Table of ContentsView AllTable of ContentsPsoriasis and ImmunityCOVID-19 RiskCOVID-19 SymptomsCOVID-19 ComplicationsPsoriasis ComplicationsTreatmentsHow to Stay Safe
Table of ContentsView All
View All
Table of Contents
Psoriasis and Immunity
COVID-19 Risk
COVID-19 Symptoms
COVID-19 Complications
Psoriasis Complications
Treatments
How to Stay Safe
Living withpsoriasis, you may wonder howCOVID-19could affect your health and your treatment plan. Fortunately, since 2020, researchers have learned a lot about coronavirus and how it affects different health conditions, including psoriasis.
While psoriasis itself does not make youimmunocompromised, some of the medications you might take to treat the condition reduce your immune function.
Keep reading to learn more about the potential risks of COVID-19 for people with psoriasis, including treatment effects, how to stay healthy and reduce your risk forCOVID-19 complications, and answers to frequently asked questions.
Verywell / Michela Buttignol
Am I Immunocompromised Because I Have Psoriasis?
In people with psoriasis, the immune system mistakenly attacks healthy cells. This is what causes symptoms like plaques and inflammation in the skin and joints.
Psoriasis itself doesn’t make you immunocompromised, however, medications that treat the condition can suppress the immune system. These medications can make you more susceptible to certain infections such as COVID-19.
Psoriasis and COVID-19 Risk
Coronavirus has affected people all across the globe. For those with chronic health conditions like psoriasis, there is concern about COVID-19 and the risk of complications in an already fragile immune system.
What is known is that certain groups are particularly vulnerable to contracting COVID-19 and becoming severely ill. This includes people older than age 65 and people who have serious medical conditions, such as:
While the Centers for Disease Control and Prevention (CDC) doesn’t include people with psoriasis or otherautoimmune diseasesamong those at high risk, many people with psoriasis may have additional conditions that might put them at higher risk for COVID-19.
People with psoriasis also have a higher risk forinfection, including respiratory infections andpneumonia, compared to others in the general population. The risk is even higher for people with severe psoriasis.
According to a 2021 report in theBritish Journal of Dermatology, people with psoriasis have a 36% increased risk for infection and a 33% increased risk of death due to infection.That risk exists with and without factors related to comorbidity (existing conditions).
Comorbidities in Psoriasis
Data were presented at the American Academy of Dermatology Virtual Meeting Experience 2021 regarding the connection between psoriasis and COVID-19 risk andsystemic(whole-body) treatments for psoriasis and how they might contribute to risk.
Overall, the study’s researchers found people with psoriasis were more likely to get COVID-19 when compared to others in the general population. Data showed a 33% increased risk based on the number of people with psoriasis who contracted COVID-19 compared to those without psoriasis (controls) who also contracted the virus.
They speculated that the increased risk was attributable to the use of systemic therapies that could increase the risk for upper respiratory infections, like COVID-19. People with psoriasis also have ahigher risk for comorbidities, such as obesity and high blood pressure—conditions that have been linked to severe COVID-19 infections.
In this study, researchers reviewed data covering more than 280 million people. They identified people ages 20 and older who had either psoriasis or psoriatic arthritis from May 1, 2019, to January 1, 2020. They compared these cases to a follow-up period from January 1 to November 11, 2020. The researchers found that certain medications reduced or increased the risk of COVID-19 infection in the study population:
Symptoms of COVID-19 With Psoriasis
Thesymptoms of COVID-19you might experience with psoriasis are the same as they would be for anyone else who gets COVID-19. The most common symptoms are:
Some people might experience more severe symptoms, such as a high fever and shortness of breath. It takes about two to 14 days to develop symptoms if you have been exposed to COVID-19.
Complications of Psoriasis and COVID-19
If youtest positive for COVID-19, have symptoms, or think you have been exposed to the virus, you should reach out to your primary healthcare provider right away. Be sure to tell them you are takingimmunosuppressive drugsto treat psoriasis.
