Chronic stress can lead to a worsening of psoriasis. Peak levels of stress increase the risk of a psoriasis flare one month later.
The correlation of stress with psoriasis has been well known. Now, a study published in the October issue of the British Journal of Dermatology, “How Stress Gets Under the Skin“, shows how stress leads to changes in cortisol levels that influence psoriasis severity.
Cortisol is a hormone produced by the body that regulates a wide range of bodily functions, including inflammation. High levels of cortisol reduce inflammation. Acute stress acts via the HPA axis to increase cortisol levels in the body. However, chronic stress can lead to an overall reduction in cortisol levels
The researchers followed 62 patients with psoriasis for 6 months, measuring their self-reported measures of stress, psoriasis severity (as measured with the PASI score) and blood levels of serum cortisol.
The researchers found that peak levels of daily stress predicted an increase in psoriasis severity a month later. The peak levels of daily stress were also significantly associated with lower cortisol levels. Those who persistently experienced higher levels of daily stress had lower average cortisol levels than patients who experienced lower levels of daily stress.
The researchers concluded that the “results suggest that daily stressors influence disease outcome in patients with psoriasis by affecting cortisol levels at moments of high stress. Furthermore, patients with persistently high levels of stressors seem to have a specific psychophysiological profile of lowered cortisol levels and may be particularly vulnerable to the influence of stressors on their psoriasis.”
Here is concrete evidence of the mind-body connection and its role in psoriasis. Now, if only there were a cure for psoriasis.
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Isn’t it a little like saying eggs cause chickens and chickens cause eggs- it’s circular reasoning when you consider that the disease itself is the primary stressor for us. I developed erythrodermic psoriasis 9 months ago after a two week vacation during which I felt better overall and was less stressed than I had been in years. I am a nurse and have worked in the I.C.U. for years including six years in a very busy metropolitan Emergency Room and my mild plaque psoriasis remained stable throughout that time despite incredibly high levels of daily stress for years on end. The effects of this illness far exceed any other stress I have ever experienced in my entire life in any circumstance. Is there any illness that ISN’T affected negatively by stress? Why waste effort researching a self-evident fact? Show me one patient with any chronic illness that isn’t being stressed by it! THE DISEASE ITSELF CREATES CHRONIC STRESS . The best way to reduce stress in psoriasis patients is to control or relieve the symptoms if not cure the disease. Giving us back a relatively comforable, normal life would remove the greatest stress in our lives. Stress doesn’t cause psoriasis, psoriasis causes stress. You don’t need a PhD to see that – you only have to ask the people who have it. We went through the same process with heart disease when the concept of a “Type A” personality was identified as a causative factor of heart disease until we figured out there were other factors at work. the predictive value of personality types in heart disease was de-bunked years ago- let’s not repeat the same mistake again.