Psoriasis

Psoriasis is a chronic inflammatory skin disease, affecting approximately 2% – 3.5% of the population, that’s about 152-200 million people give or take (Menter, A., & Stoff, B., 2010)(Meng, S., et al., 2018). Psoriasis is currently labeled as an ‘incurable’ disease by orthodox medicine, however, when taking a look at the root cause and working from there, psoriasis can be prevented, managed, and reversed. The first written description of the disease is believed to have been by the Greek philosopher Celsus (25 BC -45 AD), however, during this time and until 1841 when there was made a medical separation (by Austrian dermatologist Ferdinand Herba – he had lobbied for the ‘psoriasis’, a term coined by the Greek physician Galen, to be used for the scaling skin disease), psoriasis was often confused with leprosy (Menter, A., & Stoff, B., 2010) (Fry, L., 2004).  

What is Psoriasis?

Psoriasis is an autoimmune skin disease, that can be lifelong if lifestyle and environmental factors are not adjusted. Psoriasis, though an inflammatory skin disease, is a topical manifestation of what is also occurring inside the body (Pagano, J.O.A., 2008). The immune system sends a continuous signal to speed up the skin cell growth cycle resulting in a faster turn over of skin cells every few days where it would normally take about one month. This leaves a pile-up of dead skin cells on the surface of the epidermis and throughout the dermis (Fitzgerald, M., 2014). Psoriasis is primarily characterized by scaling, patchy and silvery looking skin and an immune system that has an excess of T helper cells (Lipski, E., 2012).

Psoriasis can occur as a result of intestinal permeability (Kharrazian, D., 2013), or perhaps an overproduction of cytokines which are produced naturally by the immune system to stimulate inflammation. There is no one reason psoriasis occurs, there are many factors that come into play to result in such a drastic flare-up of inflammation (Pagano, J.O.A., 2008). High toxicity in the body and impaired liver function is another major player in the occurrence of psoriasis. When the liver, kidney, and lungs are overloaded the skin begins to eliminate toxins at an increased level (Freeman, S., 2000) (Holford, P., 2009).

The effects of psoriasis are cyclical, meaning they flare up and down, this is often a sign our bodies give to alert us that something we are doing is not right (Lipski, E., 2012). This might be the way we handle stress, or what we eat or what we put into or onto our bodies. Our understanding of what psoriasis is has changed and continues to change. Older research states that psoriasis has no cure and there is no reason as to why it occurs. Newer research, that takes nutrition into account is showing that there is a strong correlation between how we treat our bodies and the development of psoriasis. With dietary and lifestyle improvements, sometimes drastic change can occur and psoriasis can be reversed.

Who is Affected by Psoriasis

Although psoriasis affects 2% – 3.5% of the population it is not an even distribution. There are parts of the world where the disease is nonexistent, such as on the Samoa islands of Polynesia. A study conducted in South America of 25,000 people also found no detection of the illness in any of the test subjects (Menter, A., & Stoff, B., 2010) (Thoman, J., 2014). Psoriasis mainly affects Caucasians of the western world (Fry, L., 2004). The United Kingdom has a rate of about 1.7%, the United States of America a rate of 2.5-2.6% (the rate affecting African Americans is far less, at a rate of 1.3%). Populations that reside close to the Arctic have a rate as high as 12%. It is in such cases that we truly see how the lack of sunlight harms the body and potentially propagates this illness. To get a more global view, Nigerians experience a rate of 0.8%, particularly psoriatic arthritis, this is an example of how there are other reasons for the development of the disease. China has a rate of 0.3% of its population and India a rate of 0.8% (Menter, A., & Stoff, B., 2010).

Though there are racial variations for this illness, there is no gender preference for psoriasis, it is predominantly equal amongst both men and women. The one variation is that at an early age more women are affected by the disease, however, after the age of 40, more men are susceptible to contracting the disease (Thomas, J., 2014).

Is Psoriasis an Autoimmune Disease?

Psoriasis is an autoimmune disease, though that fact is sometimes forgotten. The immune system begins to send a continuous signal to speed up the skin cell growth cycle, resulting in a faster turn over of skin cells every few days (between 3-4), when the body is functioning properly the exchange of cells is about every 28 days or so. This results in a pile-up of dead skin cells on the surface of the epidermis and throughout the dermis (Fitzgerald, M., 2014).

Is Psoriasis Contagious

Psoriasis is not contagious, you cannot contract the disease by touching someone else or being in intimate contact with them. There is, however, inheritance, though it’s the likelihood is still very small unless you are a first degree relative (aka your genetic offspring or parents)(ed. Yawalkar, N., 2009).

