INTRODUCTION:

Psoriasis affects millions of people worldwide, causing physical discomfort and emotional distress. The interplay between stress and immune response exacerbates the condition. Yoga, known for its stress-reducing and immune-modulating properties, presents a complementary therapy for managing psoriasis symptoms. The most significant and primary defensive organ on the exterior of the body is the skin. It provides defence against harmful UV radiation, dust, viruses, injuries, microbes, and poisons.

It also has a significant impact on homeostasis, immunological surveillance, sensory receptors, and fluid loss management. Three layers make up skin.¹

· The epidermis, the skin's outermost layer, influences skin tone and acts as a waterproof barrier.

· The dermis, which is located under the epidermis, is home to sweat glands, blood pots, lymphatic vessels, hair follicles, and connective tissue.

· The hypodermis is a deeper layer of connective tissue and fat under the skin.

Understanding Psoriasis: Psoriasis is an autoimmune disorder in which the body's immune system attacks healthy skin cells, leading to rapid cell turnover. This results in thick, scaly patches on the skin, often accompanied by itching and discomfort. The exact cause of psoriasis is unknown, but genetic predisposition, environmental factors, and immune dysregulation play crucial roles. Stress is a significant trigger that can lead to flare-ups and worsen symptoms.² The body's immune system becomes hyperactive in psoriasis, a chronic (long-term) non-infectious epidermal sickness that causes skin cells to divide faster than normal ones. erythematous, clearly identified papules with cylindrical patches covered in slivery micaceous scales are the clinical signs that define this medical disorder. Elbows, knees, and scalp are the most common places for scaly, inflammatory skin patches to appear, but other body areas may also be impacted. The prevalence of psoriasis in the world's population ranges from 2-3%. Psoriasis is rather prevalent in the general population, with a frequency of 0.6% to 4.8% and 0.44 to 2.8% in India. It primarily affects people in their third or fourth decade of life, with males being affected two times more frequently than females.³ Although the precise origin of psoriasis is uncertain, T cells are thought to have a mediating role in the inflammatory illness. Many psoriasis sufferers have been linked to certain HLA antigens. Psoriasis can get worse when using certain medications, such as NSAIDs, lithium, beta-blockers, steroids, and chloroquine. Psoriasis usually gets better in the summer and gets worse in the winter. In addition to these illnesses, psoriasis may also be brought on by psychological stress, alcohol, tobacco, and obesity.⁴

Types: it has many types like:

· Plaque vulgaris- is another name for plaque psoriasis. It manifests as red, elevated, swollen skin with scales or slivery areas covering it. Location: hands, foot, scalp, elbow, knee, and lower back.

· Guttate psoriasis: tiny papules appear on the proximal extremities and upper trunk. Skin folds like the axilla, inguinal, and perspiration regions are affected by inverse psoriasis. Lesions have little to no scaling and a shiny, smooth, brilliant red appearance.

· Pustular psoriasis: A pus-filled lesion encircled by red skin is known as pustular psoriasis. It shows up at the hands and feet. The surface peeling and scaling of erythrodermic psoriasis can give the appearance of burning. Every bodily place is impacted. The use of powerful coal products, allergic reactions, and sunburn are the causes.

· Nail psoriasis: it manifests as tiny, yellow-brown nails with chalk buildup beneath the nails.

· Individuals with psoriasis may experience different symptoms, but common ones include: Thick, red skin patches with silvery white scales that itch or burn, usually on the elbows, knees, scalp, trunk, palms, and soles of the feet. Skin that is cracked, dry, and bleeding. Nails have thick, pitted, and ridges.⁵

The psoriasis on certain bodily parts, diagnosis is typically straightforward. Nails, knees, elbows, ears, and scalp.

Laboratory test: biopsy

The Role of Stress in Psoriasis: Stress is a known trigger for psoriasis flare-ups. Studies suggest that stress activates the hypothalamic-pituitary-adrenal (HPA) axis, leading to increased cortisol levels and inflammation. Chronic stress can impair immune function and exacerbate autoimmune conditions, including psoriasis. Yoga reduces stress through mindfulness, controlled breathing, and relaxation, thereby potentially lowering psoriasis-related inflammation.⁶ Exercise enhances the quality of the life⁷

METHODS:

Yogic managements: Proposed Yoga Regimen for Psoriasis Patients To achieve maximum benefits, psoriasis patients can follow this structured yoga regimen:

· Morning: 15 minutes of breathing exercises (Anulom Vilom, Kapalbhati) followed by 20 minutes of gentle asanas (Bhujangasana, Setu Bandhasana, Trikonasana).

· Afternoon: 10-minute mindfulness meditation session to manage stress levels.

· Evening: 30 minutes of restorative yoga (Shavasana, Balasana, Yoga Nidra) to promote relaxation and healing.

1. Asanas (Physical Postures):

· Shavasana (Corpse Pose): Induces deep relaxation and reduces stress, helping to minimize flare-ups.

· Bhujangasana (Cobra Pose): Improves circulation and supports immune function by stimulating the adrenal glands.

· Setu Bandhasana (Bridge Pose): Enhances detoxification and reduces inflammation, benefiting skin health.

