Years ago, if someone had told me, as a professional comedian and humorist, that I would author an article in Practical Dermatology®, I would have made a strong wager against it. Back then, I was far too immature to be trusted with dermatological terms like “horny layer” and “infarcts.” Over the years, however, I began to see the power of humor not just to entertain, but to connect with people and even enhance health and well-being. Today, as President of the Association for Applied and Therapeutic Humor (AATH, aath.org), my focus is the study and application of humor to improve health and human performance. While I’m not saving lives, my aim is to improve them with humor. I’d like to share information about the therapeutic potential of humor that you may find helpful, specifically for your patients with psoriasis.

As dermatologists, you help patients with the physical issues of psoriasis. But what if you could also help them navigate some of the accompanying social and emotional challenges...with humor?

The Science of Humor: Laughter Does the Body Good

You’ve probably heard the saying, “Laughter is the best medicine!” While laughter alone is not going to cure a skin condition, most people don’t appreciate how and why laughter and humor can be important to our health. Laughing is not just fun, it’s also good for you—literally.

Humor can create positive changes in our thoughts, feelings, behaviors, and biochemistry. It plays a significant role in wellness. Laughter appears to make the body more able to fight disease and repair itself. A growing body of research shows the scientific benefits of humor, and recent research shows that humor and laughter can have a significant impact on overall health and well-being. Laughter is an excellent addition to treating almost any condition, with the exception, perhaps, of urinary incontinence.

Humor and laughter are shown to:

• Decrease levels of stress hormone^1,2
• Lower blood pressure³
• Strengthen the immune system^4,5,6
• Decrease pain.^7,8,9

What Happens When We Laugh?

Laughter involves the entire body. When we laugh, the body relaxes, and natural “feel-good” chemicals are released in the brain. “Feel good” chemicals are a real medical term, right? I almost forgot who I’m writing for. How about dopamine, serotonin, oxytocin, and endorphins? These promote an overall sense of well-being and can even temporarily relieve pain. In the lungs, more air is exhaled out than usual, allowing a larger inhalation of fresh oxygen that enriches the blood to nourish the heart, brain, and body tissues.

When we experience something funny, hundreds of chemical changes occur. Cognitive performance improves, as neurons shift toward expressing creativity, insight, and innovation, while turning down the noise of the stress response.¹⁰

Using Humor to Cope with Psoriasis

Humor can be an effective tool to help people cope with the challenges of living with a chronic disease like psoriasis. Living with psoriasis can be uncomfortable physically, emotionally, and socially. Traditional medicine is the foundation for treating psoriasis, and medications may help to effectively alleviate physical symptoms. Since laughter reduces stress, and psoriasis can be triggered by stress, then a healthy “dose” of laughter may also help to reduce the intensity or frequency of a psoriasis flare.

It’s also important to address the emotional and social challenges of living with psoriasis. The identified benefits of humor and laughter can help your psoriasis patients adjust their mindset to better navigate the emotional and social challenges that often accompany the condition. Handling uncomfortable psoriasis-related situations can be difficult, but humor can help provide a lifeline to help people with psoriasis not only survive but thrive. Using humor can help to:

• Break the ice
• Build confidence
• Navigate awkward moments
• Strengthen connections with other people.

Further, laughter and humor can help build relationships, which is good news, as living with a chronic condition like psoriasis can be socially isolating. Social support can help build the foundation to cope with living with a chronic condition.

The AATH recently launched a new initiative on the therapeutic benefits of humor, with a focus on people living with psoriasis, in partnership with Sun Pharmaceuticals. Our goals are to teach people how to make humor a habit, own their story, and put humor into practice by using it daily. We’ve developed a Humor Report and Humor Tool Videos with psoriasis-specific tips that are available online for you and your patients at PsOReal.com/humor-tools.

Putting Humor into Practice for Psoriasis

It is possible for patients to use the power of humor to take the lead in fighting the frustration, discomfort, and emotional stress of psoriasis. Humor isn’t a talent; rather, humor is a habit. The key is to be intentional, taking an active role and learning to experience humor by choice, rather than by chance. Intentionally seeking out humor is a great “prescription” to help people with psoriasis cope with symptoms, make conversations about psoriasis a little easier, and reduce stress or break the ice.

Here are some tips to help your patients incorporate humor into their lives:

• Three Funny Things Intervention. Write down three funny things every day. One of our AATH researchers from the University of Zurich¹¹ found that people who write down three funny things that happened each day for only one week were able to increase their overall happiness and decrease depressive symptoms for up to six months! The great thing about this exercise is that people can begin to train their brains to find the humor in things in real time, rather than just in retrospect.
• Five-minute funny. Set an alarm for a daily five-minute humor break, where you’ll watch a funny video, learn a new joke, or tell a funny story to someone.
• Go to a comedy club. Discover new comedians or go see one of your favorites.
• Involve your friends. Call or meet with friends who make you laugh. Find a “humor buddy” and send each other funny videos, GIFs, or articles.
• Take advantage of resources. Consider our new humor tools!
• Take a class. Try an improv comedy class or look for a laughter yoga class near you.

