Psoriasis and HS: The Importance of Mental Health

Research Spotlight: Uncovering burden disparity: A comparative analysis of the impact of moderate-to-severe psoriasis and hidradenitis suppurativa.

Why Does This Matter?

Afflicting hundreds of thousands of Americans every year, hidradenitis suppurativa (HS) is a common skin condition in which pimple-like boils appear on a patient’s skin. Even more common, psoriasis is the skin condition in which scaly dry patches form on a patient’s skin. Both skin diseases can be detrimental to the mental health of individuals suffering from these conditions. Patients with HS or psoriasis have a greater chance of heart attacks, must pay extensive health care costs, and face lower self-esteem as a result of their skin conditions.1–3 Examining these obstacles that HS and psoriasis patients face, researchers aimed to compare these patients’ quality of life to one another in their latest study.

Comparing the Mental Health Toll of Two Different Skin Conditions

Researchers compared HS and psoriasis patients from 5 previously published clinical trials.4 The quality of life of these patients was measured by the Visual Analog Scale (VAS) for pain, Total Work Productivity Impairment, Dermatology Life Quality Index, EuroQOL 5D VAS, and Short Form-36 Health Survey (mental and physical component scores).

On average, the HS patients experienced a lower quality of life than the psoriasis patients.

Specifically, HS patients experienced more bodily pain, worsened mental health outcomes, and lower work productivity than psoriasis patients. When the researchers examined the patients’ self-reported surveys, HS patients also reported that their skin condition impaired their daily lives more frequently. HS patients did score higher on the EuroQOL 5D VAS indicating more optimal health, but overall, HS patients reported worse quality of life than the psoriasis patients.

Table 1. Comparison of HS and psoriasis patients and different indices


Hidradenitis Suppurativa


Visual Analog Scale (VAS) for Pain, 0 (no pain) to 100 (maximum pain)



Short Form-36 Health Survey, 0 (poor health related quality of life (HRQoL)) to 100 (best HRQoL)

Physical: 39.6*

Mental: 41.5*

Physical: 49.0*

Mental: 47.5*

EuroQOL 5D VAS, 0 (worst imaginable health) to 100 (best health)



Total Work Productivity Impairment, 0 (no impairment) to 100 (maximum impairment)



Dermatology Life Quality Index, 0 (no impairment on HRQoL) to 30 (maximum impairment of HRQoL)



*Comparison of all values statistically significant between groups (p<0.05)

Hidradenitis Suppurativa Has a Greater Burden of Disease Than Psoriasis

Both psoriasis and HS are debilitating skin conditions, but researchers never compared the consequences these skin conditions wrought on their patients with one another. Based on the study, HS patients may experience a worsened quality of life than their psoriasis counterparts, suggesting that the skin condition’s effects extend to the mental health of HS patients. This study emphasizes the need for more resources to better understand the complex skin disease that is hidradenitis suppurativa. Notably, this study does not mean to undermine the burden of patients who suffer from psoriasis, but rather to point to an area of dermatology that warrants further study.

Key Takeaways

  • While skin conditions are treated dermatologically, the mental health toll of these skin conditions can be overlooked
  • Hidradenitis suppurativa and psoriasis both damage the skin of its patients, but the two diseases have never been compared through a mental health perspective
  • A recent study comparing the quality of life of psoriasis and HS patients found that HS patients suffered more bodily pain, worsened mental health outcomes, increased impairment of daily life, and lower work productivity than psoriasis patients
  • More research and resources are needed to better understand and support HS patients
* This Website is for general skin beauty, wellness, and health information only. This Website is not to be used as a substitute for medical advice, diagnosis or treatment of any health condition or problem. The information provided on this Website should never be used to disregard, delay, or refuse treatment or advice from a physician or a qualified health provider.


  1. Kimball AB, Guerin A, Latremouille-Viau D, et al. Coronary Heart Disease and Stroke Risk in Patients with Psoriasis: Retrospective Analysis. Am J Med. 2010;123(4):350-357. doi:10.1016/j.amjmed.2009.08.022
  2. Vanderpuye-Orgle J, Zhao Y, Lu J, et al. Evaluating the economic burden of psoriasis in the United States. J Am Acad Dermatol. 2015;72(6):961-967.e5. doi:10.1016/j.jaad.2015.02.1099
  3. Jemec GB, Heidenheim M, Nielsen NH. Hidradenitis suppurativa--characteristics and consequences. Clin Exp Dermatol. 1996;21(6):419-423. doi:10.1111/j.1365-2230.1996.tb00145.x
  4. Hamzavi IH, Sundaram M, Nicholson C, et al. Uncovering burden disparity: A comparative analysis of the impact of moderate-to-severe psoriasis and hidradenitis suppurativa. J Am Acad Dermatol. 2017;77(6):1038-1046. doi:10.1016/j.jaad.2017.07.027