Can Psoriasis Cause Hearing Loss? What the Research Really Shows
Psoriasis is known for red, scaly patches on the skin. But it doesn’t stop there.
Growing evidence shows psoriasis is a whole-body inflammatory disease. And one of its lesser-known effects may be on your hearing.
This article breaks down what the science says about psoriasis and hearing loss. You’ll learn the possible causes, the warning signs, and what you can do to protect your ears.
Quick Answer: Yes, Psoriasis Is Linked to Hearing Loss
Multiple studies confirm that people with psoriasis face a higher risk of hearing problems than people without it.
The connection is strongest for sensorineural hearing loss. This is inner ear damage that affects how sound signals reach the brain.
Psoriasis has also been linked to sudden sensorineural hearing loss (SSNHL), a rare but serious condition that can cause hearing loss within 72 hours.
It’s important to note that not everyone with psoriasis will develop hearing problems. But the risk is measurably higher, and doctors say it’s worth paying attention to.
What Does the Research Say?
A Large 2023 Meta-Analysis Confirms the Link
A systematic review and meta-analysis published in 2023 pooled data from 15 studies involving over 202,000 people. Researchers searched major medical databases and analyzed pooled odds ratios for sensorineural hearing loss and hazard ratios for sudden sensorineural hearing loss related to psoriasis.
The results showed psoriasis was associated with measurable hearing loss across several sound frequencies, including 500 Hz, 1000 Hz, 2000 Hz, 4000 Hz, and 6000 Hz. The higher frequencies showed the biggest differences.
People with psoriasis also had significantly higher odds of developing sensorineural hearing loss and a greater risk of sudden sensorineural hearing loss compared to people without the condition.
A Korean Cohort Study Tracked Thousands of Patients
A separate long-term study used national health insurance data from South Korea. Researchers followed a matched psoriasis group of nearly 13,000 people and a control group of over 51,000 people from 2002 to 2013.
The incidence of sudden sensorineural hearing loss was significantly higher in the psoriasis group than in the control group, and psoriasis was found to increase the risk of sudden sensorineural hearing loss even after adjusting for other health conditions.
This type of study is valuable because it tracks people over time. It shows psoriasis patients developing hearing loss at higher rates, not just reporting it after the fact.
Italian Researchers Found Similar Auditory Damage
A clinical study out of Italy compared psoriasis patients directly with matched healthy controls using hearing tests and ear exams. Hearing loss, mostly of the sensorineural type, was significantly more common in psoriasis patients than in controls.
Conductive and mixed hearing loss showed up more often in patients who also had psoriatic arthritis compared to those with skin-only psoriasis. Longer disease duration and smoking also raised the risk.
Notably, psoriasis tended to be more severe in patients who had hearing loss than in those who didn’t. This suggests a possible dose-response relationship between disease severity and ear damage.
Abnormal Ear Function Even Without Obvious Symptoms
Researchers writing in Acta Dermato-Venereologica found abnormalities weren’t limited to hearing thresholds. Tympanogram abnormalities, which reflect how the eardrum and middle ear function, showed up more often in psoriasis patients than in controls.
This tells us psoriasis may affect more than just the inner ear. The middle ear and eardrum function can be involved too, even before a person notices any hearing changes.
Why Would Psoriasis Affect Hearing?
Chronic Inflammation Is the Likely Culprit
Psoriasis is an autoimmune disease. Your immune system mistakenly attacks healthy tissue, causing the inflammation that shows up as skin plaques.
That same inflammation doesn’t always stay confined to the skin. Researchers believe circulating inflammatory proteins can also damage delicate structures inside the inner ear.
TNF-Alpha and the Cochlea
Some researchers have connected hearing loss in psoriasis patients to higher blood levels of TNF-alpha, a protein that rises during severe psoriasis flares, which may cause damage to the cochlea, the spiral-shaped organ responsible for hearing.
The cochlea relies on tiny hair cells and a rich blood supply to convert sound into nerve signals. Inflammation and impaired blood flow can damage these structures over time.
Autoimmune Attacks on the Inner Ear Aren’t New
The idea of autoimmune-related inner ear damage isn’t new. Case reports describing autoimmune sensorineural hearing loss date back to the late 1950s, long before researchers connected the pattern specifically to psoriasis.
This history matters. It shows that autoimmune-driven hearing loss is a recognized phenomenon, and psoriasis fits the broader pattern.
