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Psoriasis and Asthma: What’s the Connection?

Medically reviewed by Steven Devos, M.D., Ph.D.
Written by Emily Wagner, M.S.
Posted on February 20, 2024

Psoriasis and asthma may seem unrelated, but doctors and researchers have found that there may be a connection. MyPsoriasisTeam members have reached out to others to ask if they have any information. “Have a question. Does anyone know if there’s a link that psoriasis sufferers are more likely to become asthmatic?” asked one member.

In this article, we’ll cover what psoriasis and asthma are and how they’re related to each other. We’ll also go over whether your psoriasis treatments may make your asthma symptoms worse. If you’re living with both conditions, it’s important to talk to your doctor or dermatologist. You can work together to create the best treatment plan and manage your psoriasis and asthma. Your doctor can also talk to you about other conditions related to psoriasis.

What Is Psoriasis?

Psoriasis is a skin condition that makes your skin dry, itchy, and scaly because of problems with the immune system. Too much inflammation causes skin cells to grow and shed too quickly. Normally, your skin replaces old cells with new ones every month. Psoriasis speeds up this process to just three to four days. As skin cells build up, they create raised lesions or plaques — especially along the scalp, elbows, and knees.

Psoriasis involves specific immune cells known as T cells. Normally, these cells help activate other immune cells and protect your body from infections. People with psoriasis have an overactive immune system that causes T cells to attack their skin cells.

Doctors and researchers aren’t exactly sure why the immune system overreacts, but there are certain triggers that can lead to symptoms. Examples of common psoriasis triggers include:

  • Injuries to your skin, like sunburn, cuts, or scrapes
  • Stress
  • Dry and cold weather
  • Certain medications, like antidepressants and corticosteroids for inflammation
  • Consuming alcohol
  • Smoking tobacco
  • Infections like strep throat

Psoriasis symptoms tend to come and go over time in flare-ups (symptoms worsening) and remission (symptom clearance). It’s important to work on avoiding your triggers to better control your psoriasis.

What Is Asthma?

Asthma is a chronic (long-term) lung disease that causes airway inflammation and swelling in the lungs. This inflammation also triggers mucus production, making it harder to breathe. When living with asthma, your airways are especially sensitive to:

  • Allergens (substances that trigger allergic responses) like pollen
  • Irritants like pollution or tobacco smoke
  • Viruses
  • Acid reflux (a condition that causes stomach acid to back up into your throat)
  • Bad weather, like dry and cold weather in the winter or high humidity
  • Physical exercise

Coming in contact with a trigger can make your asthma symptoms worse — known as a flare-up or asthma attack. During a flare-up, you’ll cough, wheeze, and have trouble breathing. These symptoms usually go away with rescue treatment. Leaving asthma untreated can cause scarring and permanent changes to the airways, making it harder to breathe.

Like psoriasis, it’s important to avoid your asthma triggers. You can also take maintenance medications to prevent asthma attacks and live a healthier life.

Psoriasis and Asthma Share Risk Factors

Many people wonder whether their psoriasis can trigger asthma. It’s important to note that this isn’t the case. Instead, studies show that these two conditions share risk factors and can develop in similar ways.

You may be at an increased risk of developing either asthma or psoriasis if you have a family history of either condition, such as having a parent or sibling with it. Smoking tobacco can also raise the risk of these conditions because it contributes to inflammation.

Psoriasis and asthma also share some comorbidities — meaning that similar conditions also occur alongside them. For example, people with psoriasis and asthma also tend to have a high body mass index (BMI).

Psoriasis, Asthma, and Inflammation

Although the two conditions seem different on the outside, psoriasis and asthma share similar causes. Both are caused by extra inflammation affecting the skin in psoriasis or the airways in asthma.

Your immune system uses chemical messengers known as cytokines to create inflammation. Researchers have found that a type of cytokine called interleukins play a role in both psoriasis and asthma. Specifically, interleukin (IL)-17a helps recruit T cells to the skin. These cells are responsible for creating inflammation that causes your dry, red, itchy skin in psoriasis.

Studies in both animals and humans have found that IL-17 also plays a role in asthma. Researchers note that people with asthma have certain changes in the IL-17 gene that others don’t. This inflammatory messenger can also be found in the airways of those with asthma.

Does Psoriasis Increase the Risk of Asthma?

Studies show that people with psoriasis are more likely to develop asthma compared to those in the general population. One study from Taiwan looked at more than 10,000 people with psoriasis and 41,000 people without it. The authors found that people with psoriasis are 1.38 times as likely to develop asthma compared to those without.

For example, if the risk of developing asthma is 5 percent for people without psoriasis, the risk for those with psoriasis is 6.9 percent. This means the overall risk of asthma with psoriasis is slightly higher. The study authors also found that people ages 50 to 64 with psoriasis are 1.49 times as likely to develop asthma, and those 65 and older are 1.63 times as likely.

Just because you’re more likely to develop asthma with psoriasis, it doesn’t mean you will. Many people with risk factors never develop a condition.

Certain Psoriasis Treatments May Worsen Asthma Symptoms

The U.S. Food and Drug Administration (FDA) often approves medications for treating more than one condition. Biologics are lab-made protein drugs used to treat inflammatory diseases like psoriasis and asthma. For example, the biologic drug dupilumab (Dupixent) is approved for treating asthma and another skin condition known as atopic dermatitis (the most common type of eczema).

Researchers are always looking for new ways to treat people with previously approved drugs. Risankizumab-rzaa (Skyrizi) was approved in 2019 for treating moderate to severe plaque psoriasis and psoriatic arthritis. Because psoriasis and asthma are both caused by overactive inflammation, researchers thought risankizumab-rzaa would also work to treat asthma.

However, a clinical trial from 2021 found that treatment with risankizumab-rzaa doesn’t help improve severe asthma symptoms. In fact, people in the study who received the biologic treatment had worse asthma than those who received a placebo (inactive drug treatment).

MyPsoriasisTeam Members Share Their Experiences With Psoriasis and Asthma

MyPsoriasisTeam members have also found that their psoriasis medications can make asthma worse. One shared, “I also have asthma and psoriasis, it’s tough. I’m not coming off a biologic due to getting too many lung infections while on it. The lung infections set off my asthma.”

“I’m having a really bad time at the moment. My psoriasis was under control but then my asthma was bad, so I was prescribed oral steroids. It treated my asthma, and initially my psoriasis but as soon as my steroids stopped, my psoriasis is now worse than ever,” shared another member.

If you’ve noticed your psoriasis or asthma getting worse after starting or stopping a treatment, make sure to talk to your doctor. They can adjust your dose or change medications to help you control both conditions. Do not discontinue your medications without consulting your health care providers.

Find Your Team

On MyPsoriasisTeam, the social network for people with psoriasis and psoriatic arthritis and their loved ones, more than 125,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis and psoriatic arthritis.

Are you living with psoriasis and asthma? What other questions do you have? Share them in the comments below, or start a conversation by posting on your Activities page.

Posted on February 20, 2024
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Steven Devos, M.D., Ph.D. received his medical degree and completed residency training in dermatology at the University of Ghent, Belgium. Learn more about him here.
Emily Wagner, M.S. holds a Master of Science in biomedical sciences with a focus in pharmacology. She is passionate about immunology, cancer biology, and molecular biology. Learn more about her here.

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