How Psoriasis Can Affect Bones
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More Than Skin Deep: How Psoriasis Can Affect Bones

More Than Skin Deep: How Psoriasis Can Affect Bones
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Updated on June 9, 2025
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People often assume that psoriasis only affects the skin. More accurately, psoriasis is an immune-mediated condition, which means its effects can go much deeper than the skin's surface.

 Along with an increased risk for health conditions like psoriatic arthritis, heart disease, and diabetes, people with long-term psoriasis tend to have a greater risk of weakened bones (osteoporosis) and loss of bone mineral density (osteopenia).

People with psoriasis and psoriatic arthritis may be more likely to develop bone fractures than those without either condition, although research suggests that isn't necessarily because they have a higher risk for osteoporosis.

“People who have a chronic inflammatory disease like psoriasis are more likely to have a loss of bone density over time,” says Christopher Ritchlin, MD, MPH, a rheumatologist at the University of Rochester Medical Center in New York. “I think all patients should be aware of it because it's a real problem for some people that may not be adequately addressed.”

What to Know About Your Risk for Osteoporosis

However, not everyone with psoriasis will develop osteoporosis, says Dr. Ritchlin. This is in part because osteoporosis is a very complicated disease with many potential risk factors.

One of these risk factors is biological sex. About 20 percent of women age 50 and older have osteoporosis, compared with around 4 percent of men in the same age group. The risk also increases with age: About 27 percent of women age 65 and older have osteoporosis, compared with around 6 percent of men.

“Postmenopausal women are more likely to have a rapid loss of bone,” Ritchlin says, explaining that women lose estrogen with age, and “estrogen is a major hormone that's important for maintaining bone density.”

People with psoriatic arthritis may also be at greater risk of osteoporosis. This type of arthritis can cause pain and stiffness in the spine, which can limit your ability to move. “If you can't move the spine, that can result in the loss of bone density,” says Ritchlin.

There's also evidence that genetics may play a role in increasing a person's risk for osteoporosis, says Adelaide Hebert, MD, a dermatologist with the McGovern Medical School at UTHealth Houston. If you have a parent or sibling who has osteoporosis, you may be more likely to develop it.

4 Ways to Help Prevent Osteoporosis if You Have Psoriasis

What's good for your overall health is also good for your bones. Here are four habits you can develop to help reduce your risk of osteoporosis.

1. Exercise Regularly

Exercise, “especially vigorous exercise that's weight-bearing,” says Ritchlin, can put stress on your bones, which helps strengthen them. This, in turn, can help prevent bone loss.

Weight-bearing exercise is any activity that works your bones and muscles against gravity:

  • Walking, hiking, jogging, and running
  • Dancing
  • Playing tennis, basketball, soccer, and volleyball
  • Climbing stairs

If you already have some bone loss, talk to your doctor about what you're able to do. You may want to avoid high-impact exercises involving jumping or twisting. If you're not able to be as active as you'd like, tell your doctor. They may refer you to a physical or occupational therapist who can help you modify certain exercises.

2. Incorporate Strength Training

Just as lifting weights strengthens muscle fibers by stressing them, lifting weights puts stress on your bones, strengthening them in the long term.

You don't have to opt for dumbbells, though. You can use resistance bands or do body-weight exercises like push-ups. Three sets of 12 repetitions of the exercise of your choice is the standard for effective strength training, but you can do more or less as you're able. Aim for two strength-training sessions a week.

3. Get Enough Vitamin D

People with psoriasis tend to be lacking in vitamin D, with levels up to 7 times lower than those without psoriasis.

It's not clear whether getting more vitamin D helps protect your bones, says Ritchlin, but if you're low (below 20 nanograms per milliliter), it's a good idea to try and get more. Your doctor can check your vitamin D level with a blood test, says Dr. Hebert.

Vitamin D is called the Sunshine Vitamin because exposure to sunlight triggers your body to produce the vitamin. You can soak up vitamin D by spending about 10 minutes outdoors daily.

