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.
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:
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 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 have a cluster of conditions, including:
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.
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:
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.
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.
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:
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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