by Psoriasis, a systemic disease, involves inflammation throughout the body, but it is only visible on the skin.
Your skin itches and burns, and you have scaly, swollen, red areas on your knees, elbows, and scalp. After weeks of trying to treat it yourself with various over-the-counter ointments (almost never a good idea!), you visit a dermatologist who examines your skin and tells you, “You have psoriasis.”
You’ve seen all those recent TV commercials about plaque psoriasis, but it never occurred to you that it could cause your problem, and you certainly never thought it was something people could get when they’re older.
Psoriasis is a chronic autoimmune disease that affects more than 3% of the American adult population.
But, according to the American Academy of Dermatology, there are two peak incidences of the disease, with most cases occurring between the ages of 20 and 30. However, the peak period for late-onset psoriasis is between 50 and 60 years of age. age, and most people develop it between the ages of 57 and 60. Women tend to develop it at a younger age than men.
Psoriasis is a chronic autoimmune disease that affects more than 3% of the American adult population. The immune system becomes overactive, leading to an abnormally rapid cycle of production of new skin cells, which die and then accumulate on the surface of the skin.
This causes scaly, dry, cracked skin that is itchy and bleeding, with lesions most commonly found on the scalp, elbows, knees, trunk, palms, and soles of the feet. There may be thick, pitted nails.
Between 25 and 30 percent of people with psoriasis develop psoriatic arthritis, usually about seven years after developing psoriasis.
Jessica Kaffenberger, MD, associate professor of dermatology and director of the Division of Medical Dermatology at The Ohio State University Wexner Medical Center, says, “Psoriasis is a systemic disease in which inflammation exists throughout the body but is only visible on the skin.
He explains that between 25% and 30% of people who suffer from this condition develop psoriatic arthritis, usually about seven years after developing psoriasis itself, although a small percentage develop it before the skin manifestations, adding that “arthritis “Psoriatic disease is characterized by swelling in the back of the leg, pain in the heel, swelling of the fingers and toes, and morning stiffness that decreases during the day.”
It differs from osteoarthritis, a degenerative joint disease often associated with aging, which is often referred to as a “wear and tear” disorder.
Psoriasis symptoms sometimes go through cycles, becoming more severe for a few weeks or months, followed by periods in which they decrease or even go into remission. Most cases are mild and can be treated with topical creams and ointments. However, more severe cases may require phototherapy or the administration of oral or biological medications.
The goals of treatment are to reduce inflammation, discoloration of the lesions, and the amount of thickness and peeling. Results can be evaluated by a change in PASI (psoriasis severity index), used to rate the severity of symptoms and measure the patient’s response to treatment, and by BSA (body surface area), which estimates the percentage of each region of the body. affected.
According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, there are different types of psoriasis, the most common being plaque psoriasis, marked by red, raised patches of skin covered by silvery-white scales. Many people with psoriasis have other serious conditions, including:
- Cardiovascular disease, hypertension, high cholesterol levels.
- Metabolic syndrome
- Mental health problems such as depression, anxiety, low self-esteem, social anxiety.
- Celiac Disease
- inflammatory bowel disease
Dietary Approaches for Psoriasis Treatment
Because there is a high correlation between psoriasis and cardiometabolic disorders, improving diet (likely with subsequent weight loss) will have a positive impact on co-occurring conditions such as diabetes, cardiovascular disease, metabolic syndrome, and kidney disease. fatty liver.
The National Psoriasis Foundation recommends eating an anti-inflammatory diet rich in fruits and vegetables, lean proteins, whole grains, and healthy unsaturated fats, which outlines many of the components of the Mediterranean diet.
“Several studies have been conducted over the years to determine the best foods or diets for controlling psoriasis, as well as those that appear to be most harmful. It has been found that a diet high in sugar, which is known to increase inflammation , has the greatest negative impact on psoriasis symptoms,” says Kaffenberger.
A diet that includes an excessive intake of simple sugars causes dysbiosis (an imbalance of the organisms normally present in the intestine) with an increase in bacteria and inflammatory substances called cytokines.
Coffee, which contains antioxidant-rich polyphenols, has been shown to have an anti-inflammatory effect, suggesting it may benefit psoriasis.
A 2017 study published in the journal Dermatology and Therapy surveyed more than 1,200 psoriasis patients who were members of the National Psoriasis Foundation and found that about 43% of respondents were unsure whether diet affected their psoriasis.
Those who checked yes for dietary influence noted that their symptoms were exacerbated by sugar, alcohol, tomatoes, other nightshade vegetables such as eggplant and peppers, gluten, and dairy. Excessive alcohol consumption has been associated with the development of psoriasis, as well as increasing its severity.
Less commonly reported triggers included meat, processed foods, soda, bread, eggs, and spicy foods. The study also asked patients if there were foods that seemed to improve their symptoms. 35.1% of individuals reported that dietary supplements reduced skin irritation, while others recommended vegetables, fruits and fish.
Dietary supplements that were helpful included vitamins (especially vitamin D), probiotics, fish oil/omega-3, and turmeric capsules. Fruits and vegetables provide many antioxidants (such as carotenoids, flavonoids, vitamins, and minerals), which have been inversely correlated with C-reactive protein (CRP), a measure of inflammation.
Several patients reported favorable results following Pagan, Vegan, and Paleolithic diets, and others praised gluten-free, low-carbohydrate, high-protein, Mediterranean, and vegetarian diets. The Pagano Diet was created by chiropractor John Pagano, author of the 2008 book “Healing Psoriasis,” and believed that psoriasis was a manifestation of leaky gut syndrome, in which the skin worked overtime to release toxins.
Coffee, which contains antioxidant-rich polyphenols, has been shown to have an anti-inflammatory effect, suggesting it may benefit psoriasis. However, according to the Psoriasis and Psoriatic Arthritis Alliance, the evidence on its usefulness needs to be more consistent.
Some studies show that higher coffee intake correlates with increased symptoms. In contrast, others show that coffee can improve the effectiveness of some medications to treat psoriasis.
Research has suggested that its effect on psoriasis is dose-dependent: moderate consumption (up to three cups per day) relieves symptoms and decreases inflammation, and higher caffeine intake has an adverse effect.
Healthy living and psoriasis
“Because adipose tissue (fat) is a metabolically inflammatory substance, weight loss for those who are obese can be extremely helpful in reducing the symptoms of psoriasis, as well as reducing the comorbidities that often coexist.” says Kaffenberger, who adds that “intermittent fasting has been shown to decrease inflammation and increase life expectancy, but many people find the diet difficult to follow.”
Now that you’re well aware of the supposed link between diet and psoriasis, you may want to make some modifications to increase your healthy eating habits (never a bad idea whether you have the disorder or not). These changes may include:
- Avoid highly processed foods, foods high in saturated or trans fats, and foods high in added sugar or refined carbohydrates.
- Increase consumption of plant-based foods rich in fiber, such as vegetables, fruits, nuts, seeds and whole grains.
- Eat lean proteins and fatty fish, which are high in omega-3s; limit red meat consumption
- Use healthy unsaturated fats such as extra virgin olive oil and vegetable oils and eat healthy fats such as avocado or dark chocolate.