Psoriasis Causes

There is no one cause of psoriasis, even with genetics, although the susceptibility of the disease is high, not all individuals are affected during childhood and some never have to live with the inflammatory disease. As with many illnesses, it is a combination of issues that result in the disease manifesting. The causes listed below can spur the development of the disease, however, they are also issues that increase the severity of the illness in individuals with psoriasis. Psoriasis is the systemic inflammation of the body, as a result, anything that places pressure on or weakens the immune system will exasperate symptoms.

Genetics

Genetic predisposition or genetic susceptibility refers to the likelihood of an individual developing a disease as a result of their genetic makeup. These variations to their genetic structure are often a result of an inheritance from their parents or ancestry, and although they can contribute to the development of a disease they do not cause it (Genetic Home Reference, 2018). Psoriasis has several genetic traits that can predispose an individual to the disease. Located on chromosome 6 is the human leukocyte antigen [HLA] which in class I has been associated with the early onset of the disease and class II the late onset of psoriasis (Thomas, J., 2014).

Individuals who carry the allele CW0602 are four times as likely to develop guttate psoriasis, compared to individuals who do not carry this allele. Though not fully determined, genetic predictions, such as with chromosome 6 and HLA are imperative for determining the development of pediatric psoriasis. The onset of psoriasis in adulthood has many other factors that can come into play apart from genetics (ibid). With young children, the health of the mother, what was consumed by her as well as her mental state, has an impact on the development of the child. Cesarean birth, even vaginal birth with poor good bacterial diversity,  affect the development of the child and may predispose them to issue with their digestive health. This can, with individuals with psoriasis, have a negative effect.

Knowing what you are genetically predisposed to can be one of the most powerful ways to combat disease as gene expression can be modified (Genetics Home Reference, 2018) (Murray, M.T., & Pizzorno, J., 2012). For example, if you are predisposed to diabetes or imbalanced blood sugar levels, it is a good idea to not gorge yourself on sweets eat a healthy diet, make sure your hormone levels are in check and that you manage your blood sugar levels. The same goes for psoriasis. Psoriasis is an inflammatory disease of the skin and body, thus making sure that your immune system is functioning optimally, consuming foods that reduce inflammation and keep the body alkaline. Removing excess toxins and maintaining the healthy integrity of the digestive system and the gut-brain axes will strengthen the body and drastically lower your chances of developing the disease.

Dysbiosis and Digestive Health

Psoriasis, along with many other autoimmune diseases have been garnering a lot of connection with digestive health. Diet and ethanol consumption (sugar and alcohol) have a big impact on the number, variety, and strength of microorganisms in the digestive system. The digestive system of an individual with psoriasis will have a decrease in bacterial diversity, SIBO, liver disease (which is also linked to a lack of vitamin D and insufficiency of bile acids) and inflammation (Ely, P.H., 2015) (Kharrazian, D., 2013).

Balancing bacteria colonies in the gut will aid in improving gut health, reducing inflammation and improve the absorption of nutrients. Consumption of dandelion root tea/coffee, milk thistle and supplementing with bile salts and vitamin D can enhance the functioning of the liver and once again aid in the repair of the digestive lining. Bringing up the immune system by supplementing with probiotics and adding fermented food into your diet can aid in bringing up good bacteria colonies. To learn more about SIBO and digestive health click the links.

Liver and Pancreatic Function

A pancreatic function that is impaired or acute pancreatitis can also be seen to contribute to psoriasis (Lipski, E., 2012). The function of the pancreas is tied into the functioning of the liver which both aid in protein, fat and carbohydrate digestion. The pancreas with pancreatic juices and enzymes, the liver with bile (which is stored in the gallbladder). When food is not digested properly it can lead to malnutrition and a build-up of bad bacteria, particularly in the small intestine, known as SIBO. Over time this can result in intestinal permeability, an increase in toxicity both leading to impairment to the immune system and an elevation in inflammation.

If the liver is heavily burdened with excessive alcohol consumption, caffeine, toxins, processed foods, etc, it will not be functioning optimally, nor will it be able to sufficiently produce bile acid. If the gallbladder has been removed or has a large number of gallstones present, similarly bile acid will not be able to be administered sufficiently to digest food, therefore it is imperative to supplement with bile salts and HCL (Murray, M.T., & Pizzorno, J., 2012).