Shared Vascular Pathways
Sudden sensorineural hearing loss is thought to occur, in part, because of poor blood supply to the inner ear. Psoriasis is a well-known immune-mediated disease, and its autoimmune pathophysiology is consistent with the immune-mediated systemic vascular hypothesis behind sudden sensorineural hearing loss.
In simple terms, psoriasis and sudden hearing loss may share the same underlying inflammatory and vascular pathways. That overlap could explain why the two conditions show up together more often than chance would predict.
Psoriatic Arthritis and Hearing: An Even Stronger Link
Psoriatic arthritis (PsA) is a related condition where inflammation targets the joints. Some people have both psoriasis and PsA, while others have joint inflammation with minimal skin symptoms.
Research comparing people with psoriatic arthritis, people with psoriasis alone, and a healthy control group found the psoriatic arthritis group was more likely to report hearing impairment, and audiometric testing backed up those self-reports.
Even after adjusting for other risk factors, people with psoriatic arthritis were significantly more likely to have hearing loss than either psoriasis patients without PsA or the control group. This suggests joint-related inflammation may carry an even higher risk to hearing than skin symptoms alone.
Separate case-control research also suggests a link between psoriatic arthritis and inner ear damage, which can affect both hearing and balance. Balance problems and dizziness sometimes accompany the hearing changes.
If you have both psoriasis and joint pain, it’s worth mentioning any hearing changes to your rheumatologist as well as your dermatologist.
Can Psoriasis Medications Affect Hearing Too?
This is a fair question, since some drugs are known to damage hearing on their own.
At least one case report has documented a woman who developed sudden bilateral sensorineural hearing loss after being treated for psoriasis with acitretin, a retinoid medication. This remains an isolated report rather than an established pattern, but researchers have flagged it as worth further study.
Some study authors have specifically noted that large psoriasis cohort studies often don’t account for whether patients’ medications could have been ototoxic and contributed to sudden hearing loss. This is an important research gap, and it means the full picture isn’t settled yet.
Common systemic psoriasis treatments include methotrexate, cyclosporine, acitretin, and biologic drugs. None of these are classified as major ototoxic drugs in the way that certain antibiotics or chemotherapy agents are, but talk to your prescribing doctor if you notice any hearing changes after starting a new medication.
Warning Signs to Watch For
Hearing loss linked to psoriasis can develop gradually or suddenly. Knowing the signs helps you catch it early.
Gradual signs include:
- Trouble understanding speech in noisy places
- Frequently asking people to repeat themselves
- Turning up the TV or phone volume more than usual
- Ringing or buzzing in the ears (tinnitus)
Sudden sensorineural hearing loss is a medical emergency. It typically involves a rapid drop in hearing, often in one ear, that develops over hours to a few days. If this happens, seek medical care immediately, since early treatment improves the odds of recovery.
How Is Psoriasis-Related Hearing Loss Diagnosed?
There’s no single test that confirms psoriasis caused a hearing problem. Instead, doctors build a picture using several tools.
- Pure tone audiometry measures the quietest sounds you can hear across different frequencies.
- Tympanometry checks how well your eardrum and middle ear are functioning.
- Speech reception testing evaluates how well you understand spoken words.
- Blood tests may be used to check inflammatory markers, especially if autoimmune involvement is suspected.
If you have psoriasis and notice any hearing changes, ask your doctor for a referral to an audiologist or ENT specialist (otolaryngologist).
Can You Prevent or Reduce the Risk?
There’s no guaranteed way to prevent hearing loss if you have psoriasis. But several strategies may lower your risk or catch problems early.
- Keep psoriasis well controlled. Since disease severity appears linked to hearing risk, effective treatment may help protect your ears too.
- Avoid smoking. Research has tied smoking to a higher rate of hearing loss in psoriasis patients.
- Get regular hearing checks, especially if you have psoriatic arthritis or long-standing psoriasis.
- Protect your ears from loud noise, since noise exposure adds an extra burden on top of inflammatory damage.
- Report symptoms early. Sudden hearing changes need urgent medical attention, ideally within days, not weeks.
When to See a Doctor
Talk to a healthcare provider if you have psoriasis and experience any of the following:
- Sudden hearing loss in one or both ears
- Persistent ringing or buzzing sounds
- Ongoing difficulty following conversations
- Dizziness or balance problems along with hearing changes
Early evaluation gives you the best chance of managing or reversing the problem, particularly with sudden sensorineural hearing loss.
