For most people, psoriasis causes red, itchy, and scaly patches on the skin. But for some, the tight, dry, and inflamed lesions can also cause pain in the skin. One study found that pain was self-reported as a symptom in over 4 in 10 people with plaque psoriasis.
For some others, the same immune system that causes plaque on your skin could instead inflame the joints in your body. This may cause aches, swelling, and pain. It could also be a sign of psoriatic arthritis – another autoimmune condition that about 1 in 3 people with psoriasis develop over a 5- to 10-year period after they’ve had psoriasis.
While it’s not clear why some people with psoriasis have pain and others don’t, here’s a look at the different kinds of pain you can expect, how to spot triggers, and what you can do to manage it.
What Causes Pain With Psoriasis?
As with many autoimmune conditions, psoriasis flare-ups happen when your immune system misfires and attacks your own body. But experts don’t know what exactly causes skin pain.
One study found that you’re more likely to have pain with psoriasis if you:
- Are female
- Are older
- Have other severe medical conditions (co-morbidities)
- Have severe psoriasis symptoms
- Experience long-lasting psoriasis flare-ups
How Psoriasis Pain Shows Up
Skin pain with psoriasis can come in many ways. It can be:
- Sensitivity to heat or cold
- Tender skin
- Cramping from tightness
- A stinging sensation
- Pain related to unconscious scratching
Pus-filled bumps on your skin from certain severe types of psoriasis, such as pustular and inverse psoriasis, can be very painful.
For example, the friction from inverse psoriasis can cause your skin to become inflamed, raw, and sore, leading to pain. Inverse psoriasis happens where your skin rubs against or touches nearby skin, in folds and creases like the buttocks, armpits, or the backs of your knees.
With pustular psoriasis, pus-filled red or brown bumps show up on your hands and feet that often look like a rash or infection. They don’t have any bacteria in them, but they become red and swollen, and can cause a lot of pain.
If you have severe psoriasis, you’re also more likely to get psoriatic arthritis. This can look like:
- Joint pain in your hands and feet
- Joints that are swollen, red, and tender to touch
- Heel pain
- Muscle weakness
- Stiffness and dull aches that ease up during the day
If you notice such symptoms, tell your doctor right away. They can take a look and see if your symptoms have changed or become worse and change your treatment accordingly.
It’s also important to note that psoriasis is largely described as a physical condition with visible symptoms that you’re able to see with your eye. But when it comes to pain, research shows that your understanding of pain and level of pain, be it deep or surface level, is also influenced by your mental well-being.
For example, if you’re stressed or you’re sad, unable to cope with the social pressure of living with psoriasis, you might be more hyper-aware of your psoriasis-related pain.
How Can Pain From Psoriasis Impact Your Life?
Pain related to psoriasis can take a toll on your mental and physical well-being and overall quality of life. Research shows that people who experience pain with psoriasis are more likely to:
- Have a hard time sleeping
- Miss work or school
- Have trouble with daily activities
- Have disturbed or low-quality sleep
- Be less productive
- Avoid certain clothing
- Experience a negative impact on personal relationships
Living with pain can affect your day-to-day life and can be overwhelming. This can cause feelings of anxiousness, isolation, and depression. It can also affect your overall health and increase your risk for related conditions like diabetes and heart issues.
What Kind of Triggers Should You Watch For?
Triggers for psoriasis flare-ups vary from person to person. Some of the common triggers are:
- Skin injury
- Illness such as a viral infection
- Cold weather or other environmental triggers
- Allergic reactions
- Certain foods
- Certain medications
If you notice your pain starting up or getting worse with any of these triggers, tell your doctor about it. If foods or certain beverages are triggers, try to limit or avoid them.
How Can You Manage the Pain?
There are many ways to control and manage pain with psoriasis such as lifestyle changes, medications, and certain therapies.
Lifestyle changes. Stress can often make psoriasis symptoms like itching and redness worse. Try to find ways to manage and control stress in your day-to-day life. You can:
- Do yoga and body movement exercises that are known to lower stress.
- Try breathing techniques like meditation.
- Enjoy relaxing activities like a walk.
If you’re unable to get stress under control, tell your doctor about it. They might prescribe medications or refer you to a licensed therapist or counselor to help you find strategies to cope.
Medications. You can take certain over-the-counter medications to manage pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin can help relieve pain and reduce inflammation for some people. It can also lower joint pain and stiffness or other muscle aches you may have.
There are also topical creams that are available over the counter or through a prescription that can relieve or numb the itching during flare-ups.
If you have severe flare-ups that cause pain and lower your quality of life, your doctor might give you disease-modifying antirheumatic drugs (DMARDs) or “biologics” that are designed to ease the immune system’s overreaction and lessen your symptoms. They can also help slow your condition, especially psoriatic arthritis, from worsening.
There are many types of DMARDs. Ask your doctor which one might be right for you.
Therapies. Ultraviolet (UV) light therapy is a simple, safe, and inexpensive therapy that can help make many people’s symptoms less severe. When the light hits your skin, it can cause changes within your skin cells and lower “cytokines” – a type of protein that triggers psoriasis. This can lower inflammation and itching.
Exposure to sunlight can also help reduce severe symptoms or flare-ups. Experts suggest a 20- to 30-minute walk before noon can boost UV light and vitamin D absorption. This in turn can ease your symptoms.
But take precautions to avoid sunburn, as this can make your pain and other symptoms worse. Put on broad-spectrum sunscreen, with at least 8% zinc oxide and an SPF of 30 or higher, before you head out.
Photo Credit: AaronAmat / Getty Images
Arthritis Foundation: “Light Therapy for Psoriatic Arthritis.”
National Psoriasis Foundations: “Oral Treatments,” “Life with Psoriasis,” “Causes and Triggers.”
American Academy of Dermatology Association: “Psoriasis: Signs and Symptoms.”
National Health Service (U.K.): “Psoriatic Arthritis.”
The Journal of Dermatological Treatment: “The Experience of Pain and Redness In Patients With Moderate To Severe Plaque Psoriasis.”
Advances in Dermatology and Venerology: “Psoriasis and Skin Pain: Instrumental and Biological Evaluations.”