Lifestyle Choices

Alcohol and smoking cigarettes flare up the symptoms of psoriasis and increase the susceptibility of the disease developing. Studies have noted that psoriasis is more common in individuals who smoke than in those who do not. Alcohol, when consumed, drastically worsens the symptoms of psoriasis. Individuals who are heavy drinkers or alcoholics tend to develop extensive and highly inflamed skin lesions. This is a result of these two substances compromising the immune system (Thomas, J., 2014). Both substances harm the immune system,  liver, and digestive system, resulting in a build-up of inflammation. Alcohol, in particular, has a connection with causing digestive issues when consumed in excess as alcohol produces acetaldehyde and reactive oxygen species in the body which then can contribute to the permeability of the digestive lining. Excessive alcohol consumption also leads to a loss of good bacterial colonies which can lead to acidity in the body, an increase in infection as well as an increase in inflammation (Kharrazian, D., 2013)

Certain foods, such as corn, soy, peanuts, sugar, and wheat can aggravate psoriasis. Knowing what you are allergic or intolerant to can make a big difference. 16% of individuals with psoriasis have an antibody to gliadin, a protein in barley, rye, and wheat. There is also a strong correlation between celiac and gluten sensitivity, Crohn’s disease and psoriasis development. Consuming foods that your body is intolerant to not only places a burden on your digestive system but also your immune system and over time these issues can manifest themselves on the skin topically, if not as psoriasis, eczema, rosacea, or simply dry skin (Lipski, E., 2012). Eliminating inflammation producing foods, as well as acid-forming foods, can make a big difference in how you feel and the symptoms you exhibit. A diet low in healthy fat can make an individual more susceptible to an occurrence of psoriasis or its proliferation (Freeman, S., 2000).

Sunlight

When looking geographically at individuals who have the disease, the farther from the equator the more individuals suffer from psoriasis. This may be contributed to a lack of vitamin D production by the skin or is sun exposure is not an issue it can point to an issue with the health of the liver. Sun exposure or ultraviolet exposure for those already afflicted with psoriasis can be very painful. As the skin is inflamed, the protective barrier that was once there is now exposed, nonetheless, it is still very beneficial. Applying lavender shea butter or natural aloe vera can aid the skin in healing itself after being exposed to sun and prevent burns. The Dead Sea is a very beneficial destination for healing psoriasis in individuals, with an 80-85% elimination of the disease in a four-week duration by the sea. The combination of sunlight and sea salt is incredibly healing for the skin as well as the entire body (Murray, M.T., Pizzorno, J., 2012).

Medication

Several medications have become associated with the onset of psoriasis as well as for those already suffering from the disease, the worsening of symptoms (Thomas, J., 2014). This is not to say that if you take these medications (or experience withdrawal as in the case of steroids) that psoriasis may develop, but it should be something you speak with your physician about especially if there is heredity of the disease in your family, or if multiple causes for psoriasis development are relevant to you.

• Beta-blockers
• Antimalarials (40% of individuals suffering from psoriasis have their symptoms inflamed)
• antibiotics
• steroid withdrawal
• nonsteroidal anti-inflammatory drugs
• tetracycline
• lithium

Environment 

The environment that one lives in plays a part in determining the likelihood of contracting psoriasis. Areas with low seasonal temperatures, further from the equator, lack of sunlight or restricted ultraviolet light exposure can increase the likelihood of the disease (ed. Yawalkar, N., 2009).

Stress

Stress, both physical and psychological play a role in increased psoriasis development as well as symptoms in individuals already suffering from psoriasis.  Obesity and holding excessive excess weight have been linked to increased risk of psoriasis (ed. Yalwalkar, N., 2009).  The reason why symptoms flare up because stress affects and changes the hypothalamic-pituitary-adrenal response which leads to a flare-up of symptoms as a result of stress (Thomas, J., 2014). Physical stressors or trauma to the body such as surgery, electrical or chemical injury can increase psoriasis symptoms and bring about the appearance of ore lesions (ibid).

Bacterial, Viral Infections, and Dysbiosis

Bacteria and viral infections can also cause psoriasis in some individuals, particularly in individuals who have a compromised immune system (Thomas, J., 2014). Streptococcus and HIV infections, as well as hepatitis B and C, increase susceptibility. Issues with liver enzymes have also been shown to increase susceptibility (ed. Yawalkar, N., 2009).

Streptococcal infections (streptococcal pharyngitis/perianal and streptococcal dermatitis), in particular, spur the development of guttate psoriasis whereas HIV increases the susceptibility of developing exacerbate psoriasis as well as increased symptoms in those that already suffer from the disease (Thomas, J., 2014)(ed., Yawalkar, 2009). In children, streptococcal throat infections can result in the emergence of guttate psoriasis or the development of chronic plaque psoriasis (Thomas, J., 2014).