If you test positive, you should also contact the healthcare provider who treats your psoriasis so they can tell you how to manage your psoriasis care while you are recovering. They might suggest you alter or delay your next dose or treatments that suppress your immune system.
Your healthcare provider will also give you information about treatment options for preventing aflare-up(period of high disease activity) during this time.
There isn’t enough evidence on how COVID-19 affects people with psoriasis or if they might be affected differently than people without psoriasis. Regardless, COVID-19 is highly transmissible and spreads rapidly, which means everyone is at risk. Even if you don’t have symptoms, you can still spread COVID-19.
Serious complications of COVID-19 include:
These complications can affect anyone who contracts the infection, especially those with a higher risk for the condition. But, it is unknown whether people with psoriasis have an elevated risk for these types of complications. The small amount of research available seems to indicate that their risk isn’t different from others in the general population.
One small study reported in 2020 in theNew England Journal of Medicinefound that people with inflammatory diseases like psoriasis who tookbiologicsand developed COVID-19 were not more likely to develop complications than people who weren’t taking these drugs.
An April 2021 report in theJournal of Clinical Medicinesuggests biologics are beneficial to people with psoriasis who contract COVID-19.The report’s authors note that there are many case reports of people with psoriasis who are presenting with mild COVID-19 infections, and these cases mainly seem to have more favorable outcomes.
The authors also note that while higher levels of TNF have been found in people with COVID-19, overall they believe that TNF inhibition is effective in reducing coronavirus and associated complications of COVID-19, including organ damage.
IL-17 inhibition might also be effective in controlling inflammation that could lead to COVID-19 severe disease, but the study’s authors note that the role of IL-23 inhibition and processes in COVID-19 was not yet known.
The study’s authors emphasize the importance of adherence to psoriasis treatments during the current pandemic. They also stress that psoriasis treatment isn’t a prevention tool for COVID-19, and they encouragepeople with psoriasis to get the COVID-19 vaccine.
Long COVID-19 and Psoriasis
Most people who get COVID-19 recover completely within a few weeks. But some will continue to have symptoms, orlong COVID, after their initial recovery. Symptoms in long COVID persist for more than four weeks after the initial COVID-19 diagnosis.
Older adults and people with serious medical conditions are more likely to experience lingering COVID-19 symptoms. Still, even younger, generally healthy people can feel unwell for weeks or months after their infection.
Common long COVID symptoms might include:
Researchers don’t know if people with psoriasis or other autoimmune diseases have a higher risk for long COVID. However, some have been studying the link between COVID-19 and the development of autoantibodies—similar to the same autoantibodies responsible for psoriasisinflammation.
Autoantibodies are immune cells that mistakenly target healthy tissues and organs. The research has shown that these autoantibodies can act as a driving force in long COVID.
While this research is helpful, it doesn’t explain if having pre-existing autoantibodies in psoriasis and other autoimmune conditions could contribute to more severe COVID-19. Additionally, it doesn’t give any indication of how long COVID might affect someone with psoriasis.
Even if an additional risk of long COVID for people with psoriasis exists, most people who have severe psoriasis are already onmedicationsthat counteract the inflammatory response of autoantibodies, which could potentially reduce the risk of long COVID.
Unfortunately, the researchers in the long COVID study did not discuss this issue or the effects of treatment of long COVID in people with psoriasis.
Additional Complications of Psoriasis
Certain immunosuppressant drugs such as cyclosporine can cause kidney damage or high blood pressure. There is also an increased risk of developing skin cancer, especially if you’ve taken other immunosuppressive drugs in the past.
People with psoriasis also have an increased risk of developing conditions such as:
Psoriasis Treatments and COVID-19
People who are immunocompromised are believed to have a higher risk for COVID-19. While this usually applies to people with cancer onchemotherapyand those with poorly controlled HIV/AIDS, it can also apply to people who take medications that affect the function of their immune systems.
