The COVID-19 pandemic has led to job losses and other stressors. People with psoriasis may find that symptoms such as itching, desquamation, and discoloration get worse during times of stress.
Psoriasis is a chronic inflammatory disease that affects the skin. The most common type of psoriasis causes scaly patches of skin called plaques. Some people with psoriasis also develop psoriatic arthritis, which causes joint pain and stiffness.
Some people with psoriasis found that their symptoms worsened during the COVID-19 pandemic. Pandemic-related stress may be responsible for this.
Read on to find out how stress can affect psoriasis
Stress and psoriasis
Certain triggers can cause a flare-up of psoriasis, which occurs when symptoms increase the stress is a common trigger of psoriasis
“Stress can definitely cause symptoms of psoriasis to worsen, trigger flare-ups, and cause symptoms such as itching, flaking, and redness to become more pronounced and annoying,” Dr. Anna Chacon, a board-certified dermatologist from My Psoriasis Team, told Medical News Today.
Studies suggest that the link between psoriasis and mental health goes both ways.
People with psoriasis are at increased risk of depression, report the authors of a 2020 review, but in return, more stress and depression can lead to more psoriasis.
Stress associated with a pandemic
Many people have experienced stress during the COVID-19 pandemic. Some research has linked mental stress during the pandemic to worsened psoriasis symptoms.
In an international survey of people with psoriasis, 42.7% said their psoriasis symptoms have worsened during the pandemic (the survey is currently in the preprint phase before publication.)
More women than men reported that their psoriasis symptoms worsened, but the study authors found that this could be because the survey included more women than men overall. The researchers also found that the results may not necessarily apply to everyone, as predominantly white Europeans took part in the survey.
Of the survey participants, those who said their psoriasis got worse were more likely to report symptoms of anxiety or depression
Various pandemic-related stressors can contribute to stress, anxiety, and depression. In addition to fear of the development of COVID-19, this also includes changes in:
- social life
- job security
“There are many pandemic-related stressors, including job insecurity, financial problems, changes in working hours or schedules, lack of access to healthcare, and development of comorbid conditions,” said Dr. Chacon. “Others include fear of continuing biological immune-based therapy due to fears of [developing] COVID-19.”
Social isolation and job loss
To curb the spread of COVID-19, many governments have passed temporary legislation to close or reduce working hours for non-essential businesses, schools, and other locations.
Many have also passed laws to restrict social gatherings in public and private spaces or to introduce blockages.
These measures have interrupted the usual rhythm of life, contributed to social isolation and disrupted employment and income for many people.
A 2020 online survey of adults with psoriasis in China found a link between loss of income during the pandemic and worse psoriasis symptoms. Restrictions on outdoor activities were also associated with worse symptoms.
Access to healthcare
Many clinics and other medical centers have only set limited in-person appointments during the pandemic. This has made it harder for some people to seek treatment for psoriasis, anxiety, depression, or other health issues.
Losing health insurance also makes it harder for people to get healthcare. Commonwealth Fund researchers estimate that millions of Americans lost employer-sponsored insurance during the pandemic.
These barriers to healthcare can result in delays or interruptions in treatment and increased stress.
Concerns about treatment of P
Some people are worried about how treating psoriasis will respond to COVID-19 at their risk
Medical professionals often treat moderate to severe cases of psoriasis with systemic therapies, including biological medications and other injected or oral medications.
Many systemic treatments have an impact on the immune system, which has raised concerns about how they could affect a person’s ability to fight COVID-19.
Although research is limited, the results of a small 2021 survey of Americans with psoriasis suggest that systemic treatments for psoriasis reduce the risk or severity of COVID-19, but some people with psoriasis may still have concerns, and experts need to carry out more research on this topic.
A global study from 2021 that looked at people with psoriasis who may have had COVID-19 found that people who received biologics had a lower risk of hospitalization than patients who
In the previously mentioned international survey, 18.5% of people with psoriasis had not received systemic treatments as prescribed during the pandemic. Many expressed concern about how the treatments could impact the risk of developing COVID-19.
Those who had not followed their prescribed treatment plan were more likely to report that their psoriasis had worsened.
In the 2021 survey of American adults with psoriasis, people taking biologics expressed more concern than others that their treatment could increase their risk of developing COVID-19.
Concerns about treatment can cause stress. If someone stops treatment for psoriasis, it can cause a flare-up of psoriasis
Psoriasis after vaccination
A study from December 2020 documented a flare-up of psoriasis in four patients in a single clinic following influenza vaccinations.
However, this is a very small sample. The researchers found that vaccinations are an unusual trigger for dandruff from psoriasis.
According to a controlled trial from 2020, 244 people (0.8%) of the 30,420 participants in the Moderna phase 3 clinical trial for the SARS-CoV-2 vaccine experienced delayed skin rash after the first dose. After the second dose, 68 people (0.2%) experienced a delayed rash (8 or more days after injection).
The National Psoriasis Foundation (NPF) Covid Task Force is encouraging people with psoriasis to take one of the three SARS-CoV-2 vaccines available in the US.
Stress management tips
The Centers for Disease Control and Prevention (CDC) recommend the following strategies to manage stress during the pandemic:
- Take breaks from reading, watching, or listening to the news, including stories about the pandemic.
- Set aside time for hobbies and relaxing activities, such as breathing exercises or meditation.
- Connect with other people and community or faith-based organizations.
- Try to get enough sleep, eat a nutritious diet, and avoid abusing alcohol or tobacco or other substances.
Regular exercise can also help reduce stress, which can have benefits for psoriasis. Many governments have relaxed restrictions on outdoor activities so that people can get active outside.
“I recommend trying out alternative stress control methods, including choosing a sport that is good for your skin,” said Dr. Chacon.
She encouraged that people should wear sunscreen, a wide-brimmed hat, and a long-sleeved shirt to prevent sunburn when exercising outdoors. Sunburn can worsen symptoms of psoriasis.
The importance of treatment A treatment of
Psoriasis can help reduce symptoms and improve quality of life.
The NPF COVID-19 Task Force recommends that in most cases, people who do not have the coronavirus that causes COVID-19 should continue taking biological or oral treatments that their doctor has prescribed.
The task force encourages people to avoid long-term systemic steroid use for psoriatic disease whenever possible. When long-term systemic steroids are required, the task force recommends taking the lowest possible dose.
A person should not stop taking prescribed medications without first talking to their doctor. A healthcare professional can help them understand the potential benefits and risks of changing their treatment plan.
People should tell their doctor if they have frequently felt stressed, worried, angry, sad, or disinterested in things that are usually important to them. These may be signs of anxiety or depression.
Your doctor may prescribe antidepressants or refer them to a mental health specialist for assistance.
Pandemic-related stress to take away
Can cause symptoms of psoriasis to worsen Fear of COVID-19, social isolation, loss of income, and difficulty accessing healthcare are just a few of the stressors people may face.
Some people also worry about the impact that psoriasis treatments could have on their risk of contracting COVID-19, however, current evidence suggests that psoriasis treatments do not increase the risk or severity of COVID-19.
Adhering to a prescribed treatment plan for psoriasis, taking steps to manage stress, and contacting a mental health specialist if necessary, can psoriasis sy