What is it about?
Psoriasis affects not only the skin but also mental health. This article explores how emotional distress and stigma impact patients, and why a more holistic approach to care is essential. Psoriasis is a long-term, immune-mediated condition that affects millions of people worldwide. While it’s most often recognised by visible patches of red, scaly skin, its impact goes far deeper. People living with psoriasis frequently face emotional and psychological challenges, including anxiety, depression, low self-esteem, sleep problems, and difficulties in relationships. These issues can feel just as overwhelming as the physical symptoms, yet they often go unnoticed and untreated even though they can significantly affect quality of life and how well medical treatments work. This article reviews the evidence on the psychological distress experienced by people with psoriasis. It highlights how visible skin changes can lead to embarrassment and stigma, which in turn affect self-esteem and social connections. It also explains how emotional stress and mental health problems may worsen psoriasis itself, creating a difficult cycle to break. Importantly, the paper calls for a more holistic approach to psoriasis care. It emphasises the need to assess the psychological impact of psoriasis as part of routine treatment. A “stepped-care” model is recommended, offering different levels of support based on individual needs, delivered by multidisciplinary teams that include psychologists. The paper also advocates for better tools to identify emotional challenges and guide tailored support.
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Why is it important?
This review provides an overview of the psychological distress associated with living with psoriasis. It offers healthcare professionals a deeper understanding of how this distress affects patient outcomes, along with practical guidance on identifying and assessing psychological challenges in individuals with psoriasis. Treating the physical symptoms of psoriasis is essential but so is supporting patients’ mental health and emotional wellbeing. By recognising and addressing psychological distress early, we can improve outcomes for people with psoriasis, ease the burden on healthcare services, and deliver more effective, compassionate care. In short, psoriasis is not “just a skin condition.” Understanding and addressing its psychological impact is key to improving the lives of those who live with it.
Perspectives
Personal Perspective: A Psychologist’s View from Both Sides As a consultant clinical psychologist who also lives with psoriasis, I know from both a professional and personal perspective that whilst psoriasis is often framed as a dermatological issue, its psychological impact is profound and too often overlooked in clinical settings. Stigma, shame, and emotional distress can quietly erode a patient’s quality of life. These factors affect more than just wellbeing. They influence treatment adherence, healthcare costs and clinical outcomes. Despite this, psychological needs are rarely assessed as part of routine dermatological care. This review was written to help bridge that gap. It offers clinicians a clearer understanding of the emotional burden carried by many patients with psoriasis, along with practical guidance on how to identify and respond to psychological distress. The evidence is clear. Integrating mental health support into psoriasis care is not optional. It is essential. I believe we can do better for our patients. By adopting a more holistic stepped-care approach and working collaboratively across disciplines, we can improve outcomes and deliver care that truly reflects the complexity of the human experience. Psoriasis may show up on the skin, but its impact runs far deeper. As clinicians, we have both the opportunity and the responsibility to see the whole person.
Catherine O'Leary
University Hospital Llandough
Read the Original
This page is a summary of: Psychological Distress of Psoriasis Patients, British Journal of Hospital Medicine, August 2025, Mark Allen Group,
DOI: 10.12968/hmed.2024.0802.
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