Psoriasis is one of those conditions that if you suffer from it, it is something that you're told you have to live with. But that’s not necessarily the case.
Psoriasis like many skin conditions is multi factorial meaning that there’s no one known cause which often makes it harder to treat. This does mean that more often than not, then steroids, lotions and creams are prescribed to treat the symptoms of psoriasis.
But is that all there is to it or can more be done to reduce symptoms and make living with psoriasis a little less uncomfortable for those that have the condition.
So, what do we know about psoriasis?
Psoriasis is a chronic inflammatory skin disease, which means that it causes the immune system to mistakenly attack healthy cells. It causes symptoms on the skin and sometimes the joints, and this often appears as scaly and itchy patches on the skin which can often become inflamed. It can occur anywhere on the body including the scalp, hands, feet and genitals.
There are several types of psoriasis with different manifestations. The most common is plaque psoriasis which often appears as plaques from the build up of skin cells that are red, itchy and sore, with white or silvery scales.
Scalp psoriasis is found on the scalp but also the hairline, neck, and behind the ears. It causes dandruff like flakes to fall out as well as thinning of the hair.
Guttate Psoriasis also known as teardrop psoriasis appears as a rash of small red spots that are widespread particularly on the torso, back and arms and legs. This type of psoriasis often occurs in young children, teenagers and young adults.
Pustular psoriasis refers to both Palmoplantar Pustulosis (PPP) as well as Generalised pustulosis psoriasis (GPP).
People with PPP often have very red or dark skin on the palms of the hands or soles of the feet, covered with small pustules which are filled with a clear or creamy fluid.
So what causes Psoriasis?
Now this part is unknown, in fact its multifactorial meaning that there are often several reasons that psoriasis appears.
If you type in Google causes of psoriasis there will be lots of different theories and ideas. What we do know is that Genetics plays a big part in the development of psoriasis, as does our immune system, Stress, our gut health as well as food triggers.
One thing is for sure, is that treating the symptom often isn’t the best solution and that we should be looking at the route cause and supporting our body to reduce symptoms rather than just cover them up with steroids and lotions that often just strip away the inflamed skin which then comes back when new skin cells regenerate.
If genetics plays a big part in it, does that mean you are predisposed to the condition and there’s nothing you can do? That’s definitely not the case. Okay so one of your parents had it, but that’s not to say that you will inherit this condition, in fact we have the power to turn on and turn off certain genes that predispose us to illnesses and diseases.
This is particularly relevant with autoimmune conditions which often predispose us to them. But autoimmune diseases arise from not only our genes but also environmental triggers. You see a combination of these two things disrupts our bodies own immune system’s ability to ignore a person’s own tissue and cells, therefore resulting in the symptoms of psoriasis.
So, we have the ability to almost turn off these genes that predispose us to certain conditions and our environment, lifestyle, diet and stress levels all play a part in this.
What we know is that psoriasis is inflammation but that’s not necessarily on the skin, in fact most inflammation begins within the body and we know that psoriasis is a combination of increase in inflammatory markers such as IL-23, IL-17 pathway, reactive oxygen species, suppression of T cells which results in inflammation, and gut dysbiosis.
Yes the gut plays a pivotal role in symptoms of psoriasis. With 70% of our immune system produced in the gut, then any imbalances within the gut can result in dysregulation of the immune and inflammatory pathways and auto-immune conditions.
Very often unbalanced dietary habits play a role in the manifestation of psoriasis and gut dysbiosis, with Higher intake of trans fats, lower intake of fish and dietary fibre, combined with high intake of simple sugars, red meat and alcohol. These factors cause a cascade within the bodies inflammatory pathway causing inflammation and gut dysbiosis.
Studies have shown that people with psoriasis have less diversity in the gut microbiota than healthy individuals.
So if we know that Psoriasis is an inflammatory condition, what we need to be looking at is reducing the inflammation and that includes what we eat, our lifestyle as stress can be a big trigger for inflammation and our lifestyle.
Omega 3 from oily fish has a big influence on not only our gut health but also reducing inflammation. The EPA and DHA found in fish such as salmon, sardines and mackerel are anti-inflammatory, and they help to reduce production of pro-inflammatory cytokines within the body. Omega 3 fats also exert a positive action by reverting the microbiota composition in these diseases and increase the production of anti-inflammatory compounds.
Deficiency in vitamin D has been associated with increased autoimmunity as well as an increased susceptibility to infection. Vitamin D has many roles within the body from supporting bone health to immune function by modulating the innate and adaptive immune responses. and with this in mind, numerous studies have shown that vitamin D plays a role in reducing auto-immunity susceptibility and even reduce inflammation associated with these conditions.
Probiotics are live bacteria that can have a positive influence on our own gut microbiota. Stress, high consumption of sugar, low dietary fibre in our diet, alcohol consumption, medicine use, antibiotic use can all influence our own gut flora causing imbalances and inflammation that isn’t just localised in the gut but can manifest in others areas such as the skin, and joints. Probiotics provide our gut with beneficial bacteria that helps to restore and balance out the good bacteria from the not so good bacteria which can result in inflammatory issues.
Fibre rich foods such as prebiotics, colourful vegetables, fruit, wholegrains help to feed that good bacterium and provide wonderful nourishing nutrients that reduce inflammation and support gut, skin and immune health.
Although there isn’t any one fix, there is lots that can be done to establish a cause, reduce inflammation and improve symptoms without the need to use steroids and lotions. Remember that we are all different and there isn’t a one size fits all approach to any condition but that’s where Nutritional Therapy plays a part in establishing what works for you, looking further than just the symptom and working to address any imbalances and helping to find comfort.
If you would like to find out more about how nutritional therapy can help you or to book an appointment click here.
Calder P. Omega-3 fatty acids and inflammatory processes: from molecules to man. Biochemical Society Transactions. 2017;45(5):1105-1115.
Costantini L, Molinari R, Farinon B, Merendino N. Impact of Omega-3 Fatty Acids on the Gut Microbiota. International Journal of Molecular Sciences. 2017;18(12):2645.
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