People with psoriasis want to do everything they can to keep their condition under control. Taking medication can help you minimize flare-ups, and so can avoiding known triggers — including psychological stress.

That’s because psoriasis and stress are intricately linked. Although psoriasis is a genetic condition, environmental factors — such as a stressful life event — often trigger it, according to the American Academy of Dermatology. Also, having psoriasis is stressful in itself, which contributes to flare-ups, too. That’s why it’s crucial to make stress management a key component of your psoriasis treatment plan.

Doctors and researchers do not yet fully understand what causes psoriasis, but the autoimmune disease is thought to occur when the immune system turns on the body, causing skin cells to grow abnormally and rapidly. Because stress can have an impact on the immune system, doctors have long suspected a link between stress and psoriasis, and recent research supports this theory.

"Psoriasis is very stress dependent. It flares very easily when patients are under stress, and it tends to improve when they're relaxed," says Vesna Petronic-Rosic, MD, dermatologist and associate professor of medicine at the University of Chicago Medicine. Many people with psoriasis even recall their first flare happening during a difficult time in their lives.

Facing Emotional Stress

“It’s impossible to avoid all stress in our lives,” says Colby Evans, MD, a dermatologist in Austin, Texas, and chairman of the board of trustees of the National Psoriasis Foundation. Psoriasis itself can be a stressful thing to deal with, and that can make managing it more difficult. For example, people with psoriasis may be uncomfortable exposing areas of their skin that show signs of the condition. "Psoriasis is a stigmatizing disease for many people because it's so visible," says Dr. Petronic-Rosic. Someone with psoriasis might avoid wearing warm-weather clothing, instead choosing to sweat in long sleeves and pants because they want to hide their skin. Feeling self-conscious or worried about these physical symptoms increases emotional stress, which can cause psoriasis to flare even more.

Before focusing on stress management, you should address the symptoms of the disease itself. "You can't just tell a patient, 'Don't stress and the psoriasis will improve,'" says Petronic-Rosic. "First, try to get the disease under control. When the skin feels and looks better, then move on to doing other things that are beneficial for well-being."

Stress Management

Stress management techniques can help you keep psoriasis under control, and there are many effective methods to consider. For one, try exercise: It's a great stress reliever with innumerable other health benefits. "I will very often tell patients to take up an exercise hobby — something that they will enjoy doing that will help alleviate the stress," says Petronic-Rosic. Some ideas include yoga, meditation, and Pilates.

People with psoriasis also should limit other behaviors related to stress. Alcohol and drugs, which people may use to reduce stress, actually make it worse. "There's a lot to be said about managing these addictive behaviors," says Petronic-Rosic. "Stress-induced behaviors, such as alcoholism and smoking, aggravate psoriasis and correlate directly to the severity of the psoriasis."

Identifying your main sources of stress can help you keep them in check — but stress management doesn't have to be done alone. Having a strong support system, including involved family members, is important for coping with a chronic condition. Counseling could also help bring stress levels under control when other techniques aren't enough.

Psoriasis is a chronic condition and often requires an effective method of continually managing associated stress. "Psoriasis will get better or worse, go into remission or flare, but it's probably going to be there for the rest of their life," says Petronic-Rosic. Psoriasis patients need to develop a coping mechanism so that they're not "constantly stressing themselves out because they have this disease." Doing so will benefit emotional health, and may positively impact psoriasis symptoms as well.