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How Does Psoriasis Affect Quality of Life?

The Impact of Psoriasis on the Life Style of the Patients

Jan 4, 2009 Hanish Babu

Psoriasis has an immense impact on social life, with quality of life being adversely affected at personal, family, professional and social levels.

Psoriasis is one of the most prevalent skin conditions in the world, affecting 2-3% of the population. This chronic condition has a significant negative impact on patients' quality of life. Psoriasis has been linked to depression and suicidal tendencies in the patients.

In a number of published studies, patients with psoriasis have reported reduction in physical and mental functioning comparable to that seen in cancer, arthritis, hypertension, heart disease, diabetes, and depression. In a survey by the National Psoriasis Foundation almost 75% of patients believed that psoriasis had moderate to large negative impact on their quality of life (QoL), with alterations in their daily activities. Another study reported that at least 20% of psoriasis patients had contemplated suicide at least once in their lives.

Psoriasis is well known to interfere with daily activities and sexual functions; generate psychological distress, and disrupt social relationships. These, in effect, create a vicious stress-psoriasis cycle which is responsible for the worsening of the condition in majority of patients.

It is estimated that psoriasis afflicts approximately 2.6% of the US population, costs the nation between $2 billion and $4 billion each year, and is associated with a high risk of suicide among the patients.

This being the fact, it is extremely important to realize that the severity of psoriasis is directly proportional to the degree to which psoriasis affects the quality of life of the patient.

The chronic and recurring nature of this disease often brings about a feeling of hopelessness in most patients. Patients are constantly concerned about the unexpected outbreaks of the disease which could interfere with their ongoing or future plans. The high and recurring cost of treatment compounds the helplessness of the patients. Lack of control over the disease activity is one of the most bothersome aspects in psoriasis patients.

Depending upon how psoriasis affects the quality of life in patients, psoriasis may be divided into 3 categories:

Mild Psoriasis: Generally less than 5% of body surface area is involved with disease.

Disease does not alter the patient’s quality of life. A mild anxiety, may be.
Patients can minimize the impact of disease and may not require treatment.
Treatments have no known serious risks (e.g., class 5 topical steroids).

Moderate Psoriasis: Generally between 5% and 10% of body surface area is involved with disease.

Disease does alter the patient’s quality of life, up to an extent. If recurrence occurs too often, the quality of life will be compromised.
The patient expects therapy will improve quality of life.
Therapies used for moderate disease have minimal risks, as mostly topical therapies suffice.

Severe Psoriasis: Generally more than 10% of body surface area is involved with disease.

Disease alters the patient’s quality of life. They often experience difficulties in adapting to the daily stress, problems in body image, self esteem, self concept and also have feelings of stigma, shame and embarrassment regarding their appearance among family as well as public.
Disease does not have a satisfactory response to treatments that have minimal risks. The systemic treatments that are effective are limited by their high risk profile. Most patients have to religiously follow the psoriasis treatment guidelines prescribed by their dermatologist to achieve optimum results desired.
Patients are willing to accept life-altering side effects to achieve less disease or no disease.

Next: Handling the Psycho-Social Problems in Psoriasis

Related Reading: Does Stress Cause Psoriasis?

Reference:

Krueger G et al. The Impact of psoriasis on Quality of Life. Arch Dermatol. 2001;137:280-284.
Monali J Bhosle et al. Quality of life in patients with psoriasis. Health Qual Life Outcomes. 2006; 4: 35.

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