Red, silvery, scaly patches on the elbows, hands or knees, plus burning or itching: Many people with psoriasis not only suffer from the actual symptoms, but also experience feelings of shame and exclusion. The inflammatory scaly patches on the skin called plaques can also appear behind the ears, on the scalp or on the feet and are not always hidden. The ups and downs in the course of the disease also cause stress, because psoriasis occurs in episodes that are difficult to predict.
It’s not just the body that takes a toll
dr Dagmar Wilsmann-Theis, head of the psoriasis special consultation at the University Hospital in Bonn, knows the mental symptoms associated with psoriasis: “These include poor sleep, for example due to the itching, but also therapies that are not or very time-consuming, or the constant fear of psoriasis a new wave.”
The causes of psoriasis are still not fully understood. Although there is a hereditary predisposition, it does not necessarily lead to the onset of the disease. Stress and other psychological burdens are among the triggers that can trigger flare-ups.
exclusion and withdrawal
Although psoriasis is not contagious, the skin symptoms often trigger regression. Questions and looks are also uncomfortable for many of those affected. They often find it difficult to explain the symptoms because the disease is very complex. “Those affected are most affected by the negative reactions from those around them,” confirmed Dr. Wilsmann-Theis. “As a result of this stigmatization, many of them develop a so-called self-stigmatization, which means that they increasingly avoid others. At some point they even withdraw from those who die and accept their illness, like their partner or their own family. Your self-esteem plummets. Even depression can develop.”
Depression is not the only possible comorbidity of psoriasis. About a third of psoriasis patients develop psoriatic arthritis, which in the worst case can lead to joint destruction. Other common comorbidities are obesity, diabetes, dyslipidemia and vascular inflammation. Psoriasis also increases the risk of heart attacks and strokes.
Psoriasis and the Psyche
People with untreated psoriasis are also at risk, both physically and psychologically. dr Wilsmann-Theis therefore pursues a holistic treatment approach: “In everyday life, mindfulness can help to keep the psyche in balance. In addition, deal with the disease openly towards others, learn to accept it and live with it. An intact social environment can help, but also a self-help group or psychotherapy.” The German Psoriasis Association, for example, operates regional self-help groups
In addition to the psyche, nutrition also plays an important role in psoriasis therapy. “Those affected should ensure their weight is normal and eat as little fat, sugar and meat as possible with lots of vegetables, fish and fruit,” explains Dr. Wilsmann-Theis. The doctor also advises: “Avoid alcohol if possible! Alcohol, like smoking, can trigger psoriasis.”
The treatment of psoriasis depends on the severity of the disease, which is determined at the beginning of therapy. For this purpose, it is examined how many parts of the body are affected by psoriasis. Psychological well-being also plays an important role, the severity increases with the psychological symptoms of psoriasis. They can be different depending on personality and life situation.
A visit to the dermatologist is worthwhile
The psychological situation is closely related to the skin symptoms. The more invisible the psoriasis is, the better most sufferers feel. Even mild symptoms should therefore be treated with ointments and creams. In some medical practices, patients can also make regular appointments for exposure to UV light.
Basic medications are the next step in treatment. They inhibit the immune response that is overridden in psoriasis patients. Because the immune system classifies the body’s own tissues as dangerous invaders, it triggers inflammation that leads to accelerated division of skin cells. The visible symptoms of the disease also begin inside the body.
“In the case of moderately severe and severe forms, regular and long-term medication with systemic therapies, which also include highly effective biologicals, is advisable,” Dr. Wilsmann-Theis. Biologics are bioengineered active ingredients that specifically target the immune response and block antibodies responsible for inflammation. With regular injections of biologics, many psoriasis patients can live symptom-free.