Social Anxiety: The Invisible Symptom of Psoriasis

The physical symptoms of psoriasis make it a highly visible disease. But the condition’s social and emotional effects can exact an invisible toll on a person’s health.

Managing Your Emotional Health to Manage Your Psoriasis

When Simon Jury was diagnosed with psoriasis at age 30, the disease was so severe that it affected about 80 percent of his body. It took years to find an effective treatment for Jury’s physical symptoms, during which time he struggled with the disease’s emotional effects.

“Most of it has been in my mind, thinking people are staring and talking about me,” says Jury. “It is very easy to think people are put off by your psoriasis; but a lot of this can be your mind playing tricks on you, making you feel insecure and anxious.”

Jury says that managing his disease doesn’t just involve medications, but also trying to maintain a positive outlook and state of mind. He adds that people with psoriasis should not be afraid to talk with their doctor about how the disease is affecting their mental health.

Psoriasis is a difficult disease to hide. The most common form of psoriasis, plaque psoriasis, manifests with raised red plaques typically covered with a silvery buildup of dead skin cells that give the skin a scaly appearance. The plaques, which often appear on the knees, elbows, and scalp, aren’t easy to conceal.

“We live in a culture where how you look is very important,” says Ann Rosen Spector, PhD, a clinical psychologist in Philadelphia. “For anyone who doesn’t look like a model, whether it’s the shape of their body or the state of their skin, it’s easy to feel bad about your appearance.”

Feeling Stigmatized Can Have Significant Consequences

People with psoriasis often feel stigmatized because of the misconception that their condition may be contagious, says Michelle Tarbox, MD, a dermatologist at the Texas Tech University Health Sciences Center in Lubbock.

“I’ve had patients who have been kicked out of public pools or asked to leave clothing stores because people do not understand that psoriasis is not a contagious disease,” says Dr. Tarbox.

“One of the most therapeutic things that I do during a first visit for psoriasis is to simply touch the psoriatic plaques. This lets me know how thick the plaques are, but it also demonstrates to the patient that I am not afraid of their skin,” she says. “I’ve had some patients who have never had anybody except for family touch their psoriatic plaques, and some have even been moved to tears.”

Tarbox says some of her patients avoid dating and relationships because they are afraid of rejection because of their skin condition. In severe cases, she has “had patients whose severe psoriasis led them to contemplate suicide.”

How to Handle and Redirect Negative Thoughts

In addition to therapy, Dr. Spector suggests that you examine the relationships in your life and make sure they are supportive ones.

“If people are going to focus on your psoriasis and not the qualities that make you who you are, you have to ask yourself if they’re worth having in your life,” she says. “If people don’t like you or don’t want to interact with you because of a skin disease, they’re probably not your kind of people anyway.”

Jury started writing a blog as a way to help himself and others. “It’s not about just finding a treatment for your skin,” he explains. “We need to be treated as a whole, because of the mental health issues that come hand in hand with this disease.”

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