Psoriasis

How Psoriasis Affects Your Whole Body

Psoriasis is more than skin deep. It involves an overactive immune system and inflammation throughout the body, which can contribute to a host of health complications.
Becky Upham
By Medically Reviewed by 
Reviewed:
Medically Reviewed

T he hallmark of psoriasis is skin discoloration — red patches in people with lighter skin tones and dark brown, purple, or violet patches in people with darker skin tones. Although these lesions (or plaques) can spring up anywhere on the body, they most often appear on the scalp, elbows, knees, and lower back.

The cause of psoriasis isn’t fully understood, but an overactive immune system, which triggers inflammation throughout the body, is thought to play a role, says Steven Feldman, MD, PhD, a researcher and dermatologist at Atrium Health Wake Forest Baptist in Winston-Salem, North Carolina.

This inflammation results in not only a buildup of psoriasis plaques, but also other changes that impact your joints, gastrointestinal tract, and other organ systems.

How Psoriasis Can Affect Other Parts of Your Body

Take a look at the widespread impact psoriasis-related inflammation can have on the body.


Heart According to the American Academy of Dermatology, psoriasis-related inflammation can affect your heart and blood vessels, increasing your risk of heart disease and stroke. An analysis published in June 2022 emphasizes the importance of monitoring for cardiovascular risk in people with psoriasis.

The good news? Treating psoriatic disease with a traditional systemic or biologic medication can help lower cardiovascular risk, says Jonathan Greer, MD, a rheumatologist at Arthritis & Rheumatology Associates of Palm Beach in Florida.

Blood sugar Over time, the overactive immune system resulting from psoriasis may start to attack cells that make insulin, increasing your risk of insulin resistance and type 2 diabetes.

Luckily, taking steps to manage psoriasis can help reduce this risk. And if you do have type 2 diabetes, research shows certain treatments, such as glucagon-like peptide-1 (GLP-1) agonists, may even help improve psoriasis skin.

Joints According to the National Psoriasis Foundation, about 30 percent of people who have psoriasis will also develop psoriatic arthritis, a condition marked by joint pain, morning stiffness, and fatigue. “The same inflammatory process that causes psoriasis can invade the joints and cause psoriatic arthritis,” explains Dr. Greer. Most people have psoriasis — sometimes for years — before developing psoriatic arthritis symptoms.

If you have psoriasis, be on the lookout for any signs of arthritis, and tell your doctor right away. The sooner you can be diagnosed and treated with psoriatic arthritis, the better your outcome and the likelier you’ll delay its progression.

Digestive system “We know that some of the genes that make our immune system overactive in psoriasis also make our immune system overactive in the bowel,” says Dr. Feldman.

Inflammatory bowel disease (IBD) can have an impact on both psoriasis and psoriatic arthritis, which are associated with a type of IBD known as Crohn’s disease, according to a study published in June 2022 in Frontiers of Immunology.

Psoriasis, psoriatic arthritis, and irritable bowel syndrome (IBS) “also fall under the same spectrum of diseases called the spondyloarthropathies,” adds Greer.

Eyes The same inflammation that causes dry, scaly skin can also affect your eyes, which can be uncomfortable and impact your vision, says Galen Foulke, MD, a dermatologist and assistant professor at UNC School of Medicine in Chapel Hill, North Carolina.

“Eye involvement in psoriasis is not extremely common," says Dr. Foulke. However, it does occur in about 10 percent of people who have psoriasis.

Psoriasis has been linked to an increased risk of inflammatory eye conditions, such as conjunctivitis (inflammation of the eyelid/conjunctiva). “People with psoriasis who also have psoriatic arthritis are at a much higher risk for developing uveitis (inflammation of the iris),” he adds.

Nails Your nails may also be affected by psoriasis, because nails are produced by the skin. “The root of the nail is very close to the last joint of your finger,” Feldman explains. “If psoriasis gets in those cells, in what’s called the nail matrix — which is what forms the nail — that can cause little pits in the nail. If the inflammation is in the skin under the nail, it can cause a buildup of scales between your skin and the nail, which may cause it to loosen and thicken.”

Nails may also change shape, turn a yellow-brown color, or develop horizontal ridges, called Beau’s lines, according to the National Psoriasis Foundation.

People with psoriasis who experience nail symptoms also appear to be more likely to develop psoriatic arthritis compared with those who don’t have nail involvement, according to a study published in The Journal of Rheumatology.