Dysbiosis, which is an imbalance of the bacteria in the digestive system, often signaling that there is an overgrowth of bad bacteria, can also lead to psoriasis development in individuals. When dysbiosis is present in the system the body is more susceptible to taking on bacterial and viral infection, leaving the individual to have a very hard time fighting off the infection(s). H.pylori bacteria is one such infection and it has been shown to reside in many individuals who suffer from psoriasis. When the infection is treated and the integrity of the digestive system is brought back into balance the symptoms of psoriasis often disappear or the individual experiences a great improvement in how they feel (Lipski, E., 2012). Candida overgrowth is another pressing issue that is often found in individuals with psoriasis, and as with H.pylori, when this underlying cause is treated and balance is brought back to the digestive system symptoms of psoriasis subside in many individuals (ibid) (Holford, P., 2009). Candida albicans, as well as other forms of candida which are becoming more common in their overgrowth in the body expel toxic waste when they overgrow, when immune function is impaired as well as digestion toxin production within the body is a big issue and has a big impact on the liver and other pathways of elimination such as the skin (Murray, M.T., & Pizzorno, J., 2012).

Psoriasis Symptoms and Types of Psoriasis

Psoriasis often affects small areas on the body, such as the scalp, knees, elbows, hands, and feet or psoriasis can cover the entire body. About half the individuals suffering from psoriasis will experience distinct changes to their nails (National Institute for Health Care Excellence, 2017). Psoriasis on the nails will be seen as signs of nail pitting, crumbling of the nail, separation of the nail from the bed, yellow or pink oil drop like patterns on the nail as well as thickening of the nail itself (Young, M., et al., 2017).

Below is a list of different forms of psoriasis and characteristics that pertain to each form. However, apart from the physical issues of psoriasis, there are also the functional, psychological and social issues that go along with the disease. The severity of psoriasis does vary between the different forms of the disease, to properly assess the form that is affecting the individual in question by the psoriasis area and severity index as well as by calculating the total skin surface that is affected (Tampa, M., et al., 2017).

Lifestyle factors, how and what you eat, your mental health, physical activity, the environment you live and work in and the people you surround yourself will all play a part in your general health and wellbeing. Psoriasis is an autoimmune disease when left untreated and lifestyle not adjusted can lead to other complications in health such as cardiovascular disease, lymphoma and non-melanoma skin cancer  (National Institute for Health Care Excellence, 2017).

Plaque Psoriasis

Plaque psoriasis is the most common form of psoriasis and the most recognized. Plaque psoriasis can be identified by raised reddened papules (caused by increased blood flow/inflammation, also known as erythema) and coarse silvery scales. The infected area varies in size and thickness, though the distribution is symmetrical. Plaque psoriasis is found primarily on the elbows, knees, back of the neck, sacrum and scalp, less common is a growth on the ears, face, genitalia and torso (ed. Yawalkar, N., 2009) (National Institute for Health Care Excellence, 2017).

Distinguishing features of Plaque Psoriasis includes:

1. Auspitz Sign: the appearance of pinpoint bleeding at the base of the removed plaque.
2. Woronoff’s Ring: A white ring that appears around the reddened plaque.

(ed. Yawalkar, N., 2009)(Fitzgerald, M., 2014).

Guttate Psoriasis

This form of psoriasis is acute, meaning its onset is very rapid and occurs on the body as small, red and round scaly papules and plaque about 1cm in diameter, lasting for about 8 weeks. Due to its rapid onset, guttate psoriasis is often associated with infection, most commonly streptococcal pharyngitis. Guttate psoriasis can also be triggered by stress. Guttate psoriasis is most prevalent in children and adolescence, mainly appearing on the torso. Though medication may work at first it is very likely that psoriasis will come back, though not as guttate psoriasis but instead as plaque psoriasis or chronic psoriasis (ed. Yawalkar, N., 2009)(Meng, S., et al., 2018).

Inverse Psoriasis

This form of psoriasis, also known as intertriginous psoriasis,  is characterized by its distribution on the body which can be found in the armpit, genitalia, lower abdomen, and the upper inner thigh. There is a difference in the morphology of inverse psoriasis compared to plaque psoriasis. Inverse psoriasis has shiny red patches, with thin amounts of plaque and relatively no scaling. A skin sample is often needed to determine this form of psoriasis as there is often an additional fungal or bacterial growth (such as candida) that can result in misdiagnosis (ed. Yawalkar, N., 2009)(Meng, S., et al., 2018).

