Psychological Aspects of Psoriasis
Psoriasis is a skin disease that can have substantial psychological,
emotional and social impact on a person with psoriasis and on
his/her family and friends.
The way you feel about
yourself is a process maintained, in part, by a complex "feedback
loop" between yourself and others. How you want to feel about
yourself, and how you want others to feel about you may be
reinforced, counter-pointed or nullified by your interpretation of
verbal and non-verbal communications with other people. Your
interpretation of verbal and non-verbal messages from others may be
highly influenced by how you feel about yourself.
Psoriasis is a disease that can
influence (1) how you feel about yourself, (2) how others feel about
you, and (3) how you believe others feel about you. It may have
substantial impact on your interpersonal relations. The psoriasis
patient who is repelled by his/her own image in the mirror may
project that feeling to others - e.g., "I know how they must feel
about me because I know how I feel about myself."
Your skin relays non-verbal
presentations to others. Within seconds, strangers may form an
impression of you based on your surface appearance -
"weather-beaten," "old-looking," "fresh-faced," etc. A person with
oily skin and blackheads may be initially summed up as "a person who
needs to wash his/her face more often." The other person may
non-verbally communicate their initial impression, which can easily
be interpreted as negative and rejecting. A potential relationship
may end right there, on a negative note.
Or, it may not end right there. If you
have a positive feeling about yourself, an initial impression based
on "surface" appearance can often be quickly reversed. It is a
matter of letting others know "I am myself, I am not my disease."
Knowing you are more than your disease is made easier if you know as
much about your disease as possible - in other words, "know your
enemy." An enemy that is understood loses much of its psychological
power. One of the purposes of PsoriasisNet is to give people with
psoriasis an authoritative source of knowledge about the disease.
If you have visible psoriatic lesions,
an average day may contain numerous "negative" encounters making it
difficult to maintain a positive self-image. An example is provided
by a PsoriasisNet site visitor’s description of a cashier who was
visibly repelled by psoriatic lesions and refused to take money from
her hand. The customer-cashier transaction was brief, but the
reaction of the cashier troubled the woman for the rest of the day
and months later still remained as a memory of being viewed as "not
myself but my disease."
Family members and friends can
contribute to a healthy self-image if they understand the facts
about psoriasis. Feedback and support from informed family and
friends can be essential to the maintenance of psychological and
emotional health and the ability to "reject rejection" from those
who do not understand the nature of the disease. Your dermatologist
can provide ongoing support as a professional who thoroughly
understands the nature of the disease, including its psychological,
emotional and social manifestations.
Psychological and Emotional Stress
and psychological—can be a trigger for psoriasis. Stress can be an
initiating condition, or for worsening of existing lesions.
Just the fact of having psoriasis is,
in itself, psychologically and emotionally stressful. Lack of
understanding by spouse, parents, children, other family members,
friends, and co-workers can add another level of stress. A
PsoriasisNet site visitor described her overwhelming feeling of
rejection when her husband became distant because he could not bring
himself to touch her skin.
Psychological and emotional stress
should be discussed with your dermatologist. You should not attempt
to self-medicate with over-the-counter, herbal or "natural" stress
remedies. Any anti-anxiety or anti-depression medication should be
prescribed on the basis of the patient’s history, medical
examination, and avoidance of side effects that could trigger new
psoriatic lesions. Intra-family stress due to the patient’s
psoriasis may be addressed by consultation with the dermatologist
and by family counseling.
All content solely
developed by the American Academy of Dermatology
For an overview, visit
the AAD pamphlet
Psoriasis and Psoriatic Arthritis.