In women of working age, migraine and psoriasis are not "just" a headache or a skin rash, but diagnoses with a strong systemic impact. They affect work, family, and mental life, are accompanied by stigma, and bring significant economic losses. Female experts in dermatology, neurology, and health economics explained the connections between inflammation, hormones, and treatment, and why targeted and early treatment is worthwhile.
Migraine: more than a headache
Migraine is often mistaken for any headache, but it has its own typical manifestations: in addition to pain, it brings nausea, photophobia, phonophobia, and the so-called post-migraine "fog." A single attack can incapacitate for two to three days, and at higher frequency it severely limits functioning. Women suffer from it about three times more often; estrogen fluctuations play a significant role, influencing serotonin. Menstrual attacks and the associated anticipatory anxiety are also well known.
Delayed or improperly managed treatment keeps a vicious cycle of absenteeism, stress, and worry going. Some female patients do not receive modern preventive therapy despite being indicated, while self-medication and overuse of analgesics can trigger medication-overuse headache. A higher body mass index worsens the course of migraine: it increases intensity and frequency and prolongs recovery. Identifying triggers and combining prevention with adequate acute treatment helps.
Psoriasis: skin as a mirror of systemic inflammation
Psoriasis is no longer understood as just a skin problem—the inflammation also occurs inside the body. Comorbidities accumulate with the disease, including metabolic syndrome, cardiovascular problems, migraine, and psoriatic arthritis. If treatment is not started in time, the risk of further complications increases; higher risk of migraine is even mentioned with delayed treatment initiation. For women, the burden is compounded by appearance-related stigma and time-consuming topical care.
Obesity acts as an endocrine organ producing pro-inflammatory cytokines that sustain flares. This leads to more frequent sick leave, pain, and even to structural joint damage. So-called "hard-to-treat" sites also significantly worsen quality of life, such as the scalp or the genital area, even if the overall score may not look high. Today's therapeutic goal is clear skin and a return to everyday life.
Targeted therapy and the cost of inaction
The adverse impact is not only personal: in Slovakia, billions of euros are spent annually on disability and short-term sick leave, while Europe quantified the burden of migraine years ago at tens of billions and losses on the order of up to 1–2 % of GDP. Better diagnosis and early prevention would curb inefficient spending on poorly effective drug combinations and improve productivity. In dermatology, interleukin-23 inhibitors are game changers; in neurology, antibodies targeting CGRP and the so-called gepants. Real-world experience shows fewer attacks, milder courses, better adherence, and fewer clinic visits.
We run into barriers, however: rigid categorization with mandatory "steps," administrative burden, and uneven access, although specialized centers help. Registries are lacking that would objectively show the benefits and speed up proper patient routing. In psoriasis, the goal is clear, symptom-free skin; in migraine, fewer and shorter attacks, better response to acute treatment, and management of anxiety. According to experience, female patients are often willing to pay extra for effective therapy if it restores their functioning and quality of life.