Using Humor in Your Practice

As you teach patients how to use humor in their lives, you can also use humor in your own practice to help lighten the mood and connect with patients.

Prime the Pump for Positivity. In order to increase the chances of having a lighthearted and positive interaction with your patient, add humorous reading material to your waiting area, funny shows on the TVs, place funny signs in public areas, and even use a little humor on your social media or web pages. For example, one doctor’s office had a small sign that read “From ‘1 to stepping on a Lego’, how much pain are you in?” They don’t even need to be medical-related to get a smile. Why not have the boring “Please wash your hands sign” in the restroom be a picture of Han Solo that says, “Wash Your Hans?” Anything that is a little funny or different can have a positive effect on the emotional state of your patients prior to them even seeing you.

Using humor in the exam room can be a great way to build a connection with patients and help them feel at ease. You don’t necessarily need to try to be funny in order to use humor.

• Funny pictures/signs. This is another place where a strategically placed funny quote, picture, or meme can go a long way and spark conversation. Do you have a hilarious picture of your dog or kid? Chances are someone will comment on it.
• Conversation starters. Try doing something different and have a list of questions or a stack of cards with questions on them and have the nurse tell each patient to choose one that the doctor will answer when he/she comes into the room. Examples of questions can be:
  • What’s the weirdest thing you’ve ever eaten?
  • If you built a themed hotel, what would the theme be and what would the rooms look like?
  • What would a world populated with clones of you be like?
    This quick dose of fun is sure to lead to some humor and easier dialogue. If it feels like the patient is comfortable with you, then you can ask them the question back.
• “What I Could Have Said Was.” Again, you don’t have to be the one creating humor. Many of your patients may have their own humorous anecdotes to share. If you’re talking with a patient about awkward social situations dealing with psoriasis, ask them if they ever thought of any funny ways to respond to those situations. They’ll likely give you an example or two that they have heard or used, and you can keep the best ones to share with future patients to make them smile.
• “Rule of Three.” If you checked out the psoriasis humor tools page, you may have seen a humor technique called the “Rule of Three.” You can create a simple one-liner with a little humor in it by following the model of saying two serious things, followed by something funny or different. Once you find one that works, you can use it with your patients. You’ll come up with the best examples because you know your patients best, but here is an example to get you warmed up:

  “Some things I can help you with are: understanding your symptoms, addressing flare ups, and writing you a doctor’s note to wear long sleeves whenever you feel like it.”

  Come to think of it, how cool would it be to have a little “prescription pads” made for your patients that said things like, “Wear jeans to the beach” that they could hand to people as a funny doctor’s note when they get asked about why they’re covering up or not participating in something?

In Conclusion

Incorporating a healthy dose of humor as part of a “treatment plan”—alongside lifestyle changes and medication— can be a helpful strategy for people to navigate the everyday realities of living with psoriasis. I hope that after learning about the benefits of humor and laughter, and specific strategies to incorporate humor into psoriasis management, that you now have a powerful new tool to help empower your psoriasis patients to live their best lives and focus on the things that matter most!

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2. Bennett MP, Zeller JM, Rosenberg L, McCann J. The effect of mirthful laughter on stress and natural killer cell activity. Altern Ther Health Med. 2003;9(2):38-45.

3. Miller M, Fry WF. The effect of mirthful laughter on the human cardiovascular system. Med Hypotheses. 2009; 73(5):636.

4. Berk LS, Felten DL, Tan SA, Westengard J. Modulation of neuroimmune parameters during the eustress of humor-associated mirthful laughter. Altern Ther Health Med. 2001;7(2):62-72, 74-6.

5. Berk LS, Tan SA, Fry WF, Napier BJ, Lee JL, Hubbard RW, et al. Neuroendocrine and stress hormone changes during mirthful laughter. Am J Med Sci. 1989;298(6):390-6.

6. Bennett MP, Lengacher C. Humor and laughter may influence health IV. Humor and immune function. Evid Based Complement Alternat Med. 2009;6(2):159-64.

7. Christie W, Moore C. The impact of humor on patients with cancer. Clin J Oncol Nurs. 2005;9(2):211-8.

8. Strean WB. Laughter prescription. Can Fam Physician. 2009;55(10):965-7

9. Bennett PN, Parsons T, Ben-Moshe R, Weinberg M, Neal M, Gilbert K, et al. Laugher and humor therapy in dialysis. Semin Dial. 2014;27(5):488-93.

10. Hanna H. American Institute of Stress. Why seeing funny will shift your stress. https://www.stress.org/why-seeing-funny-will-shift-your-stress. Accessed March 8, 2019.

11. Wellenzohn S, Proyer RT, Ruch W. Who benefits from humor-based positive psychology interventions? Front. Psychol. 2018;9:821.