What is Psoriasis?

Psoriasis is a life-long skin condition in which skin cells reproduce at a faster rate.  This leads to the appearance of irritated, scaly red patches of skin (National Psoriasis Foundation, n.d.).  Psoriasis can vary in the degree of severity.  Some may go months or years without a psoriasis flare-up, while others may experience flare-ups more often (Cassata, 2018).

What Triggers Psoriasis Flares?

1. Stress

2.  Cold weather and the common cold

  • Little sunlight means likely more flares.
  • Safe sunlight exposure helps reduce flares due to the sun’s ultraviolet light turning off an overactive skin immune system.
  • Colds or strep throat means likely more flares.

3. Diet, smoking, and certain medications

  • A gluten-free diet if one has gluten sensitivity means likely less flares.
  • Avoiding foods related to flares means less flares.
  • Smoking routinely leads to a greater risk of developing psoriasis.
  • Avoiding smoking can reduce the risk of psoriatic flares.
  • Beta blockers and lithium can contribute to more flares.
  • Reduce flare risk with alternative blood thinners and topical and/or light treatments. (Cassata, 2018).

Psychological Sequelae of Psoriasis

Managing psoriasis can be an unfortunate self-fulfilling prophecy.  The stress of worrying about when flares may occur can lead to more flares—often leaving psoriasis sufferers feeling out of control.  This perceived inability to control flare-ups can lead to learned helplessness.

Magin, Adams, Heading, Pond, and Smith (2009) conducted a qualitative study on a population of patients with moderate to severe psoriasis.  The ages of patients ranged from 25 to 73. Findings revealed prominent psychological sequelae of psoriasis: embarrassment, shame, impaired self-image, low self-esteem, self-consciousness, and stigmatization (Magin et al., 2009).  As a result of this, patients were more likely to engage in avoidant behaviors as well as have psychological comorbidities, such as anxiety, depression, and obsessive-compulsive disorder.

There are, of course, modulating factors that reduce or exaggerate the psychological sequelae of psoriasis, as mentioned earlier.  These modulating factors include age, gender, relationships with peers and doctors, external stressors, and patient vulnerability and resilience Magin et al., 2009).  For example, a younger female patient who is more prone to be vulnerable to peer criticism would likely experience greater psychological distress related to her psoriasis than her counterparts.

Reducing the Impact of Modulating Factors

Understanding the psychological sequelae of psoriasis and their modulating factors has significant implications for treatment plans.  Magin et al.’s (2009) study showed that societal relationships and therapeutic relationships with clinicians attenuate the psychological sequelae. Thus, Magin et al. suggested a patient-centered treatment plan.  This can include psychoeducation about psoriasis and coping strategies, as well as ensuring patient involvement in treatment management decisions. One way to deliver a psychoeducation program is through an online training.  Check out https://certcentral.com to start creating a psychoeducational training course for psoriasis patients.  Additionally, ensuring that physicians and dermatologists utilize a “shared care” model may enable better patient health care and reduce the negative psychological impact of psoriasis.


Cassata, C. (2018, February 1). Psoriasis: Everything you need to know [Blog post]. Retrieved

from https://www.everydayhealth.com/psoriasis/guide/

Joni. (2017, November 12). Planning for stress flares [Blog post]. Retrieved from

Planning for Stress Flares

Magin, P., Adams, J., Heading, G., Pond, D., & Smith, W. (2009). The psychological sequelae of psoriasis: Results of a qualitative study. Psychology, Health, & Medicine, 14, 150–161. doi:10.1080/13548500802512294

National Psoriasis Foundation. (n.d.). About psoriasis. Retrieved from https://www.psoriasis.org/about-psoriasis/