Psoriasis and Diet: How Foods Can Impact Inflammation

Embracing a healthy, balanced nutrition plan is often key to supporting various areas of health and wellness. After all, the foods we put into our bodies have the power to fuel us or harm us depending on a variety of factors, such as biological considerations and underlying health conditions.

And when it comes to skin conditions like psoriasis, food certainly has a part to play, especially when you’re dealing with flare-ups.

Dermatologist Anthony Fernandez, MD, PhD, explains just how the foods you eat might help reduce the severity of your psoriasis and what foods may be triggering an onset of your symptoms.

The connection between diet and psoriasis

Psoriasis is an autoimmune condition characterized by discolored scales, plaques or raised rashes on your skin. These itchy, painful plaques occur because of your immune system’s over-active inflammatory response. When your immune system targets its own healthy skin cells, it creates a cycle of inflammation and swelling that results in an over-production of skin cells and a buildup of scales. In some cases, people with psoriasis may also develop psoriatic arthritis, or inflammation in their joints.

While neither of these conditions is caused directly by anything that you eat, some foods can cause inflammation. For example, processed meats, high-sugar desserts and fried foods can all cause widespread inflammation and irritation that also eventually add to your overall amount of body fat. And studies have shown that an increase in body fat leads to more long-term inflammation, meaning you’re more at risk for psoriasis if you have overweight or obesity.

“We have great evidence to support that if you have overweight or obesity, losing weight via a hypocaloric (low-calorie) diet will improve the overall severity of your psoriasis,” says Dr. Fernandez.

That said, it’s not about how much you eat — but what you eat, how active you are and other lifestyle changes that can make a real difference when it comes to your overall health and wellness, as well as the severity of your psoriasis symptoms.

Current evidence suggests that people with psoriasis should work directly with their healthcare providers to design nutrition plans that cater to their individual needs, in addition to pursuing current treatment options for psoriasis. Focusing on improving your overall health, including your diet, not only sets you up for success when flare-ups strike, but it also helps reduce your risk for other complications associated with psoriasis, like:

• Diabetes.
• High cholesterol.
• Stroke.
• Heart disease.

“Exercise is good for your immune system, and can also help promote weight loss because of the calories that you burn,” notes Dr. Fernandez. “Wellness, in general, is good to strive for. Strategies such as eating well, exercising and getting enough sleep are all keys to help minimize the chances you’re going to flare.”

He adds that certain people improve so much with diet and exercise that they don’t need medication. “But we think of that as more the exception, and we certainly don’t say that’s all you need to do,” he says, noting that neither exercise nor diet is recommended as an alternative to medications and current treatments. But research shows these added elements to treatment can improve patient outcomes.

“For some people, the improvements they see through exercise and diet might mean all they need is a topical medicine to manage their psoriasis, as opposed to a pill or an injectable medicine that affects their immune system systemically and can come with other side effects,” he adds.

Chances are, people with moderate to severe psoriasis will likely always need medication, he notes. “However, we do believe we can minimize the medications you need to take through wellness and diet.”

Foods to avoid when you have psoriasis

A quick hunt on your favorite search engine will give you several long lists of foods you should avoid if you’re living with psoriasis. But Dr. Fernandez cautions everyone from using those checklists as wholesale advice. The reason? There’s no solid scientific evidence yet that proves there’s one specific food that causes a psoriatic flare-up for everyone.

That said, you may come across some foods that trigger some of your symptoms. When that happens, it’s important to pay attention to how those foods make you feel. For example, one person might experience a flare-up more often when they eat steak, while another person does not. Based on what we know so far, these experiences are based on your own unique biological responses, and they’re worth noting.

Keep a food journal and take notes on how you feel when you eat those foods and how you feel when you avoid them altogether. Then, bring that evidence to your healthcare provider. If you’re interested in starting an anti-inflammatory diet — or any diet, really — having this information on hand will help inform your healthcare provider’s recommendations for a nutrition plan that meets your individual needs.

“We’re always open to experimenting with simple, safe things like that,” encourages Dr. Fernandez. “Everyone’s unique and may have a unique trigger for their disease. We’ll take it seriously if brought up.”

For example, if you’ve developed food intolerances to things like gluten or you have celiac disease, a gluten-free diet can help reduce inflammation and irritation, which can then improve your overall response to inflammation and reduce the severity of psoriasis flare-ups.

Similarly, if you’re living with psoriasis and you’re looking to improve your overall health, limiting your interactions with the following may also help reduce the severity of inflammation, as well as other psoriasis symptoms:

• Alcohol.
• High glycemic/high sugar foods, like doughnuts, white bread, soda and fruit juices.
• Foods high in saturated fats and trans fats, like red and processed meats, dairy products, fried food, fast food and processed snacks.
• Ultra-processed foods, like frozen meals, candy, soft drinks and sweetened cereals.

“These foods all tend to be high in calories and many have a high sugar content, both of which can promote obesity. Foods with high glycemic indices can increase blood glucose levels and promote diabetes, too,” says Dr. Fernandez.

“Both adipose tissue itself and these foods promote inflammation and, therefore, can lead to psoriasis flares. Plus, obesity, diabetes and inflammation can all contribute to the development of heart disease.”

Foods you should eat

If you’re looking to fight the inflammation that triggers psoriasis, you want to focus on a healthy, balanced diet full of:

• High-fiber fruits and vegetables, like leafy greens, blueberries, carrots and pears.
• High-quality proteins, like beans, lentils, Greek yogurt and eggs.
• Healthy fats found in foods like avocados, extra-virgin olive oil and walnuts.
• Omega-3 fatty acids found in a variety of fish like wild salmon, herring or tuna, and flaxseed oil.

Vitamins and minerals are also important to consider, though you should get these from whole foods whenever possible. For example, vitamin D (which is commonly used in many topical treatments for psoriasis) can be found in a variety of foods like beef liver, egg yolk and Swiss cheese.

And some swear by turmeric’s anti-inflammatory properties.

But Dr. Fernandez strongly advises avoiding relying solely on supplements to decrease inflammation because more scientific evidence is needed on whether these can help treat psoriasis directly.

Plus, these methods shouldn’t be considered as first-line treatments or the only treatment for psoriasis, especially when they’re taken in the form of supplements.

“There simply is no strong evidence at the moment to support any supplements are going to make a difference with psoriasis,” he states.

The Mediterranean diet and psoriasis

Knowing what we know so far, a balanced diet full of healthy options geared to benefit and improve your overall health will likely also impact the severity of psoriasis symptoms in a positive way long term — especially if it’s helping with weight management.

While there’s no single diet-related “cure” for psoriasis, the Mediterranean diet does offer a good place to start if you’re looking for a nutritional plan that’s well-rounded and supported by a healthy body of research.

This eating style specifically is one of the most commonly recommended nutritional plans because it’s full of heart-healthy foods and anti-inflammatory ingredients that have been shown to help reduce your risk of heart attack, stroke, cancer and other conditions.

“The Mediterranean diet is the one most people recommend when discussing how to change your diet and improve your psoriasis,” confirms Dr. Fernandez. “This diet involves foods that have anti-inflammatory properties. They’re low in fat. They’re low in calories. And most of them are natural.”