Findings in the Journal of Investigative Dermatology underline the importance of a safe and calm childhood

October 21, 2025 – New longitudinal research reveals that severe stress caused by changes in family structure like divorce or separation experienced during the first year of life may triple the risk of developing psoriasis later in life. The results of the study in the Journal of Investigative Dermatology, published by Elsevier, emphasize the need to protect young children from stressful life factors that threaten their security and emotional well-being.

Psoriasis is a chronic autoimmune disorder marked by rapid skin cell growth and inflammation. While genetics and environmental factors like nutrition and smoking play an important role in the development of autoimmune disorders, this is the first study to investigate early childhood stress in relation to psoriasis. Previous studies had focused on stress just prior to the diagnosis of psoriasis.

Using data on 17,055 children participating in the longitudinal All Babies in Southeast Sweden large birth cohort study, researchers tracked stressful life factors at ages 1, 3, 5, and 8 years of age. They identified 121 participants who were later diagnosed with psoriasis. The most significant finding was that changes in family structure experienced in the first year of life increased the risk of developing psoriasis later in life three-fold.

“Changes in family structure like divorce or separation of parents, death in the family, and/or new adult or new/step siblings leading to an acute sense of insecurity and fear for the young child, seems to make the child extra vulnerable when it happens in the first year of life. This fits with the knowledge that very young individuals seem to be more vulnerable to the immunomodulatory effects of stressful life factors than older children and adults,” explains lead investigator of the study Johnny Ludvigsson, MD, PhD, Division of Pediatrics, Department of Biomedical and Clinical Sciences, Linköping University (Sweden). “The reason for the effects may be that these factors lead to a defense response that includes increased cortisol concentrations, which in turn influence the immune system.”

The researchers point out that the cohort is limited to a population with low diversity and heterogeneity in southeast Sweden and caution should be exercised before generalizing results.

Dr. Ludvigsson concludes, “Our results show—to our knowledge—a previously unreported fact that very stressful life factors early in life influence the immune system and increase the risk for autoimmune diseases such as psoriasis. There is no simple advice to avoid these factors, but everything that can be done should be done to protect young children from stressful life factors that threaten their security and emotional well-being.”

Comments on the study from noted experts in the field:

Luigi Naldi, MD, IRCCS Ospedale San Raffaele, Milan, and Centro Studi GISED; Bergamo (Italy): “Decoding how early stress imprints immunity could reveal novel psoriasis pathways. The present study suggests that the story of psoriasis is not written solely in genes and immune circuits. It may also be shaped by lived experiences, beginning early in life. By leveraging population-based registries and a cohort design, Das and Ludvigsson demonstrate that stress may precede—and contribute to—the emergence of psoriasis. The novelty of their study lies in its focus on early childhood, a sensitive developmental window during which neuroendocrine and immune systems are highly plastic.”

Yi Xiao, MD, PhD, MPH, Deputy Director of Key Laboratory of Skin Cancer and Psoriasis, Hunan Province, Department of Dermatology, Xiangya Hospital, Central South University (China), and JID Editor: “By starting in childhood, this cohort offers strong temporal evidence linking the social environment to psoriasis. Prevention must go beyond genetics and lifestyle. Both public health and clinical practice should integrate the identification and mitigation of adverse social factors into complementary care pathways.”