3 Ways Psoriasis Can Affect Your Social Life—and How to Cope

If you’re one of the roughly 8 million people in the U.S. living with psoriasis, you know that flare-ups aren’t just itchy, painful, or both. They can also have a significant impact on your psychological well-being. This is especially true if you tend to avoid social situations to hide your skin, which can be particularly isolating.

“People often think of psoriasis as a skin condition, but it’s much more than that, affecting people’s mental health and their quality of life,” says Catherine O’Leary, PhD, a clinical psychologist and the author of Coping With Psoriasis: Understanding and Navigating the Emotional Challenges. She knows the struggle all too well—her book draws from her own experience navigating severe psoriasis since childhood as a teenager. “I used to do my best to hide my skin and the distress I was feeling, and that meant I missed out on a lot,” she says. “I wouldn’t go away with friends if I had to share a room or bathroom. I would never do anything that involved a swimsuit, including lying by the hotel pool with everyone else on vacation. I would turn down invitations to outdoor summer parties because choosing an outfit [to cover my plaques] would be too stressful. Over the years it had a big impact on my social life.”

As Dr. O’Leary got older she found ways to feel more at ease with her psoriasis. “My younger self would not have believed how confident I am now with showing my skin. This hasn’t happened overnight, and there are still times when it feels hard. But I now have a toolbox of different strategies that help me cope.” Today, as a clinician and author, she helps other people with psoriasis work through issues like anxiety, low self-esteem, depression, and social challenges using many of those same strategies so they can participate in life more fully. The best part is she’s sharing them with Glamour too.

Read on to learn how to overcome some of the most common social challenges among people with psoriasis.

The challenge: You feel like everyone is judging you.

There are some prevailing myths and misconceptions about psoriasis, including that it’s a contagious skin disease or a result of poor hygiene. So when someone with psoriasis walks into a room, it’s only natural that they might wonder, What if people are thinking these ridiculous things about me? “Our minds can go into overdrive, and we imagine that everyone is looking and judging us,” Dr. O’Leary says.

How to cope: An experienced therapist can help you develop ways to break negative thought patterns like these, which can feed social anxiety; Dr. O’Leary recommends finding a practitioner that specializes in cognitive behavioral therapy (CBT), a treatment research suggests can help improve anxiety and depression symptoms associated with psoriasis (and potentially even reduce skin flare-ups as a result).

If you don’t have access to CBT or can’t get an appointment right away, Dr. O’Leary says to practice catching yourself when your thoughts begin to escalate. “Thoughts like ‘Everyone is looking at my skin and judging me’ can quickly lead to me feeling bad about myself,” she says. “Instead I try to be aware of my thinking and spot when I’m jumping to conclusions, catastrophizing, or trying to mind-read. I remind myself that just because I think something doesn’t mean it’s the truth, and there may be more balanced ways of thinking about a situation.”

The challenge: Intimacy is intimidating.

Dating with psoriasis can bring about its own set of difficulties. Some people may avoid pursuing intimacy because they dread someone seeing and touching their skin. Complicating matters is the fact that for up to 63% of individuals with psoriasis, the condition also impacts the genital area, which can cause itching, pain, and feelings of shame, not to mention necessitate conversations about flare-ups not being symptoms of a sexually transmitted disease. Because of challenges like these, genital psoriasis is linked to higher rates of depression, relationship challenges, and sexual dysfunction, according to Dr. O’Leary.