Red, silvery, scaly patches on the elbows, hands or knees, as well as burning or itching: Many people with psoriasis not only suffer from the actual symptoms, but also experience feelings of shame and exclusion. Inflammatory scaly patches on the skin, called plaques, can also appear behind the ears, on the scalp, or on the feet and cannot always be hidden. The ups and downs of the disease also cause stress, as psoriasis occurs in episodes that are difficult to predict.
It is not just the body that suffers
Dr Dagmar Wilsmann-Theis, Head of Psoriasis Special Counseling at the University Hospital of Bonn, is familiar with the mental symptoms associated with psoriasis: “These include poor sleep, for example due to itching, but also therapies that don’t work or are a lot of anxiety which takes time or constant before 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 mental stresses are among the triggers that can trigger flare-ups.
exclusion and withdrawal
Although psoriasis is not contagious, skin symptoms often result in rejection. Questions and stares 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 the most affected by the negative reactions of those around them,” confirms Dr. Wilsmann-Theis. “As a result of this stigmatization, many of them develop a so-called self-aggrandizement, which means they increasingly avoid others. At some point they even withdraw from those who accept them and their illness, such as their partner or family. Your self-esteem collapses. Depression can also develop ”.
Depression is not the only possible comorbidity of psoriasis. About one 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 therefore physically and psychologically at risk. Dr. Wilsmann-Theis therefore pursues a holistic therapeutic approach: “In everyday life, awareness can help keep the psyche in balance. In addition, face 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, runs regional self-help groups
In addition to the psyche, nutrition also plays an important role in psoriasis therapy. “Those affected should make sure their weight is normal and eat as little fat, sugar and meat as possible with plenty of vegetables, fish and fruit,” explains Dr. Wilsmann-Theis. The doctor also advises: “Avoid alcohol if possible! Alcohol, like smoking, can trigger psoriasis. “
Treatment of psoriasis depends on the severity of the disease, which is determined at the beginning of therapy. For this purpose, how many parts of the body are affected by psoriasis is examined. Psychological well-being also plays an important role, severity increases with the psychological symptoms of psoriasis. They can be different depending on the personality and the life situation.
A visit to the dermatologist is worthwhile
The psychological situation is closely related to the symptoms of the skin. The more invisible the psoriasis, the better most sufferers feel. Even mild symptoms should therefore be treated with ointments and creams. In some medical practices, patients may also make regular appointments for UV exposure.
Core medications are the next step in treatment. They inhibit the immune response which is ignored in patients with psoriasis. As the immune system classifies the body’s tissues as dangerous invaders, it triggers inflammation that leads to accelerated division of skin cells. Then the visible symptoms of the disease begin inside the body.
“In the case of moderately severe and severe forms, regular and long-term treatment with system therapies, which also include highly effective biological agents, is advisable,” explains Dr. Wilsmann-Theis. Biologics are bioengineered active ingredients that specifically target the immune response and block the antibodies responsible for inflammation. With regular injections of biologics, many psoriasis patients can live without symptoms.