A: Psoriasis, probably due to so many TV ads about over-the-counter treatments over the years, is a word most of us have heard before. “The heartbreak of psoriasis” still rings in my ears when I think about those ads! But what is psoriasis, really, and how could yoga practices influence its course?
Psoriasis is primarily a skin condition that has a very distinct pattern, which involves thickened patches, called plaques, which often, but not exclusively, appear over the boney areas around the joints. You may have even seen someone with this affecting their elbows, as this is likely the area of the body that would be exposed to your view, especially in short-sleeve shirt seasons. According to the Mayo Clinic:
“Psoriasis is a common skin condition that changes the life cycle of skin cells. Psoriasis causes cells to build up rapidly on the surface of the skin. The extra skin cells form thick, silvery scales and itchy, dry, red patches that are sometimes painful.”
Some would consider the patches unsightly, perhaps, but is likely the itching and pain that are going to be of more importance in leading to treatment of the condition for those who have it. It is a chronic condition without a cure at this time. Treatments your doctor may offer are directed at addressing the plaques and stopping the skin cells from growing so quickly. Even over the counter steroid creams and exposure of the skin to natural sunlight may help.
In addition to plaques on the joints, patches of psoriasis can also occur on the neck, in the scalp, in the folds of flesh, such as under the breasts, and on the fingernails. This varies from person to person. You are usually encouraged to seek medical attention if your patches go beyond simple itching and are painful and uncomfortable, if they interfere with your daily activities, or if you find the appearance troubling.
Although not fully understood, psoriasis is at least partly an autoimmune disease, where your immune system mistakes your cells for outside invaders. In this case, your specialized white blood cells known as T cells attack your healthy skin cells by mistake and start the inflammatory ball rolling. Yoga has been shown to have a beneficial effect on supporting a healthier immune system, so this may be one way in which yoga could be of benefit to psoriasis sufferers.
It also turns out that certain “triggers” can lead to flares in these people. Some of these triggers include: trauma to your skin (for example, from bad sunburns, scrapes, insect bites, or cuts), acute infections, heavy alcohol use, smoking, and even cold weather and good old stress. As we have often written about here at YFHA, yoga has been demonstrated to reduce stress levels, and the mindfulness skills of yoga could lead to improved self awareness that could improve your chances of identifying a trigger sooner and addressing it before it worsens you skin condition. Yoga practices can also support changing unhealthy lifestyle choices, such as smoking, and could help alcoholism and/or heavy alcohol use.
Some of these triggers also turn out to be risk factors for developing psoriasis in the first place, such as unaddressed stress and smoking. In addition, a family history of one parent or both parents having psoriasis is the biggest risk factor for developing it yourself. Obesity is another risk factor, as is serious infection like HIV, or people with recurring infections, such as ongoing strep throat. Yoga, again, can be helpful in addressing stress, smoking and can be helpful in some instances if you desire to lose weight.
It has also been observed that people with ongoing psoriasis can lead to other quality of life issues that put you at greater risk for low self-esteem, depression, or social isolation. The successes one might experience in a regular yoga class might lead to improved self-esteem, and regular attendance of a public class could help combat social isolation. And depression has been studied and found to improve with yoga, so even more reasons for adopting a regular practice!
Finally, there is a complication of psoriasis known as psoriatic arthritis, in which the psoriasis causes the same kind of damage to your joints as regular arthritis, leading to pain and dysfunction in your joints. This can be debilitating in more extreme cases. We have written about how yoga can be beneficial for arthritis in these past posts, so to learn more about yoga for arthritis, check out Yoga for Osteoarthritis and our posts on arthritis of specific joints, such as hands or spine (see How to Search).
The biggest caution for someone with active psoriasis who is just starting to do yoga would be making sure the poses you practice do not aggravate your skin symptoms. For example, if you had painful patches on your elbows, practicing forearm balance, which involves pressure and tension on the skin around the elbows, might not be a good idea—at least not while the area is painful or raw. This may seem like a common sense recommendation, but it seems worth stating just in case.
All in all, yoga seems like a good addition to the western medical treatments that someone with psoriasis is already receiving. I know of a few of my students who have psoriasis and they seem to be enjoying regular practice. And I would love to hear from any of our readers who have psoriasis. Has yoga had noticeable positive effects on the course of your psoriasis?
—Baxter
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