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Why Psoriasis is More Than a Skin Disorder

Learn about the association between psoriasis, heart disease, diabetes, mental health disorders, and more.

Why Psoriasis is More Than a Skin Disorder

Psoriasis is a chronic inflammatory skin disorder that affects millions of people worldwide. The most recognizable form is plaque psoriasis, which manifests as thickened patches of inflamed skin that have a silvery, scaled texture. However, the impact of psoriasis extends beyond the skin.

Below, learn why psoriasis is believed to be an autoimmune disease, how psoriasis is associated with a greater risk of other health conditions, and why having psoriasis can take a major toll on a person’s mental health.

Psoriasis and the immune system
Psoriasis is sometimes described as an autoimmune disease, a condition where the immune system attacks healthy tissues in the body. While this label is not definitive—mainly because the exact cause of psoriasis remains unidentified—it is known that the immune system plays an important role in psoriasis.

When a person has psoriasis, abnormal immune activity accelerates the growth of new skin cells and prevents the normal shedding of dead skin cells. This leads to a buildup of skin cells. This buildup is what forms the plaques of plaque psoriasis.

Genetics also a play role in the development of psoriasis. Research has identified several genetic risk factors—genes that make it more likely for a person to have psoriasis (though do not guarantee a person will have psoriasis). Roughly 40 percent of people with psoriatic disease have a family member with a type of psoriatic disease.

A person’s environment and behavior can also influence both the onset and severity of psoriasis. Some people with psoriasis are able to identify a particular event that preceded the onset of the disorder, such as an illness (like a viral or bacterial infection), an injury to the skin (such as a burn, sunburn, cut, or abrasion), or an event that caused a great deal of mental stress. Alcohol, tobacco, and certain medications may also influence psoriasis, either triggering onset or worsening symptoms.

Psoriasis and health risks
People with psoriasis are at an increased risk of a number of other health conditions. These include:

  • Psoriatic arthritis: This is a type of arthritis that affects people with psoriasis. It causes pain, inflammation, stiffness, and damage in the joints.
  • Certain cancers: Psoriasis is associated with an a small increase in the risk of lymphoma, lung cancer, and non-melanoma skin cancer—though it is unclear whether the risk is associated with having psoriasis or certain treatments for psoriasis that act on the immune system.
  • Obesity. People with psoriatic disease are more likely to be obese than people without psoriatic disease.
  • Cardiovascular disease: This is a collection of diseases, including heart disease, that make it difficult for the heart and blood vessels to function.
  • Type 2 diabetes: This is a metabolic disorder where the body cannot effectively use insulin, or cannot make enough insulin.
  • Metabolic syndrome: This is a cluster of concurrent conditions that includes high blood pressure, elevated blood sugar, unhealthy cholesterol levels, and excess body fat around the waist. Metabolic syndrome increases a person’s risk of heart disease, type 2 diabetes, and stroke.
  • Non-alcoholic fatty liver disease. With NFLD, triglycerides accumulate in the liver, causing damage and scarring.
  • Inflammatory bowel disease. IBD is the name given to a pair of disorders that cause chronic inflammation in the gastrointestinal tract—Crohn’s disease and ulcerative colitis (UC).
  • Uveitis. An inflammatory disease of the eye.

The relationship between psoriasis and these conditions is not fully understood. Some researchers believe the link is the abnormal immune activity that occurs when a person has psoriasis—which may cause inflammation in areas of the body beyond the skin, including joints and organs. Genetic factors are also believed to be a factor.

Because of the association between psoriasis and these conditions, it is important for people with psoriasis to work with a primary care physician to monitor and manage overall health and wellness.

Psoriasis and mental health
It should come as no surprise that psoriasis can have a major impact on a person’s mental health. The majority of psoriasis patients report that the condition negatively impacts their quality of life in regards to self-esteem, stress, relationships, and normal activities. Depression and anxiety are more common among people with psoriasis.

Psoriasis can impact mental health in a number of ways. There is the stigma associated with having a visible skin condition. The frustration when symptoms persist despite treatment. The distress brought on by uncomfortable physical symptoms, such as itching, irritation, and pain. The body-wide inflammation that is believed to occur when a person has psoriasis may also affect mental health.

Psoriasis patients are encouraged to discuss the emotional and mental burdens of the disorder with their healthcare providers, who can advise them on coping mechanisms and ways to seek treatment for these symptoms.

Medically reviewed in August 2019.

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