People with psoriasis use different immunosuppressive drug therapies, including:
Taking these medicines can partially inhibit your immune system, which adds to your infection risk.
The current guidelines of the American Academy of Dermatology recommend that people who take immunosuppressive drugs continue to take them unless they test positive or if they have symptoms of COVID-19.
According to the National Psoriasis Foundation COVID-19 Task Force, the overall existing data suggest that most treatments for psoriasis “do not meaningfully alter the risks of contracting SARS-CoV-2 or having a worse course of COVID-19 illness.”
The effects of immunosuppressive therapy on the immune system aren’t a reason to stop treatment. Your doctor is the best person to answer questions about your treatment plan. They can also best advise you on how the pandemic might affect your health situation and current treatment plan.
It is never a good idea to make any changes to your treatment plan without first consulting with your doctor. Provided you have not been diagnosed with COVID-19 and don’t have symptoms, sticking to your treatment is an important way to stay healthy. It is also the best way to keep your psoriasis from flaring up and increasing your infection risk.
With psoriasis and a compromised immune system, it’s important to stay healthy. The first step is talking to your healthcare provider about getting aCOVID-19 vaccination. Both the International Psoriasis Council and the National Psoriasis Foundation recommend that people with psoriasis take the vaccine.
So far, research has determined that the vaccine is safe for people with psoriasis. According to the International Psoriasis Council on COVID-19, “There have been some reports of new onset or exacerbation of psoriasis and/or psoriatic arthritis in people receiving COVID-19 vaccines; however, these reports are uncommon, and a causal relationship has not been established.”
Research has also found that one in 10 people with autoimmune diseases, including psoriasis, may not be properly protected against COVID-19.
Although research suggests that people using systemic medications such as methotrexate andRituxan(rituximab) might respond poorly to the vaccine, these findings are still in the early stages.None of the research confirms or suggests that people with autoimmune diseases should avoid vaccination. In fact, the American College of Rheumatology recommends that all people with rheumatic and autoimmune diseases get vaccinated.
They note that even if vaccines do not offer full protection, they are still a benefit to the public. This is because even partial protection can guard against severe symptoms, life-threatening complications, and death from COVID-19.
If you have any concerns about taking the vaccine or worry you might have adverse skin effects from the vaccine, talk to your healthcare provider. They are the best source of information about the vaccine, and they can offer advice based on your unique health situation.
To minimize your risk for COVID-19, consider also taking the following precautions:
Handwashing With PsoriasisPeople who have inflamed skin or scaly plaques on their hands may have a harder time washing their hands or using alcohol-based sanitizers.Try using hypoallergenic foaming soaps, and avoid ones with harsh abrasives and antibacterial formulas. Make sure you rinse well with water.Last, use a thick, hydrating cream after patting your hands dry to moisturize skin. Petroleum-based moisturizers like Vaseline are a good bet.If you find your skin becomes irritated from handwashing or moisturizing, ask your dermatologist about products that might be safer for your psoriasis-prone skin.
Handwashing With Psoriasis
People who have inflamed skin or scaly plaques on their hands may have a harder time washing their hands or using alcohol-based sanitizers.Try using hypoallergenic foaming soaps, and avoid ones with harsh abrasives and antibacterial formulas. Make sure you rinse well with water.Last, use a thick, hydrating cream after patting your hands dry to moisturize skin. Petroleum-based moisturizers like Vaseline are a good bet.If you find your skin becomes irritated from handwashing or moisturizing, ask your dermatologist about products that might be safer for your psoriasis-prone skin.
People who have inflamed skin or scaly plaques on their hands may have a harder time washing their hands or using alcohol-based sanitizers.
Try using hypoallergenic foaming soaps, and avoid ones with harsh abrasives and antibacterial formulas. Make sure you rinse well with water.
Last, use a thick, hydrating cream after patting your hands dry to moisturize skin. Petroleum-based moisturizers like Vaseline are a good bet.
If you find your skin becomes irritated from handwashing or moisturizing, ask your dermatologist about products that might be safer for your psoriasis-prone skin.