Pustular Psoriasis

This rare form of psoriasis is also now as von Zumbusch psoriasis. Pustular psoriasis is characterized by rapid onset of reddened, tender skin followed by the quick development of pustules ranging in size from 1-2mm in diameter, which is filled with non-infectious pus. Often accompanied by fever and illness, there is a high likelihood of morbidity or bacterial and fungal infection (ed. Yawalkar, N., 2009)(Meng, S., et al., 2018). Pustular psoriasis is most common amongst women and smokers (Young, M., et al., 2017). A high amount of neutrophils on the epidermis form macro abscesses, an occurrence that may be attributed to the increase in neutrophil chemotactic factors in the body (Fry, L., 2004).

Erythrodermic Psoriasis

Erythrodermic is a term the describes widespread redness of the skin or epidermis. This form of psoriasis involves 90% of the body being covered by thin or flat lesions of redness. The skin exudes a warmth due to the increase in the movement of the circulatory and lymphatic systems. The outermost layer of the skin, the epidermis begins to flake off. When erythrodermic psoriasis occurs on the face it can cause the eyelids to droop outwards (ectropion). Other symptoms that patients may experience include; lymphadenopathy (the abnormal growth of lymph nodes), fever or hypothermia, anemia, liver disease, uric acid build up in the body (causing edema in some individuals), hair loss, nail dystrophy and fatigue (Young, M., et al., 2017) (ed. Yawalkar, N., 2009). Mortality often arises as a result of dehydration due to fluid loss, mineral loss, protein loss, increased probability of infection, etc. (ed. Yawalkar, N., 2009)(Meng, S., et al., 2018).

Psoriatic Arthritis

This form of psoriasis not only affects the skin but also the joints of the body, psoriasis arthritis is a perfect example of how systemic inflammation can affect and be felt by the whole body. The skin and joints of the body are not the only things that are affected in this form of the disease, the periarticular structures (Husni, M.E., et al., 2017) meaning then ligaments, surrounding muscles, tendons, the central nervous system and peripheral nervous system, the lymphatic and circulatory system as well as joint capsules, connective tissue and cartilage are affected by inflammation (eds. Rovenský J., Payer J., 2009). This form of arthritis affects approximately 0.4%-1% of the population and is mainly found in individuals between the ages of 35-55 years of age (Husni, M.E., et al., 2017). For individuals who are suffering from arthritis the likelihood that they may also develop psoriasis is between 3-7% (Lipski, E., 2012). Quality of life is very poor for individuals suffering from these two chronic diseases (Husni, M.E., et al., 2017), that is why it is extremely important to prioritize changing lifestyle and dietary factors to ease inflammation in the body and on the skin. Sleep quality, body image, mental health are just some of the areas of life that are affected.

Psoriasis and Children

A common form of psoriasis that develops in children is plaque psoriasis on the scalp, guttate and inverse psoriasis are also common. In children, 2 years of younger psoriasiform diaper dermatitis is common (ed. Yalwalkar, N., 2009) (Thomas, J., 2014). Many children are diagnosed with eczema, food intolerances,  allergies, and chemical exposure can result in an eruption of eczema on the skin. However, it can happen that psoriasis is misdiagnosed as eczema and it is not until later on in the child’s life, perhaps in adulthood that psoriasis is determined to have existed as it often resurfaces later on in life. Distribution of the infection on the skin is one way to establish if the child has psoriasis (ed. Yawalkar, N., 2009).

Psoriasis in Women

In women, psoriasis severity flares up often corresponding to hormonal changes, such as during menstruation or menopause or as a symptom of PMS as well as thyroid, adrenal or digestive imbalances. Psoriasis does, for most women improve during pregnancy, often as a result of temporary hormonal balance during that time. It is a good idea to work on balancing hormones, this can be done by supporting the adrenal glands which are major contributors to hormone production, as well as the digestive system as a way to clear out excess cholesterol (and make room for new cholesterol – it is the basic component of all hormones), as well as supporting a healthy thyroid (Young, M., et al., 2017).

Psoriasis Treatment

Psoriasis is much more than just a skin disease – it is the systemic inflammation of the whole body. The cause and treatment of psoriasis are complex, treatment of each individual will be different. It is important to look at root causes, history and nutritional intake (Lipski, E., 2012).  When going forward with psoriasis treatment it is important to educate yourself, look into and adopt holistic treatments into your daily life to aid in reducing inflammation and other symptoms of psoriasis. It is important to understand that sometimes you may need to adopt aggressive treatments. For those who work with, or live with individuals with psoriasis remember empathy, not sympathy. Psoriasis is a very physical and emotional disease (Thomas, J., 2014). 