Depression According to a study published in 2019, psoriasis-related inflammation may also contribute to an increased risk of depression. “Depression is common in people who have psoriasis, especially if it comes with psoriatic arthritis,” says Feldman.

Because psoriasis is a visible condition, it can lead to self-consciousness and even social withdrawal. This can lower a person’s quality of life and contribute to depression.

Meanwhile, the pain and fatigue that accompany psoriatic arthritis often keep people from being as active as they want, adds Feldman. “This contributes to a sedentary lifestyle and obesity, and further contributes to heart disease.”

A Deeper Look at the Link Between Psoriasis and Psoriatic Arthritis

Psoriasis and psoriatic arthritis are types of psoriatic disease that often go hand in hand.

Treating psoriasis and psoriatic arthritis aggressively is important, not only to improve the symptoms of both those conditions, but to reduce the risk of other health conditions as well.
— Jonathan Greer, MD
Although the conditions affect different parts of the body, they are intimately related, Greer emphasizes. “There are parts of the immune system that can affect both the skin and the joints that are common to both conditions.”

In most cases, the skin disease shows up first, years before joint symptoms begin. And the longer a person has psoriasis, the greater the chances they’ll develop psoriatic arthritis, says Greer.

But it’s also possible to have psoriatic arthritis without psoriasis.

Psoriatic arthritis can look different for everyone. “It’s often asymmetric, where it’s present on one side of the body but not the other,” says Greer. “It can also appear as enthesitis — that’s inflammation of the entheses, which is where the tendons and ligaments attach to the bone (for example, the Achilles tendon). It can also cause an entire finger or toe to swell up, called sausage digits,” he explains. And all of these things can occur if you don’t manage the skin disease first, he adds.

Luckily, treatment options are available that can treat psoriasis and psoriatic arthritis simultaneously, by targeting the underlying inflammation in the body.

“Treating psoriasis and psoriatic arthritis aggressively is important, not only to improve the symptoms of both those conditions, but to reduce the risk of other health conditions as well,” Greer says.

It’s estimated that more than 15 percent of people with psoriasis also have psoriatic arthritis but don’t know it.

Source:

National Library of Medicine

It’s estimated that more than 15 percent of people with psoriasis also have psoriatic arthritis but don’t know it.

How to Limit the Impact of Psoriasis-Related Inflammation

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Although psoriasis is linked to a greater risk of other health conditions, such as psoriatic arthritis and heart disease, there are things you can do to take care of your skin, joints, and overall health.

  1. Moisturize regularly. The National Psoriasis Foundation recommends looking for over-the-counter options that contain aloe vera, jojoba, zinc pyrithione, or capsaicin. Ingredients such as hyaluronic acid and ceramides are also important to help lock in moisture.
  2. Overhaul your bathing routine. Soaking in mineral water may help hydrate and soften your skin. Consider adding colloidal oatmeal, Epsom salts, or Dead Sea salts to your bath to help soothe psoriasis skin, says the National Psoriasis Foundation. But stay away from hot water and harsh soaps, which can worsen your symptoms, adds Feldman.
  3. Maintain a healthy weight. Obesity can be related to higher levels of inflammation in the body, says Greer. “We also know that the drugs used to treat psoriasis and psoriatic arthritis do not work as well when you are overweight,” he says. If weight loss is necessary, talk with your provider about the best way to achieve your goal. Greer recommends switching to a Mediterranean diet and exercising with low-impact activities, such as walking, riding a bicycle, or swimming. 
  4. Know your numbers. Given that psoriasis is linked to an increased risk of heart attack and stroke, it’s a good idea to know your numbers, Feldman says. “Get your blood pressure checked, and make sure your cholesterol isn’t too high.”
  5. Stay on top of your care. Psoriasis isn’t a condition you can ignore and hope for the best, says Greer. “Follow the instructions from your doctor and dermatologist.” In addition to regular follow-ups with your specialists, it’s good to stay informed about your condition, says Feldman. Checking out the National Psoriasis Foundation is one way to stay educated. 
  6. Be your own advocate. “Sometimes, dermatologists don’t look past the skin, but they should be asking about joint involvement, gut involvement, eye involvement, and systemic symptoms of fatigue,” says Greer. Likewise, he adds, a good rheumatologist should look not only for skin disease, but also for other organ system involvement.