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Skin Care

All you need to know about psoriasis and stress

Posted on 2nd Mar, 2021

Psoriasis is a chronic inflammatory skin condition with significant physical and psychosocial comorbidity that affects 2 to 3 percent of the population worldwide. There are four psoriasis diagnosed with the most common form psoriasis, chronic plaque psoriasis is scaly and has infiltrated skin lesions which are painful.

The other three are Inverse psoriasis which tends to affect skin creases such as those under the arm, around the groin and buttocks, or under the breast. The red patches may be moist rather than scaling. The next is Pustular psoriasis which as the name suggests is small pustules spread over the body. The last is Guttate psoriasis which causes many teardrop-sized patches over the body but not on the face.

This disease though treatable cannot be cured. It can affect the daily life of the individual, cause depression and a host of other psychological problems with some individuals taking the extreme step of suicide too.

Though psoriasis results in a red rash of the skin and leaves the affected mentally vulnerable, one of the root causes for this is stress. There is a clear and the first step towards this is, destressing yourself by being positive in mind, body and spirit. Stress plays a direct role and due to stress, there is a general escalation of skin diseases with psoriasis leading the front.

There are many experimental studies conducted that prove there is a correlation between psoriasis and stress. The studies state, longer periods of high stress moderate the disease course in psoriasis with daily stressors resulting in an itch. The alternate is, living in a high stressed out life, chances of related conditions, like cardiovascular (heart) disease, depression and other mental health issues, diseases like type 2 diabetes also become a part of the problem.

Studies have shown it can be treated if there are stress relief interventions for the people who have chronic stress issues. The cortisol response changes when stress relief is given. To reduce stress in your daily life, start with meditation, exercise, and do talk to your dermatologist to refer a psychologist or a support centre to help you with your fears.

Psoriasis preys on your mind more than on your body and it is highly stigmatizing with many thinking it is infectious and contagious which is not the case. In other words, it is not an airborne or water borne disease that transfers itself from the affected person to another be it in your work-place or a public space.

Large organizations and companies help the affected by talking to them, taking their coworkers into confidence, and making them understand what this is all about, how to treat the affected person with a lot of love, compassion and care. In school, students and teachers could be educated about this disease and made sure they treat the diseased person the same as others. In relationships, be it with your family or spouse for that matter, it is nothing to be embarrassed about.

Talk about it. Be open and share information with them so they understand you better. Truly loved ones will not aim to hurt you but, will go out of their way to help you. Lastly, certain fabrics and clothes can be worn to cover the affected part in the body and also help in ensuring you are not susceptible to constant itching. Do wear clothes that are soft and made of cotton and avoid polyester and polyester blended clothing.

Stress management therapy can help

Also, people undergoing stress management training have responded positively to psoriasis with a considerable reduction of treatment duration. As there is clear and direct link between skin infectious diseases and psychological problems, there have been a few studies that state dermatologists in Netherlands referred only eight patients per year to a psychologist and 50 percent of dermatologists have never referred their patients who are under the high stressed category to anyone.

It is evident that the first level of intervention has to be made by dermatologists and patients to be referred for further mental treatment and positive reinforcements. We need to understand that psoriasis is a chronic disease that carries a significant psychological comorbidity burden,
and it has been found that with increased stress a negative impact on skin involvement happens.

The severity of psoriasis keeps fluctuating and Individuals are likely to cycle between differing levels of severity throughout their lifetime as the body undergoes flare-ups and remissions. A study found that people who believed the cause of their psoriasis to be emotional were more likely to experience pathological worry than those who believed cause to be physical.

However, perceived stress was not related to psoriasis severity as a level of perceived stress was found to be related to quality of life, depression, and anxiety. The findings suggested stress is not associated to an increase in symptoms but is associated to an increase in the impact the symptoms have on daily life and well-being.

Therefore, people with psoriasis must receive treatment encompassing primary, specialty and psychiatric care. Lastly, development of quality measures, timely interventions and standards of care related to holistically treating psoriasis patients would help improve care delivery and patient well-being outcomes.

Symptoms and managing of psoriasis in your everyday life

The first symptom of psoriasis is the itch. It affects your psyche and that leads to a detoriated quality of life more than the disease itself. Remain calm, composed and avoid stressful situations as much as possible. Try to take deep breaths, go for long walks, do gentle yoga and meditation. This will automatically reduce your stress and eventually your itch too will fade
away.

Another symptom is dryness or cracking of skin that may lead to bleeding and if your skin is dry, it may lead to severe psoriasis flares. Keep your skin moisturized to ensure there are no cracking or dying of skin. Apply only prescribed lotions and moisturizers after consulting a dermatologist.
Nails psoriasis is another form of psoriasis that can affect fingers and toes (digits). Symptoms of nail psoriasis include discoloration, thickening, deformation, and pitting.

