Stress Is The Silent Culprit of Psoriasis Flares. What Can We Do?

I live with ankylosing spondylitis, an immune-mediated disease characterized by spinal arthritis, joint inflammation, and problems with my eyes, gut, some organ, and — yep, my skin.

Psoriatic arthritis falls under the same umbrella category as spondyloarthritis. It seems as though psoriasis is a sort of peripheral symptom to my ankylosing spondylitis since psoriasis affects 9% of people with my disease.

When stress strikes...

While I have more mild psoriasis, I notice that my flare-ups occur when I am under intense bouts of stress. Worry? Rumination? Not enough sleep? You bet it will make my skin act up.

Stress is the culprit behind my inflammation in general. If I'm stressed, it will make its way to my body in no time, manifesting in annoying or downright debilitating ways. With my inflammatory arthritis, I am stiff, immobile, and in extreme pain. I might get a flutter of skin issues on my shins or my scalp with my psoriasis.

My own personal experience

I will regale you with a story: We were moving apartments, and I was at peak stress levels. We were apartment hunting for a few months, but living in New York City, the apartment search process can be incredibly daunting, and I was internalizing the stress of that process. (You have to sell your soul to sign a lease here.)

We moved into an apartment that I didn't necessarily love (it was on the 29th floor of a sky rise, and I learned too late that I genuinely hate heights!), so my stress came creeping through. In those first few days, I woke up with red patches on my shins and little itchy circles that reminded me how fragile my body could be when disoriented or thrown off of a routine.

I had also just come off Humira, the biologic prescribed to me for my ankylosing spondylitis. Perhaps my inflammation levels were all whacked out. Maybe it was the stress. Or maybe it was how these things go.

Protecting cortisol levels

There's no doubt that stress is related to inflammation, and when you live with an inflammatory disorder, protecting our cortisol levels becomes all-consuming.

I stopped thinking about stress management as a chore ("I have to meditate! I have to go to yoga!) and started integrating stress management into my everyday life. Instead of worrying about worrying about stress, I rearranged my life to devote time to self-care, quiet time, and limiting the experiences that put pressure on my mental health.

The importance of prioritizing wellness

I say no to things sometimes. I get off the computer and stretch. I get into nature more often. I gravitate toward people that lift me. I turn to art for relaxation. And I prioritize balance.

Building routine rest and space to breathe into my day has become an art — and honestly? It's changed my life for the better. Instead of feeling 'ruled' by my immune issues, I see them lending me some insight. It's not always easy, and it's a privilege to be able to manage your stress at all. But I think it's as important as medication and diet. After all, stress is the silent killer.

How does stress affect your skin?