· Trikonasana (Triangle Pose): Enhances blood flow and reduces stress-induced inflammation.

· Balasana (Child's Pose): Helps in relaxation and reduces anxiety, which can trigger psoriasis flare-ups.

2. Pranayama (Breathing Techniques):

· Anulom Vilom (Alternate Nostril Breathing): Balances the nervous system, reduces stress, and enhances oxygen flow to tissues.

· Bhramari (Humming Bee Breath): Lowers anxiety, promotes mental clarity, and has a calming effect on the nervous system.

· Kapalbhati (Skull Shining Breath): Detoxifies the body and improves skin health by increasing oxygen supply to cells.

3. Meditation and Mindfulness:

· Guided Meditation: A-kara, U-kara, M-Kara, Om meditation helps patients cope with emotional stress and promotes a positive mental state.

4. Yoga Nidra: Enhances deep relaxation and cellular healing, reducing stress-related inflammation.

5. Diet: The illness known as psoriasis is immune-mediated. This indicates that an overactive immune system is the source of the inflammation. Thus, a diet low in inflammation might be beneficial. vitamins, antioxidants, and a diet high in fiber and omega 3. Avoid more sugar, salt, meat, saturated fat, etc.

DISCUSSION:

yoga offers multiple benefits, such as psychological, spiritual, and physical. With biological processes and a physical shape that represents the body, Annamaya Kosha is the state of grossest health. Panchamabhutas, or solid matters (Earth, water, fire, air, and space), make up this component. Mind is referred to as the Manomaya Kosha. Here in Kosha reside ideas, feelings, desires, loves, dislikes, and other such things. Stress, a pathological state, is brought on by any disruption to this Kosha. This component's harmony is disrupted by persistent stress, concern, or anxiety. The underlying cause of stress-induced psychosomatic diseases, such as psoriasis, is an imbalance in the Manomaya Kosa. At the Manomaya Kosa, amplified likes and dislikes lead to uncomfortable emotional spikes known as "Aadhi." Disrupted lifestyles are caused by chronic, uncontrollably high levels of stress-inducing emotions such as Kama (strong desire), Krodha (rage), Bhaya (fear), Matsarya (jealousy), etc. The 'Nadis', or channels of Prana, branch off and are dispersed throughout the body. These agitations produce severe variations in the flow of Prana in these channels. Every single cell in the body, which makes up the Annamaya Kosa (physical body), needs a sufficient amount of prana energy to carry out its biochemical operations effectively. It is commonly known that without an appropriate amount of Prana, the biological system cannot function. Because of this, the Manomaya Kosa's instabilities seep into the Annamaya Kosa through disturbed or vitiated Prana flow. Therefore, yoga techniques—which we have referred to as an integrated approach to yoga therapy—should provide at all three levels to repair the imbalance through a series of yogic practices.⁸

Scientific Evidence and Studies:

Several studies have explored the benefits of yoga in reducing inflammation and stress, which are directly linked to psoriasis severity.⁹ found that participants practicing yoga for 12 weeks showed a significant reduction in Psoriasis Area and Severity Index (PASI) scores compared to a control group. Similarly, highlighted the role of yoga in improving immune balance and reducing inflammatory markers in autoimmune disorders.¹⁰ Another study demonstrated that psoriasis patients practicing yoga experienced a notable improvement in skin hydration, reduced itching, and better sleep quality. These findings suggest that yoga can serve as a complementary therapy in conventional psoriasis treatment.¹¹

Mechanisms of Yoga in Psoriasis Management:

1. Reduction of Inflammation: Yoga has been shown to lower inflammatory markers such as C-reactive protein (CRP) and interleukin-6 (IL-6), which are elevated in psoriasis patients.¹²

2. Improved Immune Function: Regular yoga practice balances immune responses, reducing the hyperactive immune attacks on skin cells.¹³

3. Stress Reduction: Yoga enhances parasympathetic nervous system activity, reducing cortisol levels and alleviating the psychological burden associated with psoriasis.¹⁴

4. Enhanced Skin Health: Improved blood circulation through yoga aids in delivering oxygen and nutrients to the skin, promoting healing and regeneration.¹⁵

Yoga Practices for Psoriasis Management:

CONCLUSION:

Yoga is promoted as a therapeutic intervention for various diseases as well as a preventive tool. It is essential to the promotion of good physical, mental, emotional, and spiritual health as well as to recovery. Various yogic techniques help with immunomodulation, and they also lessen stress on the body and mind. Thus, these yoga exercises improve the quality of life for psoriasis patients, which lowers the frequency of psoriasis flare-ups, and increases the patients' capacity to manage their condition. Dermatologists and healthcare practitioners should consider recommending yoga as a complementary approach to conventional treatment. Patients should consult with healthcare providers before incorporating yoga into their routine, ensuring that the selected practices are safe and effective.

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Received on 16.10.2024 Revised on 20.12.2024

Accepted on 28.02.2025 Published on 19.03.2025

Available online from March 28, 2025

Res. J. of Humanities and Social Sciences. 2025;16(1):19-22.

DOI: 10.52711/2321-5828.2025.00004

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.