Few foods naturally contain vitamin D (fatty fish like salmon and tuna), but you can also consume fortified foods like milk and breakfast cereals.

 Vitamin D is found in soy, almond, and oat milks, too, so you can opt for those if cow's milk triggers your psoriasis.

4. Ask Your Doctor if You Should Take Osteoporosis Medication

If you have psoriasis, you may already be taking medication to control the inflammation, which may help protect your bones. There are also medications that can help slow down bone loss.

“We're very fortunate that now we have a number of medications that can help with bone strength,” says Hebert. Your dermatologist may not be the doctor to prescribe them, however. Still, she says, “we want to take care of the entire patient, even if we don't manage every aspect of their care.” Your primary care doctor or a rheumatologist might be the person to prescribe osteoporosis medication.

The Takeaway

  • People with psoriasis or psoriatic arthritis are more likely to lose bone density over time and develop osteoporosis. However, not everyone with psoriasis will develop this condition.
  • One major risk factor for developing osteoporosis is biological sex. Women are around 5 times more likely than men to develop the condition.
  • If you have psoriasis, taking medications to aid bone strength, getting enough vitamin D, exercising regularly, and strength training can help prevent the onset of osteoporosis symptoms.

Resources We Trust:

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. About Psoriasis. National Psoriasis Foundation. March 18, 2025.
  2. Wi D et al. Psoriasis and osteoporosis: a literature review. Clinical and Experimental Dermatology. March 13, 2022.
  3. Chen TL et al. Bone Mineral Density, Osteoporosis, and Fracture Risk in Adult Patients with Psoriasis or Psoriatic Arthritis: A Systematic Review and Meta-Analysis of Observational Studies. Journal of Clinical Medicine. November 19, 2020.
  4. Sarafrazi N et al. Osteoporosis or Low Bone Mass in Older Adults: United States, 2017–2018. Centers for Disease Control and Prevention National Center for Health Statistics. March 2021.
  5. Osteoporosis. Mayo Clinic. February 24, 2024.
  6. Campbell BJ. Exercise and Bone Health. American Academy of Orthopaedic Surgeons. July 2020.
  7. Witstein JR. Starting a Strength Training Program. American Academy of Orthopaedic Surgeons. August 2023.
  8. Bhat GH et al. Vitamin D status in Psoriasis: impact and clinical correlations. BMC Nutrition. October 19 2022.
  9. Vitamin D Fact Sheet for Consumers. National Institutes of Health Office of Dietary Supplements. November 8, 2022.
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Blair Murphy-Rose, MD

Medical Reviewer
Castle Connolly Top Doctor

Blair Murphy-Rose, MD, is a board-certified dermatologist in New York City and the founder of Skincare Junkie. She is an accomplished cosmetic, medical, and surgical dermatologist, specializing in leading-edge facial rejuvenation techniques, including injectable fillers and botulinum toxin injections, advanced laser procedures, noninvasive body contouring, and removing lumps and bumps with precision. She is an expert in the treatment and detection of medical conditions, including skin cancer, acne, rosacea, eczema, and psoriasis. Dr. Rose believes in a comprehensive approach to skin health and incorporating a skin-care routine tailored specifically for each individual and utilizing a wide array of tools to target specific skin concerns.

Rose has been published in peer-reviewed journals, including the Journal of the American Academy of Dermatology, Dermatology Surgery, and Pediatric Dermatology, and has been featured in numerous publications, including Vogue, Elle, Allure, Cosmopolitan, Self, Women’s Health, The Wall Street Journal, and The New York Times.

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Maria Masters

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Maria Masters is a contributing editor and writer for Everyday Health and What to Expect, and she has held positions at Men's Health and Family Circle. Her work has appeared in Health, on Prevention.com, on MensJournal.com, and in HGTV Magazine, among numerous other print and digital publications.

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