Summary
Having psoriasis does not put you into a high-risk group for COVID-19 infection or complications. People with psoriasis who are taking immunosuppressive therapy should continue to do so. If you test positive for COVID-19, your healthcare professional will advise what modifications may be needed.
The COVID-19 vaccine is recommended for people with psoriasis. It, and standard infection-prevention precautions, are the best way to avoid COVID-19.
Can I Test Positive for COVID-19 After Being Fully Vaccinated?
The information in this article is current as of the date listed. As new research becomes available, we’ll update this article. For the latest on COVID-19, visit ourcoronavirus news page.
18 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.People with certain medical conditions.Naldi L.Risk of infections in psoriasis. A lesson to learn during the SARS-CoV-2 pandemic.Br J Dermatol. 2021;184(1):6. doi:10.1111/bjd.19190PracticeUpdate.AAD VMX: psoriasis diagnosis linked with increased risk of contracting COVID-19.Haberman R, Axelrad J, Chen A, et al.Covid-19 in immune-mediated inflammatory diseases—case series from New York.N Engl J Med. 2020;383(1):85-88. doi:10.1056/NEJMc2009567Kamiya K, Komine M, Ohtsuki M.Biologics for psoriasis during the COVID-19 pandemic.J Clin Med. 2021;10(7):1390. doi:10.3390/jcm10071390Centers for Disease Control and Prevention.Signs and symptoms of long COVID.Wang EY, Mao T, Klein J, et al.Diverse functional autoantibodies in patients with COVID-19.Nature. 2021;595:283–288. doi:10.1038/s41586-021-03631-yNational Psoriasis Foundation.Cyclosporine.Sadeghinia A, Daneshpazhooh M.Immunosuppressive drugs for patients with psoriasis during the COVID-19 pandemic era. A review.Dermatol Ther. 2021;34(1):e14498. doi:10.1111/dth.14498American Academy of Dermatology.Guidance on the use of immunosuppressive agents.Torres T, Puig L.Managing cutaneous immune-mediated diseases during the COVID-19 pandemic.Am J Clin Dermatol. 2020;21(3):307-311. doi:10.1007/s40257-020-00514-2National Psoriasis Foundation.COVID-19 Task Force guidance statements.International Psoriasis Council.Revised IPC statement on COVID-19.Simon D, Tascilar K, Fagni F, et al.SARS-CoV-2 vaccination responses in untreated, conventionally treated and anticytokine-treated patients with immune-mediated inflammatory diseases.Ann Rheum Dis. 2021;80(10):1312-1316. doi:10.1136/annrheumdis-2021-220461Spiera R, Jinich S, Jannat-Khah D.Rituximab, but not other antirheumatic therapies, is associated with impaired serological response to SARS- CoV-2 vaccination in patients with rheumatic diseases.Ann Rheum Dis. 2021;80(10):1357-1359. doi:10.1136/annrheumdis-2021-220604American College of Rheumatology.Fifth update of ACR COVID-19 vaccine guidance supports fourth doses for high-risk rheumatic disease patients.Centers for Disease Control and Prevention.COVID-19: how to protect yourself and others.Armstrong AW, Chambers CJ, Maverakis E, et al.Effectiveness of online vs in-person care for adults with psoriasis: a randomized clinical trial.JAMA Netw Open. 2018;1(6):e183062. doi:10.1001/jamanetworkopen.2018.3062
18 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.People with certain medical conditions.Naldi L.Risk of infections in psoriasis. A lesson to learn during the SARS-CoV-2 pandemic.Br J Dermatol. 2021;184(1):6. doi:10.1111/bjd.19190PracticeUpdate.AAD VMX: psoriasis diagnosis linked with increased risk of contracting COVID-19.Haberman R, Axelrad J, Chen A, et al.Covid-19 in immune-mediated inflammatory diseases—case series from New York.N Engl J Med. 2020;383(1):85-88. doi:10.1056/NEJMc2009567Kamiya K, Komine M, Ohtsuki M.Biologics for psoriasis during the COVID-19 pandemic.J Clin Med. 2021;10(7):1390. doi:10.3390/jcm10071390Centers for Disease Control and Prevention.Signs and symptoms of long COVID.Wang EY, Mao T, Klein J, et al.Diverse functional autoantibodies in patients with COVID-19.Nature. 