When all you can see is scales, bumps, and pustules on the skin, it is easy to assume that psoriasis is just a skin condition, but the effects of psoriasis go beyond what the eyes can see. Living with psoriasis puts you at risk of other health problems too.
Not treating psoriasis not only worsens the condition, the inflammation that triggers your skin symptoms could also affect other parts of your body and lead to other diseases. Psoriasis can also influence many aspects of your daily life.
The Effects of Psoriasis Beyond the Skin
An increasing body of evidence has indicated that psoriasis is associated with various systemic comorbidities. People with psoriasis have a greater risk of cardiovascular complications, diabetes mellitus, high blood pressure, Crohn’s disease, etc.1
Additionally, up to 30% of people living with psoriasis develop psoriatic arthritis (PsA) and experiences painful joint inflammation, which may precede skin symptoms2. Surveys conducted between 2003 to 2011 by the National Psoriasis Foundation showed that patients with moderate to severe psoriasis were more likely to develop PsA than patients with mild psoriasis3.
Furthermore, a new study in 2019 identified an apparent correlation between psoriasis, psoriatic arthritis, and hearing loss. People living with psoriasis face a higher risk of developing sudden deafness where their ability to hear diminishes substantially in three days or less due to the rapid inflammation that takes place during a flare-up of psoriasis symptoms4.
The Effects of Psoriasis on Quality of Life
According to the Malaysian Psoriasis Registration, 89.3% of adult patients reported that psoriasis had affected their quality of life, where symptoms and feelings such as itch and pain as well as embarrassment due to psoriasis were the aspects that caused the most negative impact5.
As a visible condition, psoriasis greatly influences the way a person views themselves and the way they are perceived by others. Patients often experience difficulties with their body image, self-esteem, and struggle with stigma and embarrassment regarding their appearance6. Studies have also found that people with psoriasis have a higher risk of depression and anxiety than those without it. Another study reported that at least 20% of psoriasis patients had contemplated suicide7.
The effects of psoriasis also extend into many aspects of a person’s daily life and personal relationships. The pain and itching that go along with psoriasis flares can also cause exhaustion and impact how well someone performs at school and in the workplace. It has caused nearly 60% patients miss an average of 26 days a year8.
Other than that, people with psoriasis may feel a lack of support and understanding from friends or family about their condition and could have difficulty spending time with them. They may avoid going out in public, wearing clothing that shows their plaques, or participating in activities like swimming that make it difficult to hide their symptoms9.
The Importance of Treatment
Treating your psoriasis is more than just managing your skin symptoms. Keeping your psoriasis under control can help you manage these wide-ranging health and psychosocial implications and improve your quality of life.
If you have psoriasis, you should work closely with your doctor to find an individualized treatment plan that fits your lifestyle. This will likely involve a variety of treatments, including topical treatment, oral medications, light therapy, and biologic therapy.
Psoriasis treatment has evolved to be more effective and targeted than conventional treatments. New medications can target many areas of the body, or even specific parts of the immune system, rather than the entire immune system10.
If you are unsure about how to manage your condition, speak with your dermatologist about the treatment options that may be suitable for you. Your dermatologist can help review your previous treatments (if any) to help you find the right treatment.
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References
1Mayo Clinic. 2021. Psoriasis - Symptoms and causes. Available at: https://www.mayoclinic.org/diseases-conditions/psoriasis/symptoms-causes/syc-20355840
2Healthline. 2021. Psoriatic Arthritis: Types, Symptoms, Diagnosis, and More. Available at: https://www.healthline.com/health/psoriatic-arthritis
3Armstrong, A., Schupp, C. and Bebo, B., 2012. Psoriasis Comorbidities: Results from the National Psoriasis Foundation Surveys 2003 to 2011. Dermatology, 225(2), pp.121-126.
4Semenov, Y., Hsiang, E., Huang, A., Herbosa, C., Hui, X., Kwatra, S., Cohen, B. and Anadkat, M., 2019. Association Between Psoriasis with Arthritis and Hearing Impairment in US Adults: Data from the National Health and Nutrition Examination Survey. The Journal of Rheumatology, 46(6), pp.587-594.
5Ministry of Health Malaysia. 2016. The Ninth Annual Report of the Malaysian Psoriasis Registry. Available at: https://www.dermatology.org.my/DermReg/files/Annual_Report_MPR_2007_2016.pdf.
6Monali J Bhosle, Amit Kulkarni, Steven R Feldman and Rajesh Balkrishnan. 2006. Quality of life in patients with psoriasis. Health Quality of Life Outcomes 4: 35. doi: 10.1186/1477-7525-4-35.
7Krueger G, Koo J, Lebwohl M, Menter A, Stern RS, Rolstad T. The impact of psoriasis on quality of life: results of a 1998 National Psoriasis Foundation patient-membership survey. Arch Dermatol. 2001;137: 280–284.
8LH de Arruda and AP De Moraes. 2001. The impact of psoriasis on quality of life. The British Journal of Dermatology 144(58) :33–36. doi: 10.1046/j.1365-2133.2001.144s58033.x.
9Laura E. Marusinec. 2015. Risks of Not Treating Psoriasis. Available at: https://www.healthgrades.com/right-care/psoriasis/risks-of-not-treating-psoriasis.
10Joshua Zeichner. 2020. Behind the counter: Biologics for psoriasis. Medical News Today, March 13. Available at: https://www.medicalnewstoday.com/articles/biologics-for-psoriasis.