Anti-inflammatory Diet for Psoriasis

In the 1980’s professor Herman Mielants, along with his colleges from Ghent University performed colonoscopies on individuals suffering from various forms of psoriasis to see if there was a correlation between epidermal inflammation and digestive health. They uncovered extensive bowel inflammation – which for many patients was the beginning of Crohn’s disease. Today we know that individuals suffering from psoriasis are four times as likely to develop inflammatory bowel disease (Fett, R., 2017).

What we eat has such an impact on how we feel and function. When we experience systemic inflammation when our skin begins to change its structure, when we feel constantly fatigued, ill and mentally unwell, that is not how we should feel and we can change that. Psoriasis will require changes to the diet and elimination of certain foods that can increase inflammation. The first thing to do is to remove inflammatory promoting foods from the diet to support the body in naturally reducing inflammation these include;

• processed foods
• sugar in all its forms (unprocessed honey and pure maple syrup are exceptions – though eat them in moderation)
• wheat and grains (if they are fermented they can be good on occasion)
• nightshades such as tomatoes, peppers, eggplant, and white potatoes which naturally bring up inflammation in the body
• vegetable oil and margarine
• conventionally produced animal products
• finally, any foods that you are intolerant too independently.

Turmeric

Turmeric and its polyphenol compound curcumin are amazing at reducing inflammation. Adding turmeric into your diet through cooking is a great way to give your food an antioxidant boost. A tsp of turmeric into your orange or lemon juice in the morning, especially if you are doing warm water with lemon juice to wake up your digestive system, turmeric gives the tonic that extra antioxidant kick (Murray, M.T., & Pizzorno, J., 2012). It will take time, the benefits will not happen overnight, especially if you are using turmeric in its whole food form. A 2018 study in India found that a turmeric tonic taken twice daily for nine weeks had amazing results for individuals with mild to moderate psoriasis. It aided in the reduction of erythema, scaling and lesions as well as improving quality of life (Bahraini, P., et al., 2018). Supplementing with high potency curcumin daily can be a great alternative to medicinal pain relieves. Not only will it aid in reducing systemic pain, but also inflammation, increase wound healing and aiding to relieve itching (ibid) (Zdrojewicz, Z., et al., 2017).

Fermented Foods

Beneficial bacteria works wonders at reducing systemic inflammation. Individuals suffering from psoriasis tend to have lower counts of beneficial bacteria – higher counts of bad bacteria often in the form of SIBO which directly influences the development of candida overgrowth as well as irritable bowel disease. The bad bacteria that often fester include E.coli, Salmonella, Prevotella, Collinsella, Klebsiella (Fett, R., 2017). Repairing the guts integrity by reintroducing healthy microorganisms to our distorted gut is an important step in healing. Bifidobacteria is a healthy bacteria that is very beneficial for reducing psoriasis symptoms particularly B.longum and B.breve. It is best to obtain this bacteria from a probiotic supplement or by fermenting food naturally at home (ibid).

Below are a few probiotics that can aid in restoring gut integrity. Probiotic foods should be consumed as a side to each meal, supplementing with an additional probiotic with that meal is also a good idea.

Kefir

Consuming kefir has been shown to suppress psoriasis systemic inflammation by reducing cytokine production. Kefir can also be topically applied to the skin to reduce itching and bring down inflammation in psoriasis patients (Jones, S.N., 2017).  Just as with any fermented food it is best if you can make your own. You can easily purchase a kefir making kit online, one for making dairy or coconut kefir or for making water kefir. Choosing goat milk as a dairy option is best.

Kimchi

Kimchi is a delicious spicy Korean dish of various fermented vegetables. A 2015 study found that l.plantarum k8 lysates found in kimchi were found to increase hyaluronic acid production in the body which aids in boosting skin hydration. Less water loss from the skin and softening of the skin also results as well as reducing signs and symptoms of psoriasis (Kim, H., et al., 2015).

Vitamin D

A lack of sun exposure or vitamin D (which can also be a result of hormonal imbalance or liver dysfunction) is one of the contributing factors for the development of psoriasis. Although it may not work alone for reducing symptoms of the disease in combination with an anti-inflammatory diet and other dietary, lifestyle and supplemental changes vitamin D can do a tremendous amount of good for individuals with psoriasis. Most of us today do not have a sufficient amount of vitamin D in our body, sunscreen use, lack of sun exposure, poor liver function and cholesterol-lowering medication all reduce vitamin D stores in the body.

