Hormones like cortisol and estrogen may lead to psoriasis symptoms.
Your hormones play a complex role in your health. They help you know when it’s time to eat, time to sleep, and time to flee a dangerous situation. Hormones also play a role in your psoriasis. High levels of certain hormones could trigger a flare or worsen your symptoms.
Stress Hormones and Psoriasis
Some of the hormones that may affect psoriasis are stress hormones—namely cortisol and adrenaline. Your body releases these when you’re in a stressful situation because they help prep your body for “fight or flight.” They help increase your heart rate and blood pressure so that you have more oxygen supply and energy.
However, high levels of cortisol and adrenaline can also lead to low levels of inflammation in the body over time. Since psoriasis is already an inflammatory disease, this extra inflammation can make psoriasis symptoms worse.
That’s why stress management is an important part of your psoriasis treatment. Examples of good stress management include:
- Taking breaks at work
- Exercising regularly
- Getting enough sleep
- Using relaxation techniques (like meditation)
- Eating regularly to avoid low energy
- Limiting or avoiding drugs and alcohol
The Complex Role of Estrogen
Female sex hormones like estrogen have a complicated role in your psoriasis. Estrogen can actually have an anti-inflammatory effect, and that could benefit your psoriasis symptoms.
However, estrogen may also have a negative effect on cell turnover. This is the rate at which you shed your dead skin cells and replace them with newer skin cells. People with psoriasis already do this at a higher rate, so new skin cells build up before you’re ready to shed your old ones. This is what leads to thick plaques.
Estrogen levels change drastically throughout a woman’s life, particularly throughout the menstrual cycle, during pregnancy, and during menopause. Both estrogen and progesterone go up during pregnancy, and about half of pregnant women with psoriasis find that their symptoms improve during this time. After childbirth, these hormones go back down, and symptoms may reappear.
How Do You Know If Hormones Are Causing a Flare?
Remember, there are many triggers for a psoriasis flare. It’s helpful to keep a symptom diary to help you notice patterns, which can help you pinpoint your own unique triggers. If you’re repeatedly having flares during times of stress, or life events linked to estrogen changes, these might be triggers for you.
No matter what stage of life you’re at, there are safe and effective treatments that can help you find relief from your skin condition. Talk to your doctor about what is appropriate for you, or if you think your current treatment isn’t the right fit for you.
Heather Summe, MD, is a dermatologist in New York City. Dr. Summe is the Chief of the Division of Dermatology at Lenox Hill Hospital. She is also an Assistant Professor of Dermatology at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell.
- Ceovic R, Mance M, Mokos ZB, Svetec M, Kostovic K, Buzina DS. Psoriasis: female skin changes in various hormonal stages throughout life—puberty, pregnancy, and menopause. Biomed Res Int. 2013:571912.
- Roman II, Constantin A, Marina ME, Orasan RI. The role of hormones in the pathogenesis of psoriasis vulgaris. Clujul Med. 2016;89(1):11-18.
- Pregnancy and breastfeeding. National Psoriasis Foundation. (Accessed on May 11, 2021)