red, scaly, and sometimes itchy spots. According to various estimates, from 0.5% to 4.6% of the population is affected.  This is an autoimmune disease, that is, something causes the immune system to attack its own organism, taking healthy cells for “enemies”. This leads to a very rapid growth of new cells, which move to the surface of the skin and form thick plaques. Normally, skin cells are renewed every 4 weeks and exfoliate gradually, without forming growths. 
In many cases, psoriasis is a genetic disease, which means it is caused by a malfunction in certain genes. For example, if one of a pair of identical twins has psoriasis, then with a probability of 70% the second twin will also have it. At the same time, dizygotic twins have a 20% chance of this disease.
Note. Identical twins are formed from the same ovum, i.e. they have the same genotype. Fraternal twins are formed from two or more ova, have a different genotype, and have similarities as brothers and sisters.
The hereditary factor is also high: 35% – if a close relative is ill and 50% – if both parents are ill. 
As a rule psoriasis develops as a result of a combination of genetic factors and environmental influences. For instance:
- increased BMI 
- smoking and, less likely, alcohol
- streptococcal infections, other viral and fungal diseases
- AIDS virus
- taking certain medications. 
Is it possible to permanently get rid of psoriasis?
“I’m not young anymore, but plaques still appear from time to time. Will it be like this for the rest of my life?”
Psoriasis is a chronic disease, and unfortunately it is impossible to completely recover from it. However, you can go into stable remission and control the symptoms. Therefore, a consultation with a competent doctor, a full examination and follow-up observation are all very important. This will help take into account the peculiarities of the course of the disease and detect any triggers that cause its exacerbation.
How then does psychosomatics affect psoriasis? Who is at risk of psychosomatic psoriasis?
“I noticed that whenever I get nervous more plaques appear. Can psoriasis have only psychosomatic causes?”
The impact of genetics on the development of psoriasis is very high, and if you do not have a predisposition to this disease, then it will not appear out of nowhere. But if you have a genetic predisposition, then stress, along with other environmental factors, can cause its exacerbation.  There are frequent cases when the first manifestations of psoriasis appear after stress, that is, stress acts as a specific catalyst that triggers the body’s immune response.
Psoriasis caused by psychosomatics does not differ at in-person examination or by photo from that caused by other factors. The symptoms are the same.
But what about the tables of psychosomatic causes of psoriasis? For example, those by Louise Hay?
“My neighbor advised me to read Louise Hay. Hay says that each disease is triggered by its own emotion, and that everything can be cured by affirmations, that is, repetitions of positive affirmations. It seems dubious to me. Is this true?”
Indeed, proponents of alternative medicine often cite specific causes of the occurrence and development of psoriasis. For instance:
Fear, problems with self-esteem, lack of principles, refusal to bear responsibility for own actions
Phobias, fear of people, secrecy, experiencing emotions within oneself
Appearance of turbid energy that comes out: hatred, resentment, impatience, anxiety
Pride, refusal of love, high importance of own principles and goals
Such tables have several visible problems:
- Unfortunately, the authors of such tables often contradict each other and name mutually exclusive factors, for example, the absence of principles and their high significance at the same time.
- Attempts to associate like with like bear more similarity to sympathetic witchcraft. Therefore, strange explanations for diseases often arise, for example, that worms and lice appear due to loneliness, to be sort of pets that are always with us.
- Authors often focus only on the psychological way of getting rid of diseases and refuse medical factors. For example, Sinelnikov believes that one cannot use any ointments for skin diseases, even if, for example, moisturizing the skin plays an important role in the treatment of psoriasis. In some diseases, this approach can be life-threatening, for example, with appendicitis.
- Instead of looking for suitable solutions, a person plunges into soul searching and begins to blame him/herself for the manifestation of the disease. “Not only do I have psoriasis, but it’s also my fault that I have it.” As a result, the stress level becomes even higher, which can provoke a stronger reaction.
- Extremely low conclusiveness. Studies do not confirm such a direct correlation. In each case, stress can be based on different emotions, so the reasons for this disease being exacerbated will be different in different people. And, as we already know, there can be other reasons apart from psychological.
Why is non-medical psychosomatics so popular if it is not evidence-based?
“But so many people believe in it. A friend says that it helped her. Maybe there is something to it?”
To some extent this is explained by the fact that such theses are clear and simple. Psoriasis? This is because of anxiety. Or reticence. Or fear. Usually there is a list of possible causes, and the likelihood that you will find something fitting is very high. If it’s not phobia, then it’s anger. If not pride, then touchiness. It is unlikely that we can find many people who are never angry, afraid of nothing and never become offended. On the other hand, medical reasons are difficult to understand. Just try to figure out how genes work and what disorders lead to psoriasis.
Another reason is that these answers are clear and simple. Just read a few affirmations and everything will turn out okay. To some extent this resembles a magic pill. Science does not give definite answers about the causes of psoriasis, and there are a lot of possible triggers for the disease. Therefore, the treatment of this disease is a huge undertaking on the part of the patient. It includes psycho-hygiene, a change in lifestyle, the rejection of bad habits, a change in nutrition and constant skin care. Reading out affirmations is much easier.
And, of course, sometimes this approach helps too. Firstly, it can reduce stress, and if the exacerbation was caused by it, the psoriasis will recede. Secondly, this disease is characterized by a wave-like course with periods of spontaneous remissions,  which may coincide with the reading of affirmations.