Vitamin D, apart from being an essential hormone in the body, defends against opportunistic invaders into the body, aids in the stimulation of antimicrobial peptides, is very potent against pathogenic bacteria in the digestive system, as well as viruses and boosts the immune system. Psoriasis apart from systemic inflammation is also a disease in which the immune system of the individual is on the fritz. Supporting the immune system positively, preventing nutritional deficiencies and hormonal imbalances, as well as hypertension can do a lot of good for people with psoriasis.

Healthy Fat

There has been a lot of misconception with fat. ‘Fat-free’ is seen as a healthy choice, but what should be looked at is the type of fat, because without it fat in the diet the body cannot properly function and can reduce, prevent and diminish psoriasis. Fish oil is one that constantly gets recommended as a “healthy oil”. Consuming fish can be very beneficial for the body, however, supplementing with a lot of fish oil can turn from being anti-inflammatory to inflammatory.

Healthy fats can decrease; gum bleeding, skin inflammation, psoriasis, tinnitus, cravings, hunger recurrence, lactic acid burn. Healthy fat consumption also increases the appearance of smooth skin and gives you more energy.  When fish oils are ingested at high doses for a prolonged period of time the benefits become inflammatory instead of reducing inflammation and pain, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in fish oil has the potential to increase the risk of infection and more likely to generate an immune-depressed state (Kubow, 1992) (Jaudszus, 2013).

Fish oil is good to use intermittently, use for one week and get off for a month and repeat, fish oil should be used at high doses for addressing crisis inflammation such as psoriasis. Flaxseed oil, sesame oil, evening prime rose are a great combination to use as daily maintenance to reduce inflammation. You can take the primrose as a capsule and combine the flaxseed oil and sesame into a salad dressing, into a smoothie or oatmeal.

Stress Management and Psoriasis

Modern society has a big impact on how we function. The stress of modern life, rushing about places a lot of pressure on our bodies. Individuals with psoriasis have this to deal with on top of the effect the disease itself has on their mental wellbeing. Improving mental health, implementing a positive attitude, mindfulness and strengthening adrenal function are all important in the healing process. There are indexes that doctors can use to access your level of “stress”, but let’s face it, most of us experience stress and have mental health issues to some degree. If you want a specific pinpoint answer you can ask for either a psoriasis disability index or a psoriasis life stress Inventory or you can begin to reduce stress yourself! It is possible! (Fortune, D.G., et al., 2008) (Sheriefelt, P.D., 2016).

Yoga is a great way to reduce stress, learn to manage stress better and work on mindfulness s as to be able to better manage everyday life challenges, anxiety, and stress. Excessive stress can place a great strain on the physical, mental and spiritual well-being of a patient and make it harder for the psoriasis patient to have benefited from treatment.

The skin and nervous system form together within the ectoderm of the fetus and throughout our lifetime they always remain in connection with each other. Your mental health affects the immune system response for common skin conditions such as psoriasis. Your mental health is also connected to your adrenal health. Your adrenal glands produce hormones, such as cortisol the “stress” hormone, however, when the adrenals are fatigued as a result of stress overload, an unhealthy diet, etc. It can greatly affect the functioning of the brain and body as a whole. Prolonged topical steroid use also negatively affects adrenal function, making stress management for psoriasis patients harder, which can potentially worsen symptoms. if taking topical steroids it is important to simultaneously support adrenal health (Steffensmeier, K., et al., 2017).

Supplementing with an adrenal supportive tonic such as St.Francis’ “STREST” can do wonders for your ability to handle stress. A B-complex taken three times a day will also greatly benefit the adrenal glands, as well as one’s mental and digestive health. Reducing sugar and coffee consumption can also reduce the pressure that is placed on this organ. Using maca and cacao mixture in the morning or organic first harvest green tea can give a good boost (like coffee but better for your health), keeping you alert but also relaxed and calm.

Natural Moisturizers

Cacao butter, aloe vera, shea butter, coconut oil, extra virgin olive oil, and beeswax are all beneficial creams to use topically to moisturize the skin (Fitzgerald, M., 2014) (Young, M., et al., 2017). You want to use natural organic products to prevent further toxic build-up within the body. Refrain from using petroleum-based, water-based and perfume or chemical additive creams and moisturizers, as well as steroids overtime they will aggravate the skin more and can make psoriasis symptoms much worse (Young, M., et al., 2017). In a double-blind controlled study published in 2018, 86.7% of psoriasis participants found that a topical mixture made from a combination of aloe vera and propolis reduced their mild-moderate psoriasis. Apitherapy, using hive by-products as medicine, has been shown, for centuries to be very healing. Inflammation-reducing, honey (particularly manuka), waxes, propolis, etc, are also wonderful antimicrobials and are full of nutrients. Combining honey into facial masks, hair masks or topical ointments can be very beneficial in reducing psoriasis scaling and inflammation (El-Gammal, A., et al., 2018).