Psoriatic Arthritis

One out of every three individuals affected with psoriasis also has swollen and stiff joints or psoriatic arthritis. It is guesstimated nearly 30 percent of the people with psoriasis may also develop psoriatic arthritis (PsA). Check for swollen or stiff joints in your body as ignoring PsA can lead to permanent damage to bones and joints if left untreated. Though no diagnostic tests are currently available for PsA screening tools can help to identify signs and symptoms.

Parents and children and dealing with mental health

People with psoriasis are more likely to become depressed and it is important to look for symptoms of depression and seek treatment if you need it. If your child has been diagnosed with Psoriasis, as a parent, you have to be supportive and not be embarrassed or talk negatively about the disease or the effects it has on the child’s body. Your child will instinctively assume it is something to be ashamed and embarrassed about.

You have to focus on your child, their day to day studies, playtime and be normal with them. Try to help them talk about their thoughts and feelings and allow them to express it in any form. It could be in the form of graphics, drawings or even emojis. Look out for negative emotions such as anger, frustration and confusion and talk them about it. Make them understand it is not their fault if there was a flare and they are not to be blamed for anything.

Make it explicitly clear it is not their fault and it is a part of life. Some people get this, and some do not. Children with psoriasis despite covering the affected parts may end up being bullied or teased in school or by their friends in the play area. To start with, take your child’s teacher into confidence and make them understand this is nothing to be worried about. The teacher in turn can educate the students of the class and ensure your child does not end up being bullied or teased.

First indication is your child will change his or her social behavior. They will refuse going to school, decline in grades, inactive in the play area, unruly behavior, social withdrawal and avoiding friends. The second indication would be a change of routine in eating or sleeping habits and coming up with various health related complaints that are vague by nature. Normally, children are resilient and yet sensitive. Some can blame themselves and can harm themselves or talk about committing suicide to end this once for all.

As parents, it is imperative to have a talk with your child. First you have to understand their situation, then talk about the situation and what steps are to be taken to look at this positively. Bullying is more of an emotional feeling than physical and it can leave a child feeling helpless and powerless. Talk to your child, encourage them not to feel that way and not get into any physical altercation with anyone as it will lead to more harm than good. Another form of bullying is cyber bullying, and it is really harmful.

Monitoring of social media platforms by parents for children who are under 16 is mandatory. Do not ignore the symptoms as it can lead to severe stress levels for your child and that can make psoriasis worse. Being teased, bullied, or cyberbullied also, holding back emotions like fear, anger and frustration can lead to depression and people with psoriatic disease have higher chances of being affected with depression.

As parents of your child, you have to look out and recognize signs of depression and take corrective measures and actions to ensure they do not slip into depression. Some signs of depression in your child are feelings of sadness and hopelessness, anger, fatigue, rejection, sense of fear, avoiding friends, social withdrawal and not keen to go to school with a drop in grades. The signs of depression are graver than bullying and if required, talk to a mental health expert for help.

Tips for parents of children with psoriasis

As parents, seeing your child with psoriasis affects your psyche also. Being supportive of your child mentally taxes you and you have to learn how to deal with your own emotions too. Accept this diagnosis as a part of your life and do not get frustrated. Your child can pick up the subtle anger and may blame themselves for your frustrations. Keep yourself and your child healthy, mentally, and physically.

Managing your job, juggling between school and doctors can bog you down. Do not hesitate to ask for help from your family members including siblings to help you out. Assign duties and ensure everyone is on the same page when it comes to dealing with your child.

Psoriasis and weight gain

A study published in the American Journal of Clinical Dermatology states severe psoriasis affects men more than women. It also finally comes down to genes and medically speaking, psoriasis occurs when the immune system causes certain areas of your skin to produce new cells more rapidly than normal. This leads to the thickening and scaling of the skin. Medical scientists say individuals with psoriasis inherit one or more of certain genes that can affect the immune system in a way to make them prone to psoriasis.

Another “friend” of psoriasis is weight gain. Flare ups or triggers can occur with common medications too like beta blockers used to control high blood pressure. Other triggers such as strep throat, injury to the skin and respiratory infection also leads to this disease. Maintaining a healthy diet is important and it is recommended to have more legumes, fruits and vegetables, whole grains, fish, fruit, nuts, and extra-virgin olive oil. This may result in lower flare ups and also help in shedding excess weight.

Do consult your doctor for the right medication to ensure you do not have flare ups and go stress free is the only way to treat this disease. There is no cure for psoriasis. It can only be treated and though it may go away for months or even years, the chances of it relapsing is high. You have to live with this. There is sadly no choice. As there is no cure, the idea is to reduce your psoriasis to 1% of your body surface area (a size equal to the front of your hand) within 3 months. If the target is not achieved, talk to your doctor and see what best can be done. Any treatment should be under strict advisement of your doctor only.

Treatments for psoriasis

There are creams, lotions and moisturizers that can be used on the affected part of the body. Called topical treatments, these are over the counter and prescription-based treatments that are applied directly on the skin. Consult your doctor for the right application for your type of psoriasis.

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