Psoriasis and Social Anxiety

Medically Reviewed by Stephanie S. Gardner, MD on March 25, 2022
4 min read

Psoriasis can affect more than just your skin. The appearance of inflamed patches may make you uncomfortable around others. Feeling stressed about being in groups or about putting yourself in situations where lots of people will be around can be a symptom of social anxiety.

Left untreated, social anxiety could affect your overall well-being and quality of life. However, there are resources and tools to help you manage it.

It’s common for people to feel anxious from time to time. But if that feeling comes up often and affects your day-to-day life, it could be more than just shyness. In fact, it could be a medical condition your doctor can diagnose and treat.

According to the National Institute of Mental Health, social anxiety disorder is a common type of anxiety that causes a lot of fear or worry of being watched, judged, or humiliated by others. Basically, it may stop you from living your life fully due to concerns of what others may think.

If you’re dealing with social anxiety, you may experience:

  • Fear in social situations where someone might be able to see the lesions and patches on your skin.
  • Dread of speaking in public because of what someone might think of your skin.
  • Avoiding interactions such as meeting new people, dating, job interviews, answering a question in class, or talking to people at work.
  • Inability to do everyday things, such as eating or drinking, in front of others.

The stress of constantly removing yourself from possible social situations may take a mental toll on you. Social anxiety can lead to loneliness and can put you at a higher risk for depression.

If you think you may be experiencing social anxiety, be sure to talk to your doctor or a mental health professional about it.

Psoriasis symptoms vary from person to person. Because it’s a condition in which your symptoms are often visible, it may make you feel embarrassed, or in some cases, take a toll on your mental health. You may feel:

  • Anxious
  • Ashamed
  • Self-conscious
  • Judged by others

While research on the link between psoriasis and social anxiety is limited, one small 2016 study found that 46% of the participants had social interaction anxiety. Around 47% had some level of anxiety or fear of how others would think of them based on the skin condition.

Stigma can be a factor in experiencing social anxiety with psoriasis. Research shows that some people falsely believe that psoriasis is contagious or infectious. But this isn’t true.

Another study found social anxiety among adults with psoriasis was largely related to self-worth. For those whose psoriatic symptoms started when they were 18 or younger, their social anxiety was linked more to the stigma attached to the condition.

Psychological stress, such as social anxiety, has long been linked with psoriasis. Stress is a common trigger for a flare-up and it can also worsen the itch.

One large survey of more than 32,000 people with psoriasis showed that 46% found their psoriatic symptoms to be stress reactive and 54% had symptoms flare up before a stressful event.

However, experts say the relationship between stress and the start of psoriatic symptoms or a flare-up is a fine line and can be complex.

If you are diagnosed with social anxiety, or if you find yourself feeling tense in social situations, here’s some tricks to managing that stress:

Try breathing exercises. When you’re anxious or worried, your breathing patterns may change. Try to take long, deep breaths in through your nose and let it out of your mouth. This can help regulate your breathing and ease the pit in your stomach. Exercises like meditation, yoga, and tai-chi are designed to slow down your movement and help you focus on your breath.

Learn how to relax your body. Feeling on edge can tense the muscles in your face and body. To relax your muscles, try to focus on individual groups of muscles in your face or body. Work on recognizing how they feel when they’re tense and try to relax them. Tension tends to mostly affect your face, neck, shoulders, arms, and legs.

Try visual imagery. If meeting someone, going to school or work, talking on stage, or giving a presentation gives you anxiety, visual imagery may help reduce your nerves. Try to picture the action beforehand when you’re in a relaxed state. Rehearsing a social situation in your head, including what you may be afraid of, may help you prepare for it and manage it better in reality.

Recognize negative thoughts. Constant worry or fear about what others might think about your skin can fill your head with negative thoughts. This can become a pattern and affect your quality of life. To combat it, you’ll first have to learn to recognize it.

Negative thoughts may look like:

  • Over-generalizing: Assuming all negative experiences are linked to your psoriasis.
  • Catastrophizing: Always jumping to the worst-case scenario.
  • Personalization: Feeling upset about events or incidents that may have nothing to do with you or your condition.
  • Ignoring positive thoughts: Overlooking good interactions or compliments.

Find ways to answer questions about your psoriasis. If someone asks you about your skin, if you’re able to, explain the autoimmune condition. This can help break down wrong beliefs and help you feel empowered.

Join a support group. Connect with a psoriasis support group where you can meet like-minded people who may share similar life experiences, and can offer advice.

Get professional help. If you’re unable to manage your anxious feelings, and it’s affecting your quality of life, talk to your dermatologist or a licensed therapist or counselor about it. Doctors and mental health professionals have a number of ways to help you feel better.

If you or your loved one is having suicidal thoughts, call National Suicide Prevention Lifeline at 800-273-TALK (8255).