The National Psoriais Foundation (NPF) estimates that 70 percent to 90 percent of those with psoriasis experience persistent irritation of the skin that makes them want to scratch. The problem is scratching gives only the most temporary relief, and it can make the disease even worse. When scratched, patches of skin tear away and bleed, causing the rash to spread and plaque lesions to form. Compared with other inflammatory skin disorders, psoriasis can produce particularly intense itching in the scalp as well as the lower extremities (for example, the groin and buttocks). Because dry skin aggravates itchiness, individuals commonly apply lotions, gels, ointments, and creams to keep the skin moisturized. Topical therapies also include steroids, vitamin D analogues, retinoids, calcineurin inhibitors, coal tar, and salicylic acid.
How Stress Turns Up the Itch
Flare-ups, which increase skin irritation, are commonly triggered by stress, and stress can intensify when a person worries about their flare-ups. So it can become an out-of-control negative spiral that fuels itself. RELATED: The United States of Stress “Stress alarms the immune system that we are in imminent danger,” says Richard Fried, MD, of Yardley Dermatology Associates in Yardley, Pennsylvania, and a medical board member of the National Psoriasis Foundation. “When the immune system senses imminent danger, it mobilizes to do battle against potential infection. This mobilization can result in the release of inflammatory chemicals that can help the body fight potentially dangerous threats to our health and well-being. “Unfortunately,” he adds, “these same chemicals can act as pruritogens [substances that cause the itchy sensation]. These may substantially intensify or worsen an existing itch.”
Try Out One of These Stress-Busters
Dr. Fried points out that stress is a natural survival response. “Stress is designed to mobilize all existing immune and other survival systems to fight real and anticipated threats to the body,” he says. Small doses of stress, in fact, may be healthy. A 2013 study published in the journal Psychoneuroendocrinology found that eustress, or positive stress, may help protect against oxidative damage, which has been associated with aging and disease. The chronic stress, however, can wear a body down. “The best and most psychologically pragmatic response that we can take is one that helps us to modulate the intensity and negativity of our stress responses,” says Fried. To effectively manage stress, try one or more of the following approaches:
Meditation This relaxation technique to calm the mind often involves deep breathing and a focus of attention while sitting in a quiet place. People, however, have learned to meditate in busy settings (such as on a bus or at work), and it can just take a few minutes to provide some help. The National Center for Complementary and Integrative Health says that the practice may help reduce blood pressure, irritable bowel syndrome, depression, and pain.Exercise Physical activity pumps up the endorphins in the body. These chemicals improve mood, energy, and sleep. The National Psoriasis Foundation reports that women who regularly participate in vigorous exercise are less likely to get psoriasis than less-active women, according to a large U.S. study. Patients may want to explore practices such as yoga and tai chi, which incorporate both elements of physical activity and meditation.Expert Help Some people may require expert help to get their stress under control. Mental health therapists can help. So can connecting with others to share your experience. To talk to others, consider contacting Psoriasis One to One or TalkPsoriasis.org.
Fried also recommends cognitive behavioral therapy for stress reduction. This common type of talk therapy with a mental health counselor helps a patient confront and correct negative thinking. In addition, he suggests that certain psychotropic medications may mitigate anxiety. “The approaches can all individually or in combination dramatically enhance our ability to deal with stress and potentially ameliorate our skin function,” he says.
