Psoriasis is more than a skin condition: It’s a chronic autoimmune disease that involves systemic inflammation. There’s also evidence that the skin condition may be associated with a higher risk of certain cancers, especially in people who have severe psoriasis or have had the condition for a number of years.
But it’s not clear if the disease itself is actually driving the small increase in cancer risk, or if it’s related to other factors, such as lifestyle choices or even some medications used to manage psoriasis.
Here’s what you need to know about psoriasis and cancer risk, along with expert advice on lifestyle factors, screening recommendations, and treatment options.
Psoriasis and Cancer: What the Research Shows
Several large studies have explored the link between psoriasis and cancer, and two kinds of cancer have been implicated — squamous cell carcinoma in the skin and lymphoma, says Robert T. Brodell, MD, a professor of dermatology at the University of Mississippi Medical Center in Jackson.
Psoriasis and Squamous Cell Skin Cancer
“Several ‘big data’ studies have shown a slightly higher rate of skin cancer in patients with psoriasis,” says Dr. Brodell. These are studies that look at large groups of people to find out the frequency of certain conditions in different groups of people.
Although these types of studies can be informative, they show an association, not causation, and some relationships show up simply by chance, Brodell says. Still, people with psoriasis have been shown to have an increased risk for squamous cell cancer in most of these kinds of studies.
Squamous cell cancer is a type of skin cancer that starts in the squamous cells, which make up the middle and outer layers of the skin. It’s usually not life-threatening, but if it goes untreated it can grow large and spread to other parts of the body.
But it may not be the psoriasis or the inflammation that comes with it causing the increased risk.
“Almost all patients with psoriasis come to find out that exposure to the sun and ‘tanning’ help to control their psoriasis, and there is no question that sun exposure increases the risk of skin cancer, including squamous cell carcinoma,” says Brodell.
People with psoriasis who have spent more time in the sun may have increased rates of skin cancer for this reason, he adds.
Psoriasis and Lymphoma
Evidence suggests that psoriasis may be associated with a higher risk of lymphoma, a cancer of the immune system, says Joel M. Gelfand, MD, a professor of dermatology and of epidemiology at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.
“The association of psoriasis and lymphoma is strongest for cutaneous T-cell lymphoma, a type of lymphoma of the skin,” says Dr. Gelfand. But the risk of lymphoma in people with psoriasis is still quite low, so they shouldn’t be alarmed, he adds.
Cutaneous T-cell lymphoma is a rare type of cancer that begins in white blood cells known as T cells or T lymphocytes. These cells help the body's germ-fighting immune system, but in cutaneous T-cell lymphoma, the T cells attack the skin.
“If psoriasis is not responding appropriately to treatment, then a simple skin biopsy may be necessary. Additional symptoms of lymphoma include swollen glands, weight loss, fatigue, and night sweats,” says Gelfand.
Patients with these symptoms, particularly if they are persistent for weeks or months should see their medical provider, he says.
How to Lower Your Cancer Risks
The good news? Most cancer risks associated with psoriasis are low and highly manageable. Here's how to stay proactive.
Balance Sun Exposure and Skin Protection
The slight increase risk in skin cancer doesn’t mean you have to avoid the sun completely, but you do need to take precautions (just like people without psoriasis) including:
Use sunscreen with SPF 30 or higher when outdoors.
Wear protective clothing and wide-brimmed hats.
Avoid tanning beds or intentional sunburns.
Schedule annual full-body skin exams, especially if you’re over 50 or have fair skin.
Get Regular Skin Cancer Screenings
If you’ve had light therapy (phototherapy), use biologic medications, or spend a lot of time in the sun to ease your symptoms, it’s important to talk to your doctor about skin cancer screening.
“Patients with psoriasis, especially those who receive light treatment, get a lot of natural tanning sunlight, or take certain injectable biologic medications (anti-TNF drugs), should have their dermatologist check them annually,” says Brodell.
Discuss Skin Changes With Your Dermatologist
“Tell your doctor if you see a skin lesion that is growing or changing or an ulceration that will not heal,” says Brodell. Do it right away; don’t wait until your annual appointment to get it checked out.
Make Lifestyle Choices That Protect Your Health
Some cancer risks in people with psoriasis may be driven more by lifestyle factors than the disease itself. Studies show that people with psoriasis are more likely to smoke, drink alcohol excessively, and have overweight or obesity, which are all known cancer risk factors.
Gelfand recommends the following lifestyle choices to lower your risk of cancer.
Quit smoking.
Limit alcohol intake (no more than one drink per day for women and no more than two per day for men).
Maintain a healthy weight.
Exercise regularly.
Get the HPV vaccine if you’re eligible.
Stay up-to-date with cancer screenings like mammograms and colonoscopies.
It’s also important to take your psoriasis medications as directed by your doctor, says Gelfand. “Most treatments for psoriasis do not seem to impact cancer risk,” he says.
Although there is some evidence that biologics that target TNF may increase the risk of lymphoma and possibly melanoma, those cases are very rare, he says.
“Our most targeted treatments such as biologics that block IL17 or IL23 do not appear to confer any risk of cancer and are often used in patients with a history of cancer,” says Gelfand.
The Takeaway
Psoriasis is linked to a small increased risk of lymphoma and squamous cell skin cancer.
The overall cancer risk is still low, but any skin changes should be investigated by your medical provider right away.
The best way to reduce cancer risk is sun protection, healthy lifestyle choices, and regular checkups.
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
deShazo R et al. Non-Melanoma Skin Cancer Risk Among Patients in the Psoriasis Longitudinal Assessment and Registry (PSOLAR). Journal of Drugs in Dermatology. October 1, 2019.
Squamous Cell Carcinoma of the Skin. Mayo Clinic. August 11, 2023.
Susan Bard, MD, is a clinical instructor in the department of dermatology at Weill Cornell Medicine and an adjunct clinical instructor in the department of dermatology at Mount Sinai in New York City. Her professional interests include Mohs micrographic surgery, cosmetic and laser procedures, and immunodermatology.
She is a procedural dermatologist with the American Board of Dermatology and a fellow of the American College of Mohs Surgery.
Dr. Bard has written numerous book chapters and articles for many prominent peer-reviewed journals, and authored the textbook The Laser Treatment of Vascular Lesions.
Becky Upham has worked throughout the health and wellness world for over 25 years. She's been a race director, a team recruiter for the Leukemia and Lymphoma Society, a salesperson for a major pharmaceutical company, a blogger for Moogfest, a communications manager for Mission Health, a fitness instructor, and a health coach.
Upham majored in English at the University of North Carolina and has a master's in English writing from Hollins University.
Upham enjoys teaching cycling classes, running, reading fiction, and making playlists.
