Psoriasis, a common dermatosis, is a multifactorial disease involving genetic predispositions, among other factors. Many patients report that stress exacerbates their psoriasis flare-ups. But what is the reality? Is there a link between stress and psoriasis?
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Can stress trigger psoriasis?
Summary
- Stress and Psoriasis: Is there a connection?
- Psoriasis: a stigmatising disease at the root of stress
- Some solutions to reduce one's stress
- Sources
Published September 29, 2022,
updated on August 2, 2024,
by
Sandrine, Scientific Editor
—
3 min read
Version reviewed and validated by the dermatologist, Dr. B. LEVY GAREL (France).
Stress and Psoriasis: Is there a connection?
As previously mentioned, intrinsic factors can trigger the onset of psoriasis. In 31 to 88% of cases, patients report that stress triggers their psoriasis. Furthermore, the incidence of psoriasis is significantly higher in individuals who have experienced a stressful event in the previous year. This raises a question: is stress a contributing factor to psoriasis? Is there a scientific link?
Firstly, it is crucial to understand how the brain responds to stress. Upon perceiving stress, the autonomic nervous system is activated within seconds. This triggers the secretion of catecholamines, namely adrenaline and noradrenaline. These induce the degranulation of mast cells, which are immune cells, leading to the release of pro-inflammatory molecules that are responsible for the exacerbation of psoriasis.
In another instance, the hypothalamic-pituitary system is activated. Following a cascade of reactions, cortisol, the stress molecule, is secreted by the adrenal cortex. Cortisol is responsible for inhibiting the barrier function of the skin.
Stress is also believed to be a cause of changes in epidermal permeability, promoting inflammation. Furthermore, stress could potentially inhibit the synthesis of epidermal lipids, which may lead to an increase in the proliferation of keratinocytes. In response to stress, the brain secretes substance P, which causes an increase in the proliferation of keratinocytes and an inflammatory response. Therefore, there appears to be a close link between stress and the onset of psoriasis.
The dermatologist Dr. B. LEVY GAREL clarifies on this matter: "Psoriasis is the only skin disease where the role of stress as a contributing factor to the onset of lesions is clearly demonstrated."
Furthermore, research proves that patients suffering from psoriasis perceive certain challenging situations as more stressful than those not affected.
Psoriasis: a stigmatising disease at the root of stress.
Psoriasis is also a source of stress and anxiety. Due to a poor understanding of the disease, psoriasis is a highly stigmatising condition. Indeed, individuals suffering from psoriasis may face discriminatory behaviours. This leads to feelings of rejection and shame, which exacerbate stress. Stress triggers or worsens psoriasis lesions, but conversely, psoriasis is a disease that promotes stress: it's a real vicious cycle.
Some solutions to reduce one's stress.
Some techniques, such as yoga, acupuncture, massages, allow for stress management during challenging daily situations. The physical exercise is particularly recommended, as it enables the release of endorphins, which are molecules responsible for the sensation of well-being.
Sources:
KALLNER A. & al. Stress and psoriasis : psychoendocrine and metabolic reactions in psoriatic patients during strandardized stressor exposure. Psychosomatic Medicine (1985).
HALIOUA B. & al. Stress and psoriasis. The International Society of Dermatology (2018).
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