“I’ve had this thing since childhood. Medications helped only sporadically – relieving symptoms only temporarily. When I was already studying at the Institute I visited the “psychosomatics specialist” and she told me that the psychosomatics of my hand psoriasis was caused by my unwillingness to communicate with people, like pushing them away. It seemed to fit my situation – I really had a very tense relationship with my class at school. I began to work on my sociability, but on my own, as there was little money. I stopped being scared of people, became more confident, and the plaques almost disappeared. But a year ago they began to appear again. This time I went to a dermatologist and she prescribed ointments and said that I work a lot and need to reduce stress. I followed her instructions, used ointments, regularly visited a psychologist, and the plaques disappeared. And that got me thinking that this disease was not due to my lack of sociability Right now everything is fine in this field. We discussed this topic with my psychologist. It’s just that there was a lot of stress at school, so nothing helped.”
– Ivan, 29
We can eliminate the psychosomatic causes of psoriasis
What should I do if it seems to me that I have psoriasis due to stress?
“I can see a clear connection, for if I’m nervous the plaques increase. It turns out that I myself am to blame for my illness. I start berating myself, then get more nervous, and as a result more plaques appear. It is a vicious circle. The causes of the exacerbations of my psoriasis clearly lie in psychosomatics; what is the treatment for the disease in my case?”
We offer 3 steps to help reduce the impact of stress on the development of this disease.
The first step. It is important to start by accepting the fact that we’re not personally guilty for having such a disease. This is just a constitutional peculiarity. Yes, it is strange how our body can react to external stimuli and to itself. But we didn’t personally bring this disease upon ourselves or deserved it. This is just bad luck in a genetic lottery.
It has been established that if a person associates psoriasis with emotional causes, then he/she is more likely to experience pathological anxiety. The relationship between stress and psoriasis is two-way. Not only stress affects the exacerbation of psoriasis, but the disease itself can cause and reinforce negative emotions and worsen the quality of life.  Guilt only exacerbates stress. Conversely, if a person believes that the cause is physical, then his/her anxiety will be significantly lower. 
The second step is to identify the medical treatment. If you do not trust the doctor from the nearest clinic, try to find another doctor who will inspire confidence in you. The observation of a dermatologist is necessary. The doctor will choose the treatment for psoriasis depending on the causes of the exacerbation, taking into account the role of psychosomatics. The doctor will also be able to track the dynamics of the effectiveness of different methods of treatment, and also help to eliminate concomitant diseases. For example, quite often other similar diseases, such as celiac disease, join an autoimmune disease. The examination will help identify them, and the doctor may suggest a gluten-free diet. 
Note. A gluten-free diet is effective only in cases of gluten intolerance, in other cases such restrictions are not necessary.
The third step is to take care of your psychological comfort. Stress can really provoke exacerbation, so you need to consider if there are any serious stress factors in your life. At this step you may need the help of a psychologist. In such a case, it is important to consider the psychosomatic causes of psoriasis, coupled with the physical ones and to treat them, in adults, at the same time. For example, reducing stress through meditation during photo- or photochemotherapy can accelerate the disappearance of psoriatic plaques. 
What should I do if my child has psoriasis?
“Me having psoriasis is one thing, but my child seems to have it as well. I am very worried. Are there psychosomatic causes of psoriasis in children? If stress is to blame, what should I do?”
The steps are almost the same as for adults. Accept the fact that this disease is largely caused by genetic breakdown and not by you being a bad parent. Find a good doctor, identify possible risk factors, and choose suitable medication. Analyze whether there is severe stress in the child’s life that can provoke exacerbations, for example, increased school workload or conflicts with family members.
How can a psychologist help treat psoriasis?
“If psoriasis is primarily caused by faulty genetics, then how can a psychologist help with treatment? Is it just to reduce stress?”
In addition to the fact that a psychologist can help reduce stress and remove trigger factors, there are several other important points:
1. There is a connection between poor recognition and the ability to describe one’s own emotions and the development of psoriasis – shown in some studies with about a half of all patients.  In such cases, a psychologist can help you learn to better understand your emotional state.
2. Psoriasis can trigger the development of anxiety and depressive disorders.  Working with a psychologist or implementing a special program to reduce anxiety can reduce the manifestation of these types of disorders. Also in such cases, antidepressants, antipsychotics, etc. may be indicated for treatment (only a psychiatrist can prescribe the treatment, a psychologist can only recommend a consultation with another specialist).
3. This skin disease significantly reduces the quality of life. A psychologist can help relieve stress, get rid of the stigmatization of psoriasis and help you to accept your disease and learn how to live with it.
4. A psychologist can help you change your lifestyle, which can reduce the appearance of psoriatic plaques and improve your quality of life – for example to stop overeating, start doing sports,  give up smoking or other bad habits. The 7Spsy behavior modification technique can also help change your lifestyle and reduce stress. This is a patented method of behavioral psychology based on the theories of I.P. Pavlov, B.F. Skinner, A.A. Ukhtomsky and others.
This behavior modification technique will be an excellent addition to drug treatment, will help you view the disease in a new light and reduce your pathological anxiety. You will learn to separate your emotional state from physiological causes and understand how much stress affects the exacerbation of the disease in your case.
The course can be taken remotely, at any time convenient for you. You will be able to not just do it once a week for an hour, but give the problem as much attention as you need. And our psychologists will be ready to support you by phone, during online chats or by e-mail.
Please be attentive to your health and do not administer medication without consulting a doctor. Do not self-medicate. All tips posted on this site (and on all others too) are advisory in nature and do not replace a visit to a doctor. Medical information posted on this site cannot be used for self-treatment and diagnosis. We consciously avoid a detailed description of medications to not provoke self-medication.
Information about the possible results of treatment, even if it is supported by examples from medical practice, is not a promise that similar results can be achieved in each particular case, and does not guarantee the site user to obtain similar results when using the described treatment methods. Remember, you may have a different situation to the people from our stories. In your particular case exacerbations can be caused by other triggering factors, so be sure to consult a doctor and discuss all treatment methods.
Information from this website cannot be used for self-therapy and self-diagnostics.
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