2021;595:283–288. doi:10.1038/s41586-021-03631-yNational Psoriasis Foundation.Cyclosporine.Sadeghinia A, Daneshpazhooh M.Immunosuppressive drugs for patients with psoriasis during the COVID-19 pandemic era. A review.Dermatol Ther. 2021;34(1):e14498. doi:10.1111/dth.14498American Academy of Dermatology.Guidance on the use of immunosuppressive agents.Torres T, Puig L.Managing cutaneous immune-mediated diseases during the COVID-19 pandemic.Am J Clin Dermatol. 2020;21(3):307-311. doi:10.1007/s40257-020-00514-2National Psoriasis Foundation.COVID-19 Task Force guidance statements.International Psoriasis Council.Revised IPC statement on COVID-19.Simon D, Tascilar K, Fagni F, et al.SARS-CoV-2 vaccination responses in untreated, conventionally treated and anticytokine-treated patients with immune-mediated inflammatory diseases.Ann Rheum Dis. 2021;80(10):1312-1316. doi:10.1136/annrheumdis-2021-220461Spiera R, Jinich S, Jannat-Khah D.Rituximab, but not other antirheumatic therapies, is associated with impaired serological response to SARS- CoV-2 vaccination in patients with rheumatic diseases.Ann Rheum Dis. 2021;80(10):1357-1359. doi:10.1136/annrheumdis-2021-220604American College of Rheumatology.Fifth update of ACR COVID-19 vaccine guidance supports fourth doses for high-risk rheumatic disease patients.Centers for Disease Control and Prevention.COVID-19: how to protect yourself and others.Armstrong AW, Chambers CJ, Maverakis E, et al.Effectiveness of online vs in-person care for adults with psoriasis: a randomized clinical trial.JAMA Netw Open. 2018;1(6):e183062. doi:10.1001/jamanetworkopen.2018.3062
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.People with certain medical conditions.Naldi L.Risk of infections in psoriasis. A lesson to learn during the SARS-CoV-2 pandemic.Br J Dermatol. 2021;184(1):6. doi:10.1111/bjd.19190PracticeUpdate.AAD VMX: psoriasis diagnosis linked with increased risk of contracting COVID-19.Haberman R, Axelrad J, Chen A, et al.Covid-19 in immune-mediated inflammatory diseases—case series from New York.N Engl J Med. 2020;383(1):85-88. doi:10.1056/NEJMc2009567Kamiya K, Komine M, Ohtsuki M.Biologics for psoriasis during the COVID-19 pandemic.J Clin Med. 2021;10(7):1390. doi:10.3390/jcm10071390Centers for Disease Control and Prevention.Signs and symptoms of long COVID.Wang EY, Mao T, Klein J, et al.Diverse functional autoantibodies in patients with COVID-19.Nature. 2021;595:283–288. doi:10.1038/s41586-021-03631-yNational Psoriasis Foundation.Cyclosporine.Sadeghinia A, Daneshpazhooh M.Immunosuppressive drugs for patients with psoriasis during the COVID-19 pandemic era. A review.Dermatol Ther. 2021;34(1):e14498. doi:10.1111/dth.14498American Academy of Dermatology.Guidance on the use of immunosuppressive agents.Torres T, Puig L.Managing cutaneous immune-mediated diseases during the COVID-19 pandemic.Am J Clin Dermatol. 2020;21(3):307-311. doi:10.1007/s40257-020-00514-2National Psoriasis Foundation.COVID-19 Task Force guidance statements.International Psoriasis Council.Revised IPC statement on COVID-19.Simon D, Tascilar K, Fagni F, et al.SARS-CoV-2 vaccination responses in untreated, conventionally treated and anticytokine-treated patients with immune-mediated inflammatory diseases.Ann Rheum Dis. 2021;80(10):1312-1316. doi:10.1136/annrheumdis-2021-220461Spiera R, Jinich S, Jannat-Khah D.Rituximab, but not other antirheumatic therapies, is associated with impaired serological response to SARS- CoV-2 vaccination in patients with rheumatic diseases.Ann Rheum Dis. 2021;80(10):1357-1359. doi:10.1136/annrheumdis-2021-220604American College of Rheumatology.Fifth update of ACR COVID-19 vaccine guidance supports fourth doses for high-risk rheumatic disease patients.Centers for Disease Control and Prevention.COVID-19: how to protect yourself and others.Armstrong AW, Chambers CJ, Maverakis E, et al.Effectiveness of online vs in-person care for adults with psoriasis: a randomized clinical trial.JAMA Netw Open. 2018;1(6):e183062. doi:10.1001/jamanetworkopen.2018.3062
Centers for Disease Control and Prevention.People with certain medical conditions.
