How Does Living With Pustular Psoriasis Impact Mental Health?

Reviewed by: HU Medical Review Board | Last reviewed: February 2024

Pustular psoriasis is a rare type of psoriasis that causes pustules on the skin. Pustules are white or yellow bumps on the skin filled with pus. Living with pustular psoriasis can be challenging and have a big impact on mental well-being.1,2

What is pustular psoriasis?

Pustular psoriasis is caused by an immune response that causes inflammation. It is not contagious. The pus in the pustules is caused by inflammation. In addition to pustules, pustular psoriasis can cause inflamed, red, itchy skin.1,2

When pustular psoriasis occurs all over the body, it is called generalized pustular psoriasis (GPP). GPP can cause fevers, chills, changes in heart rate, and weakness. When the condition affects small areas like the hands or feet, it may be called localized pustular psoriasis or palmoplantar pustular psoriasis (PPPP).1,2

Pustular psoriasis typically has flares. These are periods when symptoms get worse and the pustules spread.1,2

Pustular psoriasis is not the same condition as plaque psoriasis, but they are related. Some people start with a different type of psoriasis before pustular psoriasis. About 3 percent of people living with psoriasis may develop pustular psoriasis. However, some people develop pustular psoriasis by itself.1,2

How does pustular psoriasis impact your mental health?

Research shows that pustular psoriasis can have a significant impact on mental health. One study found that nearly half of the participants with pustular psoriasis had depression. Also, about 1 in 3 participants had generalized anxiety disorder.1-3

Pustular psoriasis may lead to these mental health issues in several ways. Many people report struggling to receive a pustular psoriasis diagnosis. About one-third of participants in one study said it took years to receive the correct diagnosis. Living without an accurate diagnosis can be a cause of stress.1-3

Other factors that may impact mental health include:2,3

  • Treating and managing pustular psoriasis symptoms can be especially challenging.
  • The condition may limit a person’s ability to complete daily tasks, such as exercising or running errands.
  • Living in fear of flares can increase overall anxiety.
  • The condition may make it harder to socialize or attend events.
  • People may fear stigma if others can see their pustules.

Unfortunately, the relationship between pustular psoriasis and mental health goes both ways. Emotional stress is a common cause of flares. These flares are then linked to worsening mental health.2,3

Tips for living with pustular psoriasis

Living with pustular psoriasis can be difficult. But there are things you can do to help improve your mental health. Things that may help include:2-4

  • Reaching out to friends or family for support
  • Managing stress with meditation
  • Trying gentle exercise if your doctor says it is safe
  • Wearing comfortable clothes that cover affected skin, if you prefer
  • Joining a support group
  • Engaging in talk therapy

If pustular psoriasis is affecting your mental health, talk with your doctor. They may refer you to a mental health specialist such as a therapist. Some people may find antidepressants or anti-anxiety medicine helpful.2-3

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