Psoriasis is a chronic skin condition at its core—but there’s a lot more happening beneath the surface. Psoriasis—which affects an estimated 7.5 million people in the US—is the result of an overactive immune system, which causes chronic inflammation. While we most often see the effects of this inflammation in the skin, it can also travel to other areas of the body, potentially affecting the nails, eyes, joints, heart, and more.
Read on to understand exactly what happens when you have psoriasis, how it might affect your body beyond the skin, and some treatment options that can help.
What’s happening with your immune system?
When your body needs to respond to an infection, an injury, or a substance that threatens your health in some way (like an allergen), your immune system should kick in to release various cells that fight potentially harmful invaders and protect the body. These cells travel to the affected area and start the healing process, causing inflammation. Here’s the problem: When your immune system is in overdrive, as is the case with any autoimmune condition, including psoriasis, it continues to pump out a large number of inflammatory cells, even when there’s no true threat to the body happening.
In people with psoriasis, it’s thought that there’s a faulty immune response that mistakenly identifies healthy skin cells as threatening, which causes the repair system to malfunction. This kicks off an overgrowth of new skin cells, which is what causes the hallmark psoriasis rash. The majority of people with psoriasis have plaque psoriasis, in which the “rash” appears as scaly patches, or plaques, on the skin’s surface.
This rash is just one visible sign of inflammation, but a doctor can measure inflammatory markers in your blood, Benjamin Ungar, MD, an assistant professor in the department of dermatology of Icahn School of Medicine at Mount Sinai, tells SELF. People who have psoriasis are more likely to have other autoimmune conditions as well, including certain forms of arthritis and inflammatory bowel disease (IBD). In fact, 25% of people with autoimmune diseases have more than one type—often a skin condition among them, research shows.1
And constantly having higher-than-normal levels of inflammation can wreak havoc on everything from your joints to your arteries, potentially leading to confusing body-wide symptoms.
Psoriasis and your cardiovascular health
Having moderate-to-severe psoriasis ups your risk for cardiovascular health issues and metabolic diseases, like high cholesterol and obesity, Dr. Ungar says. While there’s not a clear-cut reason why psoriasis may play a role, research suggests that systemic inflammation in the body is associated with a buildup of plaque and cholesterol in your arteries, which can eventually block healthy blood flow and put you at risk for heart disease.2
Because of these potential health risks, it’s a good idea for people with psoriasis to have annual blood pressure and cholesterol readings, and talk with their physician about any family history of heart disease, Samar Gupta, MD rheumatologist and associate professor of medicine at the University of Michigan Medical School, tells SELF. Beyond these checkups, focus on what’s in your control, such as working closely with your care team to find the best treatment for your psoriasis and adopting heart-healthy habits like eating a nutritious diet and exercising regularly in some way, he adds. Getting proper sleep and prioritizing stress-reducing habits are key, too.
Psoriasis and your joints
About 30% of people with psoriasis develop psoriatic arthritis, an inflammatory condition of the joints, tendons, and ligaments, according to the National Psoriasis Foundation. Most people are diagnosed with psoriasis first, though it is possible to develop the symptoms of psoriatic arthritis—such as joint pain, lower back pain, and swelling in fingers, toes, and feet—before psoriasis, says Dr. Gupta.