Naldi L.Risk of infections in psoriasis. A lesson to learn during the SARS-CoV-2 pandemic.Br J Dermatol. 2021;184(1):6. doi:10.1111/bjd.19190
PracticeUpdate.AAD VMX: psoriasis diagnosis linked with increased risk of contracting COVID-19.
Haberman R, Axelrad J, Chen A, et al.Covid-19 in immune-mediated inflammatory diseases—case series from New York.N Engl J Med. 2020;383(1):85-88. doi:10.1056/NEJMc2009567
Kamiya K, Komine M, Ohtsuki M.Biologics for psoriasis during the COVID-19 pandemic.J Clin Med. 2021;10(7):1390. doi:10.3390/jcm10071390
Centers for Disease Control and Prevention.Signs and symptoms of long COVID.
Wang EY, Mao T, Klein J, et al.Diverse functional autoantibodies in patients with COVID-19.Nature. 2021;595:283–288. doi:10.1038/s41586-021-03631-y
National Psoriasis Foundation.Cyclosporine.
Sadeghinia A, Daneshpazhooh M.Immunosuppressive drugs for patients with psoriasis during the COVID-19 pandemic era. A review.Dermatol Ther. 2021;34(1):e14498. doi:10.1111/dth.14498
American Academy of Dermatology.Guidance on the use of immunosuppressive agents.
Torres T, Puig L.Managing cutaneous immune-mediated diseases during the COVID-19 pandemic.Am J Clin Dermatol. 2020;21(3):307-311. doi:10.1007/s40257-020-00514-2
National Psoriasis Foundation.COVID-19 Task Force guidance statements.
International Psoriasis Council.Revised IPC statement on COVID-19.
Simon D, Tascilar K, Fagni F, et al.SARS-CoV-2 vaccination responses in untreated, conventionally treated and anticytokine-treated patients with immune-mediated inflammatory diseases.Ann Rheum Dis. 2021;80(10):1312-1316. doi:10.1136/annrheumdis-2021-220461
Spiera R, Jinich S, Jannat-Khah D.Rituximab, but not other antirheumatic therapies, is associated with impaired serological response to SARS- CoV-2 vaccination in patients with rheumatic diseases.Ann Rheum Dis. 2021;80(10):1357-1359. doi:10.1136/annrheumdis-2021-220604
American College of Rheumatology.Fifth update of ACR COVID-19 vaccine guidance supports fourth doses for high-risk rheumatic disease patients.
Centers for Disease Control and Prevention.COVID-19: how to protect yourself and others.
Armstrong AW, Chambers CJ, Maverakis E, et al.Effectiveness of online vs in-person care for adults with psoriasis: a randomized clinical trial.JAMA Netw Open. 2018;1(6):e183062. doi:10.1001/jamanetworkopen.2018.3062
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