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Does Psoriasis Affect Life Expectancy?

Posted on April 29, 2022
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Joan Grossman

Psoriasis is not a fatal disease, but it does increase the risk of comorbidities (coinciding medical conditions) that may reduce life expectancy. People with moderate to severe psoriasis have a life expectancy that is on average five years shorter than the general public. This is primarily due to an increased risk of cardiovascular disease. However, managing psoriasis symptoms may decrease the risk for comorbidities — and help increase lifespan.

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.

Life Expectancy and Psoriasis

Moderate psoriasis is defined as having plaques that affect 3 percent to 10 percent of the body surface area. Severe psoriasis involves 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 a mortality rate — or risk of death — that is nearly double that of the general population.

Risk factors that are associated with moderate to severe psoriasis include:

  • Family history of psoriasis
  • Smoking
  • Excessive alcohol intake
  • Presence of comorbidities
  • Male gender
  • Diagnosis before age 30
  • Living in an urban area

Some systemic treatments (whole-body treatments) such as biologics and methotrexate (Otrexup) have been shown to reduce mortality risk. Biologic treatments were 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 more.

Psoriasis and Comorbidities

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

Metabolic syndrome is a group of conditions that increases the risk of cardiovascular disease, stroke, and type 2 diabetes. People with metabolic syndrome have a cluster of conditions, including:

  • High blood pressure (hypertension)
  • Abnormal cholesterol and triglyceride levels
  • High blood sugar
  • Obesity with excessive belly fat

People with psoriatic disease — psoriasis or psoriatic arthritis — have metabolic syndrome at about twice the rate of people without psoriatic conditions. Metabolic syndrome is more common in people with more severe psoriasis. It is linked to changes in the immune system that lead to inflammation, disorders in the gut microbiome, 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, losing weight, and eating a healthy diet are also essential steps to prevent or treat metabolic syndrome.

Cardiovascular Disease

The connection between psoriasis and cardiovascular disease — or heart 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 that are associated with psoriasis and the development of cardiovascular disease include:

  • Obesity
  • Abnormal cholesterol and blood fat (lipid) levels
  • Diabetes
  • High blood pressure (hypertension)
  • Metabolic syndrome
  • Smoking
  • High alcohol consumption
  • Psoriatic arthritis with psoriasis

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:

  • Methotrexate (Otrexup)
  • Tumor necrosis factor-alpha inhibitors, a type of biologic therapy
  • Fumaric acid esters

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.

Cancer

Psoriasis has been linked 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.

One study also found that people with severe psoriasis had a 22 percent higher overall risk of dying from cancer than people without psoriasis.

Manage Your Risk and Support Your Overall Health

People with psoriasis can benefit from early and regular treatment. Treating your psoriasis can reduce the risk of comorbidities that may reduce lifespan. Be sure to maintain your treatment plan. Discuss your treatment options with your dermatologist if you are not satisfied with your treatment. 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:

  • Chest pain or shortness of breath
  • Unexpected weight loss
  • Fever
  • Fatigue

Important Lifestyle Changes

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:

  • Quitting smoking to reduce psoriasis flare-ups, prolong remission, and decrease the risk for other autoimmune diseases. (However, do not use a nicotine patch to stop smoking without medical advice. Some people with psoriasis may experience psoriasis flares from nicotine patches.)
  • Reducing alcohol intake to improve treatment effectiveness and reduce the risk of some comorbidities
  • Maintaining a healthy weight to improve treatment outcomes and reduce the risk of cardiovascular disease, diabetes, and liver disease
  • Eating a healthy diet to reduce the risk of comorbidities and improve your general health
  • Getting regular exercise to improve your physical and mental health and reduce the risk of cardiovascular disease and other comorbidities

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.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. Here, more than 107,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

Do you have questions about psoriasis and life expectancy? Share your experiences or questions in the comments below, or start a conversation by posting on your Activities page.

References
  1. Does Biologic Treatment of Psoriasis Lower the Risk of Cardiovascular Events and Mortality? A Critical Question That We Are Only Just Beginning To Answer — Journal of the American Academy of Dermatology
  2. Cause-Specific Mortality in Patients With Severe Psoriasis: A Population-Based Cohort Study in the United Kingdom — British Journal of Dermatology
  3. Objective Measures of Psoriasis Severity Predict Mortality: A Prospective Population-Based Cohort Study — Journal of Investigative Dermatology
  4. Clinical and Epidemiological Factors Predicting the Severity of Psoriasis — An Interdisciplinary Approach to Psoriasis
  5. Reduced Risk of Mortality Associated With Systemic Psoriasis Treatment in the Psoriasis Longitudinal Assessment and Registry (PSOLAR): A Nested Case-Control Analysis — Journal of the American Academy of Dermatology
  6. Psoriasis: Classical and Emerging Comorbidities — Anais Brasileiros de Dermatologia
  7. Metabolic Syndrome: Symptoms and Causes — Mayo Clinic
  8. Psoriasis and the Metabolic Syndrome — Clinics in Dermatology
  9. All-Cause and Cause-Specific Mortality in Psoriasis: A Systematic Review and Meta-Analysis — Journal of the American Academy of Dermatology
  10. Metabolic Syndrome and Psoriasis: Mechanisms and Future Directions — Frontiers in Immunology
  11. Prevention and Treatment of Metabolic Syndrome — American Heart Association
  12. Does Treating Psoriasis Reduce the Risk of Heart Disease and Stroke? — American Academy of Dermatology Association
  13. Psoriasis and Cardiovascular Comorbidities: Focusing on Severe Vascular Events, Cardiovascular Risk Factors, and Implications for Treatment — International Journal of Molecular Sciences
  14. Association of Psoriasis With the Risk of Developing or Dying of Cancer: A Systematic Review and Meta-Analysis — JAMA Dermatology
  15. Related Conditions of Psoriasis — National Psoriasis Foundation
  16. Healthy Diet and Other Lifestyle Changes That Can Improve Psoriasis — American Academy of Dermatology Association

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Joan Grossman is a freelance writer, filmmaker, and consultant based in Brooklyn, NY. Learn more about her here.

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