The psychological consequences of psoriasis.

Psoriasis generates a feeling of discomfort, embarrassment, and self-consciousness that leads to various psychological disorders.

• Psoriasis promotes the onset of depression.

  Psoriasis is associated with an increase in blood levels of interleukin 12 (IL-12), IL-1 alpha, IL-2 and IL-6. These cytokines can influence the hypothalamic-pituitary-adrenal (HPA) axis, which regulates the stress response. Therefore, prolonged activation of this axis may lead to an excessive production of cortisol, a stress hormone, which can disrupt emotional balance and lead to depression.

• Psoriasis leads to relational difficulties.

  The reactions and persistent stares from others towards an individual suffering from psoriasis often lead the latter to avoid social interactions. Patients tend to exhibit a behaviour of social avoidance. According to a French study conducted among 1,005 individuals, 18% of them confessed to being hesitant to dine with a person showing visible symptoms, 30% to greet with a kiss on the cheek, and 29% to shake hands. Consequently, people with psoriasis may tend to avoid family, friendly, and professional events.

• Psoriasis promotes anxiety.

  Itching induces anxiety. The urge to scratch exacerbates inflammation. Day and night, the tugging and itching are exhausting. They lead to insomnia, which accumulates fatigue during the day. Moreover, the need to adapt a skincare routine can be oppressive. Indeed, patients must ensure they avoid all sources of skin irritation and use suitable moisturising treatments. The anticipation of new flare-ups, as well as the fear of others' gaze, are all factors that contribute to anxiety.

• Psoriasis leads to hiding the body.

  In order to conceal psoriasis, patients tend to cover up more. They wear long-sleeved clothing and avoid shorts. Their body image can be affected. Moreover, they prevent the sun's rays from reaching their skin. However, exposure to the sun has beneficial effects in combating the condition.

• Psoriasis is a hindrance in professional life.

  Psoriasis prevents patients from pursuing their vocation. Indeed, it forms a barrier in professions that require direct contact with clients, such as in the fields of catering, marketing, commerce, and so on. This can lead to frustrations, difficulties in focusing, and a decrease in overall quality of life.

• FORTUNE D. G. & al. Psychologic factors in psoriasis: Consequences, mechanisms, and interventions. Dermatologic Clinics (2005).

• CHEN A. & al. Stigmatization in psoriasis. Journal of Psoriasis and Psoriatic Arthritis (2018).