Can your diet help control psoriasis?

Prioritizing anti-inflammatory foods can help manage psoriasis symptoms.

Psoriasis affects an estimated 125 million people worldwide and can cause physical discomfort and emotional distress. The usual treatments involve topical creams, oral medications and biologics, and while they can relieve the symptoms and reduce occurrences, a cure hasn't been found yet.

Psoriasis can flare and abate based on several factors, including other illnesses, stress and even the weather. Many people with psoriasis want to know if they can make lifestyle changes to manage their symptoms, including dietary changes.

It's important to realize everyone's immune system is different, so there isn't a specific psoriasis diet that works for everyone. But you may be able to figure out if certain foods contribute to your inflammation. Here's what to consider if you're thinking about changing your diet to help manage psoriasis.

What is psoriasis?

Psoriasis is a chronic autoimmune condition that often presents as raised red patches of skin, sometimes topped with silver scales or flakes. It happens when your system becomes overactive, which can cause skin cells to multiply too quickly and trigger inflammation. It can be itchy and painful, especially if the skin dries out and cracks. Patches commonly appear on the back, elbows, face, feet, knees and palms. In some cases, the inflammation caused by psoriasis can lead to joint swelling and pain or changes in the texture or color of fingernails and toenails.

What is the connection between diet and inflammation?

Inflammation is your immune system's response to injury or infection. It helps your body fight off irritants or foreign invaders, whether it's a splinter in your finger or a virus. A little bit of inflammation can help keep you healthy. But when inflammation becomes chronic — meaning it doesn't go away once you're better — it can damage your body by breaking down tissue, creating excess tissue that forms scars and allowing fluid to build up and compress nerves.

What you eat can play a significant role in promoting or reducing inflammation. Foods like fruits, vegetables and whole grains are considered anti-inflammatory because they have compounds such as antioxidants and polyphenols. Fatty fish like salmon and mackerel are also great for reducing inflammation because they're packed with omega-3 fatty acids, an essential polyunsaturated fat that your body can't produce on its own.

Foods like bacon, hot dogs and white bread are considered pro-inflammatory. Your body processes these foods differently than it processes natural foods. Pro-inflammatory foods also tend to have extra ingredients your body doesn't need and doesn't know what to do with.

What are common dietary triggers for psoriasis?

Although there isn't a definitive psoriasis diet, some foods may persistently lead to flare-ups for some people. These foods tend to be ultra-processed — meaning they are made with substances that are extracted from foods — and contain high amounts of fat, salt and sugar. Because they trigger inflammation, they can contribute to or worsen psoriasis symptoms.

Identifying your food triggers usually takes trial and error — sometimes called an "elimination diet." It involves keeping a detailed food journal so you can narrow down potential culprits.

Common dietary triggers for psoriasis include:

• Red meat: Meats like beef, lamb and pork have arachidonic acid, a polyunsaturated fatty acid that can contribute to psoriasis lesions.
• Alcohol: Not only can alcohol cause inflammation, but it can worsen existing inflammation as well. When you drink alcohol, your body metabolizes it into a chemical that can cause cell damage and oxidative stress. Alcohol can also interfere with psoriasis medication.
• Dairy: Products like cheese and yogurt, especially the full-fat versions, can contribute to inflammation. People who are sensitive to casein, a protein in milk, might notice psoriasis symptoms getting worse.
• Nightshade vegetables: These include eggplant, peppers, potatoes and tomatoes. Nightshade vegetables contain solanine, an alkaloid that can be toxic in high amounts. People who are sensitive to alkaloids may avoid eating nightshades or reduce their consumption.

Can an elimination diet help control psoriasis?

If the above foods are staples in your diet, an elimination diet can help you identify which ones trigger your psoriasis. With an elimination diet, you remove suspected trigger foods for several weeks and monitor your symptoms. If you notice an improvement, you can start to slowly reintroduce foods while taking note of any worsening symptoms. If symptoms return after you introduce a food, it may be a trigger.

Take precautions before you start removing foods from your diet. An elimination diet can be restrictive, so it's best to work with a healthcare professional or nutritionist to make sure you're still getting the nutrients you need.

The relationship between diet and psoriasis is complex, but evidence suggests that what you eat (or don't eat) can have a significant effect on your psoriasis symptoms. Prioritizing anti-inflammatory foods can help manage symptoms, but you should also be aware of potential triggers.