The relationship between stress and psoriasis is a two-way street. High stress levels contribute to psoriasis flare-ups, while flare-ups increase stress levels and negatively impact the quality of life. In some individuals, skin pain, itchiness, and the embarrassment from the appearance of psoriasis can lead to social isolation, anxiety, and depression. On the other hand, stress can activate immune cells that contribute to inflammation in inflammatory disorders such as psoriasis. Therefore, lowering stress levels using any of the following four methods can offer benefit to some patients with psoriasis.
Relaxation techniques such as meditation or guided imagery have shown to be beneficial for patients with psoriasis. In one study, patients with scalp psoriasis who practiced either meditation or guided imagery had improvement in symptoms, while those who did not practice these techniques showed no improvement. Listening to a mindfulness meditation audio recording has also been shown to have beneficial effects in patients receiving light therapy for psoriasis. Those patients who combined the meditation recording with light therapy were 3.8 times more likely to achieve clear skin, and they achieved clear skin 4 times faster than those patients who only received light therapy.
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Therapy sessions focusing on hypnosis, meditation, relaxation training, and the identification and management of stressors may improve symptoms of psoriasis. A study of 51 patients with a certain type of psoriasis called psoriasis vulgaris showed significant reductions in psoriasis activity for those patients who received seven psychotherapy sessions when compared to those patients who did not receive psychotherapy. Therefore, psychotherapy may be able to reduce stress and psoriasis severity in some patients.
"ear massage" (CC BY 2.0) by ShamaKern
Techniques related to acupuncture have been used to treat psoriasis for hundreds of years. There are many different acupuncture points (acupoints) throughout the body that can be stimulated via various techniques including acupuncture, acupressure, catgut embedding, bloodletting, and cupping. Yeh and colleagues reviewed all of the published scientific studies that investigated the effects of acupoint stimulation on psoriasis and determined that it can have significant benefits in patients with psoriasis when compared to standard therapies.
Acupressure (applying pressure at specific points without using needles) seems to be the most effective method for psoriasis, and it can be used alone or in combination with other acupuncture-related techniques. Acupoint stimulation should be done for at least 6 weeks to see results, and it seems to be more beneficial for short-term rather than long-term treatment of psoriasis. The most common side effects of acupoint stimulation include thirst, dry mouth, and dry skin.
Although scientific studies investigating the effects of massage therapy on psoriasis are lacking, many patients with psoriasis and psoriatic arthritis have shared anecdotal stories about the positive impact that massage has had on their skin appearance, joint pain, and stress level. Massage therapy can increase blood circulation, lower levels of inflammation, and provide stress relief. It is important for patients to ask their massage therapist which oils and lotions they will be using to ensure those products will not irritate their already inflamed skin.
Rigorous scientific studies are still needed to determine the effectiveness of alternative and complementary therapies for psoriasis. However, as lowering stress levels can be beneficial for overall health, adding stress-reducing techniques to a comprehensive management plan for psoriasis may be worthwhile. Patients may find some therapies more beneficial than others and should try several stress-reducing techniques until they identify a regimen that works best for them.