Delve into dermatology diseases with new approaches from conventional to complementary care.
Explore a broad spectrum of dermatological conditions and topics to enhance your practice.
Expert led instruction for every level of patient care.
Log in to see enrolled program content.
Gain practical insights and meet new colleagues.
Hover over a conference to view recordings.
The largest integrative dermatology community.
Psoriasis is a chronic disease that is more than skin deep
Psoriasis is a chronic disease that is more than skin deep. In addition to skin and joint involvement, psoriasis is linked to an increased risk of having metabolic syndrome, which includes insulin resistance, obesity, and cardiovascular diseases.[1] The many comorbidities associated with psoriasis can have detrimental effects on the quality of one’s life. The degree of both physical and emotional impairments in people with psoriasis was found to be similar to those who have diabetes, heart disease, high blood pressure, arthritis, depression, and even cancer.[2] In fact, people with psoriasis tend to have more mood-related issues such as anxiety, depression, poor self-esteem, sexual dysfunction, and even thoughts of suicide.[3,4] Over 60% of both men and women with psoriasis have symptoms of depression,[5] and nearly 80% of people with severe psoriasis believe that psoriasis has negatively impacted their lives.[6] People with psoriasis can have very severe depression. A clinical study found that approximately 10% of people with psoriasis “desire(s) to be dead” and 5% have active thoughts of suicide.[7] Clearly, the psychological impact of psoriasis is enormous.
The link between psoriasis and depression is multifactorial. The answer is not a simple explanation that the appearance of their skin makes them feel sad.[8] Sometimes the underlying causes of depression in people with psoriasis are not obvious. Several reasons have been reported to make people with psoriasis more prone to having depression:
Not necessarily. Researchers have found that the severity of psoriasis doesn’t always match the level of emotional burden that psoriasis has on a person. Therefore, even people with very mild psoriasis may experience depression.[3,21,22]
Treatment of psoriasis should be multi-faceted, with both medical and psychological care. The impact of mood disorders such as depression can affect how people cooperate and respond to psoriasis treatment. Adding anti-depressant medications to psoriasis regimens can help manage the emotional distress associated with psoriasis. Research has shown that using mood medications alone, without other psoriasis medications, can be useful in treating psoriasis.[23]
Combining physical treatment with psychological and behavior management has been shown to be more effective in treating depression than using conventional physical treatment alone. Additionally, more powerful systemic medications can significantly improve skin and joint disease, as well as the depression associated with psoriasis.[24,25] This makes sense if treatment is decreasing the inflammatory molecules that might directly be causing depression in people with psoriasis.[19,20]