World Psoriasis Day: The Impact of the Disease on Mental Health

Early diagnosis and appropriate treatment of psoriasis protect not only the physical but also the mental health of those affected, according to the International Federation of Psoriasis Patient Associations (IFPA).

On the occasion of World Psoriasis Day on October 29, IFPA emphasizes that psoriasis is not just a skin condition but a systemic disease that can also affect the joints and is associated with an increased risk of developing a range of other health problems, including mental health disorders.

“Patients with psoriasis must learn to live with it for their entire lives. Living with a chronic condition, especially one visible on the body, is not easy, and many patients develop disorders such as depression and anxiety,” explains Dermatologist-Aphrodisiologist Dr. Markos Michelakis from EDOEAP.

The challenges faced by patients in all aspects of their lives are reflected in the global survey “Psoriasis and Beyond,” which included nearly 5,000 patients from 20 countries. The survey found that more than eight out of ten respondents reported that their skin condition affects their work, emotions, and relationships.

Patients with visible skin lesions often report that others stare at them, that they feel compelled to hide their skin, and that they frequently feel socially marginalized. As a result, they begin avoiding social events and limit themselves to spaces with few people.

The disease can also negatively impact family life and relationships. In nine out of ten cases, partners report increased household duties, concerns about the patient’s health, restricted social contacts, fewer activities during vacations, and higher levels of depression and anxiety.

The impact is even greater when lesions occur in the genital area, as this can directly affect the couple’s sexual life. The itching caused by the lesions and the feelings of shame that patients often experience create obstacles to sexual activity that can feel insurmountable.

Women who wish to have children face additional challenges. More than one in three worry about the potential effects of psoriasis treatments on fertility and the health of their unborn child. Even more are concerned about passing the genetic predisposition for psoriasis to their children.

“Continuous anxiety—whether justified or not—the constant reminder of the condition as it is visible on the skin, and the impact on daily life, all diminish the quality of life for patients and pave the way for mental health problems,” notes Dr. Michelakis.

These mental health issues are very common. A recent review of medical literature showed that the prevalence of depression among patients with psoriasis is significantly higher than in the general population. Globally, more than 25% of patients with psoriasis experience depressive symptoms, and at least one in ten suffers from clinical depression. Rates vary by geographic region: in the USA, 16.5% of patients experience depression, while in Europe, the figure is 12%.

Depression is more common among psoriasis patients than in any other dermatological condition. This is largely due to the recurrent, visible skin lesions caused by psoriasis. Social stigma also plays a significant role. Many patients are isolated because others see their skin lesions and fear contagion. Some even mistakenly believe that psoriasis is a sign of poor personal hygiene.

“None of this is true,” stresses Dr. Michelakis. “Psoriasis is an autoimmune disorder caused by an overactive immune system. It is neither contagious nor a hygiene issue, yet these misconceptions persist, unfairly affecting patients.”

Social stigma undermines patients’ confidence and self-esteem and is a major source of stress. Stress, in turn, is a trigger for psoriasis flare-ups, which can lead to poor sleep, fatigue, and worsened mental well-being, creating a vicious cycle that patients must work hard to break.

Anxiety disorders, common among many psoriasis patients, can further exacerbate these problems. A recent meta-analysis of published studies found that up to 48% of patients report significant anxiety, which worsens their skin condition. Anxiety often intensifies with pruritus (itching), a major and frequently unbearable symptom of psoriasis.

“Patients must understand that psoriasis is a systemic disease, not just a skin condition,” emphasizes the specialist. “While classical manifestations appear on the skin, one in three patients also develop joint involvement (psoriatic arthritis). Furthermore, patients have double the risk of comorbidities such as hypertension and diabetes, and a much higher likelihood of developing depression and anxiety disorders.”

“Early diagnosis and appropriate treatment are key to controlling both psoriasis and its comorbidities,” he continues. “Interventions must begin early, before complications become established, because treating them later is more difficult. Finally, it is essential to educate the public about psoriasis so that it ceases to be a ‘spectacle’ and patients can experience more supportive social conditions.”