The Bottom Line
Psoriasis is no longer viewed as a skin-only condition. Research consistently shows it’s linked to a higher risk of sensorineural hearing loss, including the sudden form that requires urgent care.
The likely explanation involves chronic inflammation, immune system activity, and shared vascular pathways between the skin and the inner ear. People with psoriatic arthritis appear to face an even higher risk than those with skin symptoms alone.
If you live with psoriasis, don’t ignore changes in your hearing. Bring them up with your doctor, and consider a baseline hearing check if you have long-standing or severe disease.
Frequently Asked Questions
Can psoriasis really cause hearing loss?
Yes. Multiple studies, including a large 2023 meta-analysis of over 200,000 people, found a clear association between psoriasis and sensorineural hearing loss.
What type of hearing loss is linked to psoriasis?
The strongest link is with sensorineural hearing loss, which involves damage to the inner ear or auditory nerve. Psoriasis is also linked to sudden sensorineural hearing loss, a rapid-onset form.
Is the hearing loss from psoriasis permanent?
It depends on the type and how quickly it’s treated. Sudden sensorineural hearing loss can sometimes improve with prompt treatment, while gradual sensorineural hearing loss is often permanent.
Does psoriatic arthritis increase hearing loss risk more than psoriasis alone?
Yes. Research shows people with psoriatic arthritis are more likely to have measurable hearing loss than people with psoriasis alone or people without either condition.
What causes the connection between psoriasis and hearing loss?
Chronic inflammation is the leading theory. Elevated inflammatory proteins like TNF-alpha, along with impaired blood flow to the inner ear, may damage the structures responsible for hearing.
Can psoriasis medications cause hearing loss?
Standard psoriasis drugs aren’t classified as major ototoxic agents, but at least one case report links acitretin to sudden hearing loss. Tell your doctor if you notice hearing changes after starting a new medication.
What are early signs of hearing loss I should watch for?
Common early signs include asking people to repeat themselves, trouble hearing in noisy environments, ringing in the ears, and turning up volume on devices more than before.
How is psoriasis-related hearing loss diagnosed?
Doctors typically use pure tone audiometry, tympanometry, and speech testing. Blood tests may also be used to check for active inflammation.
Can treating psoriasis improve hearing outcomes?
Research suggests hearing loss risk correlates with psoriasis severity, so keeping the condition well controlled may help lower risk, though this hasn’t been proven as a direct treatment for hearing loss.
When should I see a doctor about hearing changes and psoriasis?
See a doctor right away if you notice sudden hearing loss, as this is a medical emergency. For gradual changes, schedule an evaluation with an audiologist or ENT as soon as possible.
Sources and References
- Wu, C. et al. “Association of Psoriasis With Hearing Loss: A Systematic Review and Meta-Analysis.” PubMed, 2023. https://pubmed.ncbi.nlm.nih.gov/37231542/
- “Association of Psoriasis With Hearing Loss: A Systematic Review and Meta-Analysis.” ResearchGate. https://www.researchgate.net/publication/371070261_Association_of_Psoriasis_With_Hearing_Loss_A_Systematic_Review_and_Meta-Analysis
- “Psoriasis Increases the Risk of Sudden Sensorineural Hearing Loss: A Longitudinal Follow Up Study Using a National Sample Cohort.” International Journal of Environmental Research and Public Health, National Center for Biotechnology Information. https://pmc.ncbi.nlm.nih.gov/articles/PMC7764529/
- “Evaluation of Auditory Functions in Patients with Psoriasis.” PMC, National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC10447668/
- “Auditory System Involvement in Psoriasis.” Acta Dermato-Venereologica. https://www.medicaljournals.se/acta/content/html/10.2340/00015555-2937
- “The Connection Between Psoriasis and Hearing Loss.” Helping Me Hear. https://www.helpingmehear.com/hearing-loss-articles/the-connection-between-psoriasis-and-hearing-loss/
- “Psoriatic Arthritis & Hearing Loss: How PsA Affects the Ears.” Healthgrades. https://resources.healthgrades.com/right-care/psoriatic-arthritis/psoriatic-arthritis-and-hearing-loss
- https://www.psoriasis.org/related-conditions/
This article is for informational purposes only and does not replace professional medical advice. If you’re experiencing hearing changes, consult a licensed healthcare provider or audiologist.
