It began with an itch, not on the skin, but in the soul.
A young woman in her thirties walked into my clinic, trying hard to keep calm. She wore full sleeves despite the heat of Bangalore and had that unmistakable Pitta spark in her eyes—sharp, focused, too intense for a Monday evening. Her voice had a well-rehearsed tone, that of someone accustomed to presenting quarterly reports. “Doctor, it’s psoriasis,” she said, rolling up her sleeves like a reluctant magician revealing a failed trick.
Red, scaly patches glared back at me.
“How long?” I asked.
“Two years,” she said. “I’ve tried everything. Creams, injections, diets. I even went gluten-free. Still, it spreads whenever I have a deadline. Or when my mother-in-law visits.”
She chuckled nervously. I nodded in knowing silence.
Let me tell you something that textbooks won’t: autoimmune skin conditions are not just battles of the body. They are whispers of the mind—messages written in inflammation. In my 25 years of practice in Ayurveda, I’ve seen a recurring pattern that no dermatologist’s prescription pad addresses: most of my psoriasis patients are, in some way, perfectionists. Overachievers. Doers. And here’s the surprising part—their skin isn’t the only thing flaring up; they’re burning up inside with stress, pressure, and bottled-up emotions.
I call it the Pitta Trap.
In Ayurveda, the Pitta dosha governs metabolism, digestion, ambition, and that inner fire that drives us to pursue goals, accomplish tasks, and achieve success. But when Pitta goes rogue, it becomes inflammation incarnate. Hot-headed, irritable, critical—both of self and others. And when this fire finds no outlet, it erupts on the skin.
I remember one case—a software engineer from Electronic City. Tall, brilliant, and as restless as a squirrel on Red Bull. His skin flared up every time his code broke. “I hate failing,” he admitted. “Even if it’s a small bug, I can’t sleep until it’s fixed.” His body had become a battlefield between ambition and acceptance, and his skin bore the scars. Every patch on his elbow screamed, ‘Relax.’ Let go. You’re not your bug reports.
Multiple studies now show a link between stress, perfectionism, and autoimmune diseases. The immune system, like a loyal watchdog, begins to bite the very hand it’s supposed to protect when it is confused by chronic stress and emotional suppression. Cortisol levels rise. Gut integrity falters. Inflammation becomes chronic. And the skin—the body’s largest organ—becomes the exit point for all that unresolved heat.
In Ayurveda, we refer to this as Ama, a toxic residue, combined with a Pitta imbalance. And if there is one thing I’ve learnt in my practice, it’s that unresolved emotions ferment like pickles in the body. Only, they don’t taste as good. They sting.
One woman—an accounts executive from Malleswaram—developed lesions on her scalp right after her wedding. She tried blaming it on bad shampoo, hard water, and even the astrologer. But as we spoke, it became clear: the real itch came from trying to be the perfect daughter-in-law. “I cook, clean, smile, work full-time—and still feel I’m not enough,” she confessed.
For her, psoriasis was not just a skin issue. It was her body protesting her self-abandonment.
In these cases, I often begin not with medicines, but with questions. Where are you suppressing anger? Why are you over-committing? What belief makes you think rest is laziness?
Many patients tear up at these questions because the truth stings more than the patches.
That’s not to say herbal medicines don’t help. They do. Wonderfully.
Neem cools and purifies the blood. Manjistha is a superb lymphatic cleanser. Khadira works like a charm in skin diseases, and Guduchi calms an aggravated immune system like a wise grandmother pacifying a cranky toddler. Aloe vera juice, amla, and turmeric become daily allies.
But if you apply a neem cream without addressing the mental flame, you’re just suppressing the messenger.
I always recommend a cooling diet—think moong dal, gourds, coconut water, barley, pomegranate, and ghee. Say goodbye to sour curd, tomato chutneys, and fiery pickles (yes, even the mango one that your ajji made with love). And put a full stop to late-night binge-watching true crime on Netflix. That’s not the heat your body needs.
But here’s the most radical part of my prescription: change your relationship with achievement.
Because perfectionism is not a badge of honour, it’s a skin rash waiting to happen.
I recently told my patient, “Learn to celebrate incomplete to-do lists. Take a nap without guilt. Laugh even when your house is a mess. Accept praise without suspicion. And for God’s sake, cry if you need to. Even Krishna wept on the battlefield.”
One girl—I’ll call her Kavya—got better only after she did something delightfully silly. She joined a pottery class. “Doctor, I finally made a crooked cup. And I love it,” she beamed. Her skin cleared within two months. I told her, “Your skin was waiting for you to let go of straight lines.”
Autoimmune diseases often teach what no therapist, spouse, or guru can. They ask us to soften. To slow down. To stop controlling everything. They are paradoxical blessings wrapped in irritation.
I see my role not just as a doctor, but as a translator. I help patients read the poetry their bodies are writing—albeit in a language of inflammation, flakes, and cracks. It’s messy, yes. But honest.
In this honesty, healing begins.
I’ve learned from my patients as much as they’ve learnt from me. Like the chartered accountant who healed faster when she took Sundays off. Or the startup founder who started journaling instead of bottling up their emotions. Or the over-giving mother who finally said, “No,” and saw her rashes recede.
There’s a line I often scribble on my prescription pad, right below the medicines:
“Heal the itch within, and the skin will follow.”
We are more than our skin, but the skin is often more truthful than our words.
If your elbows flare up, ask yourself: What am I trying to perfect? Who am I trying to please? And what part of me have I forgotten to love?
Scratching the surface won’t help. You have to go deeper.
