Psoriasis and AS: The Stress Connection

Several years ago, my boyfriend and I moved into a new, lovely apartment with a killer view of the NYC skyline. We were so excited for the move, but it was also incredibly stressful.

I was commuting to and from a new job in another state, and taking a subway and then a bus back and forth, totaling three+ hours of commuting per day. My body was exhausted, and this led to extreme disease activity (and eventually quitting my job).

When I made this move, the train commute to the bus stop got a little bit more complicated, so I was losing sleep and stressed out about the commute. Hobbling around in the morning was literally killing me.

A less than ideal situation

Back to that gorgeous view: As it turns out, a combination of elevator phobia and fear of heights wasn’t working for me. Let’s just say living on the 29th floor was not ideal. I started dreading the elevator and hated the building sounds I could hear when the weather was bad. Yes, the building made noise in the wind. No, this is not cute. 

Because the mind is inextricably connected to the body, there were so many physical manifestations of this strange moving/new job stress. Aside from all the wonderful side effects you get with AS, I also experienced psoriasis (PsO). I knew that psoriasis was potentially linked to ankylosing spondylitis since psoriatic arthritis is part of the umbrella of spondyloarthropathies.

And so, little psoriasis patches bloomed all of my shins. They were dry and red and circular, like guttate psoriasis. They were itchy and becoming more and more noticeable. I called it a stress rash, but it was quickly given a name: PsO.

Scalp psoriasis triggered by stress

Over the past few years, I also started noticing scalp psoriasis, little, nearly-invisible patches at the base of my scalp and my hairline. Stress triggers this as well, I've noticed, as do certain chemicals in my hair or not washing my hair enough. I have thick, coarse, wavy hair, and washing it often isn’t always the best solution for me, but I have to keep it clean, or else I pay the price with itchy little patches.

During the early months of the pandemic in 2020, the stress was definitely eating me alive — like everyone else. I was Cloroxing all of my groceries and crying while watching the news. My city became a living morgue, with bodies being put into bags and placed into trucks on the street. The place where I had graduated became a makeshift hospital.

Like the rest of the world, I internalized all this fear and anxiety, and even though I wouldn’t end up getting Covid for a year later, the stress made an impact on me.

Eyelid psoriasis triggered by stress

At this time I started noticing little, bumpy, circular red patches on my eyelids. I didn’t know it at the time, but it was also psoriasis. It was itchy and red and flared up and down for months.

Ultimately, what helped a lot was getting out of NYC and de-stressing. So we packed everything we had — along with our cat — and got into a van and drove straight to a beach-side house. We stayed inside away from people or walked the beach and saw no other people. This little getaway was exactly what I needed mentally, and what my body needed at the time. Taking a walk in nature outside on the beach all alone was just what I needed to reduce my cortisol levels. Within a few weeks, the patches on my eyelid were diminished. (And yes, I'm very grateful we got to do this).

Do you get psoriasis when you are stressed or as part of your ankylosing spondylitis flareups? I’d love to hear.