Psoriasis is a chronic skin condition. Beyond its visible signs, many individuals experience profound and persistent tiredness, known as fatigue, which significantly impacts daily life. This common symptom is often overlooked. This article explores the connection between psoriasis and fatigue, its underlying causes, and management strategies.
Psoriasis and Fatigue: The Connection
Fatigue in psoriasis is a deep, unremitting exhaustion that does not improve with rest. Many report this constant weariness as a challenging symptom, affecting physical and mental capabilities. Studies indicate a significant number of psoriasis patients experience severe fatigue, with rates as high as 17% in those with psoriasis and up to 28% in individuals with psoriatic arthritis (PsA). This fatigue can interfere with physical function, mental clarity, and social engagement, sometimes leading to withdrawal from usual activities.
Factors Contributing to Fatigue in Psoriasis
Psoriasis is a systemic inflammatory condition, affecting the entire body. The chronic inflammation characteristic of psoriasis plays a direct role in fatigue. The immune system, in a state of constant overdrive, releases inflammatory proteins called cytokines, such as TNF-alpha and IL-6. These cytokines consume a significant amount of the body’s energy, leading to a persistent feeling of being worn out.
Sleep disturbances are another common contributor to fatigue. The itching, burning, and discomfort from psoriasis lesions can make it difficult to fall asleep and stay asleep, leading to poor quality sleep and daytime exhaustion. Research indicates that over half of individuals with psoriasis report trouble sleeping, with a substantial percentage getting less than the recommended seven hours of sleep per night. This creates a cycle where discomfort disrupts sleep, and poor sleep can, in turn, worsen psoriasis symptoms.
Chronic pain, especially for those with psoriatic arthritis, further drains energy. Joint pain and stiffness can be physically and mentally taxing, making movement difficult and contributing to overall weariness. Fatigue associated with psoriatic arthritis is often more severe than in psoriasis without joint involvement, and studies show a strong link between fatigue and joint pain.
The psychological burden of living with a chronic, visible condition like psoriasis also contributes to profound fatigue. Anxiety, depression, and stress are commonly experienced by individuals with psoriasis, and these mental health factors can significantly impact energy levels. Depression and psoriasis can exacerbate each other, creating a cycle that intensifies symptoms like fatigue.
Certain medications used to treat psoriasis can also cause fatigue as a side effect. For instance, drugs like methotrexate, commonly prescribed for psoriasis and psoriatic arthritis, can lead to tiredness. Biologic treatments, while effective in reducing inflammation, may also contribute to a feeling of being rundown in some individuals.
Managing Psoriasis Related Fatigue
Effectively managing psoriasis is often the primary step in reducing related fatigue. Treating the underlying inflammation with appropriate therapies, such as biologics or systemic medications, can significantly improve energy levels. When the disease activity is better controlled, the body’s immune system is less overactive, conserving energy that was previously consumed by inflammation.
Improving sleep hygiene can also make a substantial difference. Establishing a consistent sleep schedule, even on weekends, helps regulate the body’s internal clock. Creating a comfortable, dark, cool, and quiet sleep environment, and avoiding screens, caffeine, and alcohol before bed, can enhance sleep quality. Moisturizing skin before bed can help alleviate itching and discomfort that might disrupt sleep.
Stress management techniques are valuable as stress can worsen both psoriasis and fatigue. Practices such as mindfulness, meditation, or yoga can help reduce stress levels and promote relaxation. Engaging in hobbies or activities that bring enjoyment can also provide a mental break and help manage the psychological burden of the condition.
A balanced diet and regular, moderate exercise can boost energy and overall well-being. Eating whole grains, fresh fruits, vegetables, and lean proteins helps maintain stable energy levels. While fatigue can make exercise seem challenging, low-impact activities like walking or swimming can improve energy and reduce pain over time.
Practicing energy conservation, or “energy pacing,” involves learning to recognize and respect personal energy limits. This means distributing activities throughout the day, taking breaks, and prioritizing tasks to avoid overexertion. Delegating tasks and learning to say “no” can also help preserve energy.
When to Consult Your Healthcare Provider
If you experience significant, persistent, or worsening fatigue with psoriasis, consult your healthcare provider. Fatigue is a legitimate symptom that warrants medical attention and should not be dismissed.
A healthcare provider can also rule out other potential medical conditions that might be contributing to your tiredness, such as anemia, thyroid issues, or sleep apnea. They may recommend blood tests or a sleep study to investigate these possibilities. If mental health concerns like depression or anxiety are contributing to fatigue, your doctor can suggest appropriate support, including referrals to mental health professionals.