PsoriasisNet Article
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.

Self-Image
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
Stress—physical, emotional 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.

An educational program brought to you by the American Academy of Dermatology.

For an overview, visit the AAD pamphlet Psoriasis and Psoriatic Arthritis.

Supported by an educational donation provided by Amgen and Wyeth.