Psoriasis is not a fatal disease, but it does increase the risk of developing comorbidities that may reduce a person’s life expectancy. People with moderate to severe psoriasis have a life expectancy that is, on average, five years shorter than people without psoriasis. This is primarily due to an increased risk of cardiovascular disease. However, managing psoriasis symptoms may decrease the risk for comorbidities — and help increase life span.
If you’re living with psoriasis, it’s a good idea to understand why psoriasis impacts life expectancy and how you can manage your risk.
The National Psoriasis Foundation defines “moderate psoriasis” as having plaques that affect 3 percent to 10 percent of the body surface area. “Severe psoriasis” refers to having plaques on more than 10 percent of the body surface area.
One study showed that people who have psoriasis on more than 10 percent of their bodies have an increased mortality risk — or risk of death — compared to people without psoriasis.
Risk factors associated with moderate to severe psoriasis include:
Some systemic (whole-body) treatments such as biologics and methotrexate (Otrexup) have been shown to reduce mortality risk. Biologic treatments have been shown to reduce the risk of mortality in as few as three months of therapy. As researchers develop more systemic treatments for psoriasis, mortality rates may decrease further.
Psoriasis is more than a skin disease. It causes chronic inflammation that is associated with many comorbidities, including psoriatic arthritis, inflammatory bowel disease, cardiovascular disease, and depression. Comorbidities that may particularly affect life expectancy include metabolic syndrome, cardiovascular disease, and cancer.
Metabolic syndrome is a group of conditions that increases the risk of cardiovascular disease, stroke, and type 2 diabetes. People with metabolic syndrome may have a cluster of medical conditions, including:
People with psoriatic disease — psoriasis or psoriatic arthritis — develop metabolic syndrome at at least twice the rate of people without psoriatic conditions. Metabolic syndrome is more common in people with more severe psoriasis. It’s linked to changes in the immune system that lead to inflammation, disorders in the gut microbiome (microorganisms that naturally live in the digestive tract), and oxidative stress that can damage DNA and cells.
People with metabolic syndrome also have a higher risk of liver disease and kidney disease. Both of these diseases are associated with a decrease in life expectancy among people with psoriasis.
Lifestyle changes are key to preventing and treating metabolic syndrome. Some people with metabolic syndrome may need medications to control their high cholesterol and blood pressure. Getting regular physical activity, maintaining a healthy weight, and eating a healthy diet are also essential steps to prevent or treat metabolic syndrome.
The connection between psoriasis and cardiovascular disease is rooted in inflammation. Researchers believe that chronic inflammation in moderate to severe psoriasis may impact the heart and blood vessels. This can increase the risk of cardiovascular disease and raise the risk of a life-threatening heart attack or stroke.
Risk factors associated with psoriasis and the development of cardiovascular disease include:
Some treatments for psoriasis have been shown to protect against cardiovascular disease, while others may increase the risk. Treatments that are linked with a decrease in the risk of cardiovascular disease include:
Other treatments may increase the risk of cardiovascular disease in some people. These include cyclosporine and acitretin (Soriatane). Be sure to talk to your doctor before making any changes to your treatment plan.
Researchers have linked psoriasis to an increased risk of developing cancer. People with psoriasis have a higher risk of developing cancer of the liver, colon, kidney, and pancreas, as well as lymphoma. Cancer with psoriasis is associated with alcohol consumption, smoking, and obesity.
People with psoriasis can benefit from early and regular treatment. Treating your psoriasis can help reduce the risk of comorbidities that may reduce life span. Be sure to follow your treatment plan. Discuss your treatment options with your dermatologist if you’re not satisfied with your treatment results. Do not stop treatment without medical advice.
Regular treatment and follow-up for psoriasis can help ensure that you are properly monitored for comorbidities and complications that may impact your risk of mortality. Seek medical care if you have symptoms that may indicate a comorbidity, such as:
You can take steps to improve your overall health and quality of life. Lifestyle changes can boost your sense of well-being and improve your psoriasis symptoms. According to the American Academy of Dermatology Association, some of the most important lifestyle changes you can make include:
Talk to your health care team if you need help making lifestyle changes. They can provide referrals to dietitians, physical therapists, and mental health professionals.
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