Adding organic lavender essential oil or turmeric to your lotion can be an excellent way to boost the benefits of a natural moisturizer. Lavender is very beneficial in the healing of skin, especially inflamed skin. Turmeric also aids in reducing inflammation topically. Calendula cream and vitamin E are also wonderfully healing for individuals with psoriasis.

Herbal Remedies for Psoriasis

Many herbs can greatly improve the symptoms of psoriasis as well as treat the disease itself. If you are looking for a natural alternative for topical application or to consume orally to reduce symptoms herbal medicine is the way to go.

Indigo Naturalis

This beautiful purple-hued floral herb is amazingly beneficial for the treatment of psoriasis, particularly distinct nail changes that occur with the illness(Lin, Y., et al., 2014). Known in Chinese traditional medicine as Qing Dai, it is used primarily as a topical ointment (Meng, S., et al., 2018). Indigo as an ointment, has also shown to improve the symptoms and reduce inflammation in individuals who have plaque psoriasis (Lin Y., et al., 2007) as well as reducing scaling and erythema.

Juniper

Oil of cade or juniper tar oil has a high concentration of phenol making it a natural and gentle, non-irritating disinfectant – an antimicrobial. Juniper oil is a very effective topically for the treatment of psoriasis. Mixing 10 drops of oil of cade with 20 ml of coconut oil, olive oil shea butter will make a wonderful topical ointment that can be administered to the skin and scalp. The oil is not meant to be consumed orally or when pregnant. It should also not be used for longer than four to six weeks as it can result in kidney irritation (Ody, P., 2017). Do note, Juniper will stain.

Burdock Root

This herbal root is a powerful flavonoid, antimicrobial, bitter and alkaloid. It works amazingly as a remedy for skin conditions such as dry and scaly skin, common features of psoriasis. It does require prolonged use to be effective, however, this slow process not only aids the skin but internal digestive issues, such as wound healing, bile production, kidney function as well as reducing joint pain and inflammation. It is great to combine a burdock with red clover. It can be used as a tincture or tea. For a tea use one tsp of dried burdock root and let it steep for 10-15 minutes, you can make this tea 2-3 times a day (Hoffman, D., 1990).

Figwort

Figwort is a wonderful herb for skin problems, including eczema, psoriasis and allergic rashes. In traditional Chinese medicine, it is known as Wuan Shen.  Figwort is powerfully cleansing to the body, are a diuretic, laxative and wonderful anti-inflammatory. The areal portion of figwort is a beneficial part of the herb for psoriasis treatment and in the healing of abscesses and wounds. Figwort is a heart tonic and should be avoided if you have a high heart rate (tachycardia) (Ody, P., 2017)(Hoffman, D., 1990).

Mountain Grape

Also known as Oregon mountain grape, the whole plant, berries, rhizome, and root can be used, and every part can be beneficial to aid in alleviating the symptoms of psoriasis. Mountain grape works on the liver and gallbladder, aiding in digestion and alleviating constipation (as it is also a laxative) and reducing systemic inflammation. It is great to be used in combination with the Burdock root. It can be used as a tincture or a tea. For a tea using 1-2 tsp of dried mountain grape root with one cup of water, brought to a boil (with the root) and left to simmer for 10-15 minutes. Drink three times daily (Hoffman, D., 1990).

Red Clover

Full of isoflavonoids, isoflavones (aid in balancing hormones), volatile oils, sterols, and phenolic acid, red clover is wonderful for combating psoriasis (Segneau, A.E., et al., 2017).

Sarsaparilla

This herb is wonderful at reducing the irritation that accompanies psoriasis, as well as reducing the scaling of the skin. Sarsaparilla is wonderful at reducing inflammation in the body, making it beneficial, not only for psoriasis but also for arthritis. Beneficial for women and men, particularly though for individuals who are low in testosterone as it contains a phenolic compound that activates testosterone production. Hormonal balance in the body, allows the body to function optimally, allowing it more energy to work on balancing the immune system and reducing systemic inflammation (Hoffman, D., 1990).

Testing To Consider

Food and Environmental Sensitivity Testing – Antigens

Celiac Test and Testing for Gliadin sensitivity

Candida Test – blood and stool samples

Organic Acid Testing

Liver Function Profile

Intestinal Permeability Testing

Nutrient Testing

Fatty Acid Testing 

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