A Functional Medicine Approach to Psoriasis
Psoriasis is a chronic, immune-mediated, inflammatory skin disorder that affects 0.91-8.50% of adults worldwide.1 This condition is characterized by skin that is scaly, red, and itchy. Not only is psoriasis physically bothersome, but it often comes with mental illnesses like depression and anxiety. The main goal for those with psoriasis is to try to clear the skin and prevent flare-ups from happening. The conventional medicine treatment for psoriasis includes topicals like emollients, corticosteroids, vitamin D analogs, and immunosuppressants. These topicals help moisturize the skin and decrease inflammation. Conventional approaches for serious psoriasis could also include systemic immunosuppressants such as methotrexate, cyclosporine, and biological agents. These medications decrease the activity of the immune system which often clears up psoriasis but can also leave the patient open to infections. In this blog post, we will explore the functional medicine approach to psoriasis.
Functional medicine is a holistic approach to healthcare that focuses on addressing the root causes of disease. In the case of psoriasis, this means looking beyond the skin and examining factors such as diet, lifestyle, and environmental toxins that may be contributing to inflammation in the body.1 There are thought to be several root causes when it comes to psoriasis flare-ups. These include infection, alcohol consumption, drugs, trauma, acute withdrawal of steroids, high body mass index (BMI), and endocrine disorders.1 The bottom line is that these all lead to inflammation.
A functional medicine practitioner can work with you to identify your specific triggers and root cause(s) and develop a plan to eliminate or manage them. For example, if stress is a trigger for your psoriasis, you may benefit from stress-reducing practices such as meditation or therapy.2 If infections are triggering your psoriasis, your provider will suggest various protocols to eradicate the infection. If certain medications are triggering flare-ups, your practitioner may work with your doctor to find alternative treatments. There are many supplements that may also help reduce inflammation and inflammatory markers. These include ashwagandha, omega-3 fatty acids, curcumin, and quercetin to name a few. Besides supplements, those suffering from psoriasis can try eating an anti-inflammatory diet rich in foods such as fatty fish, leafy greens, and berries, incorporating stress-reducing practices such as mindfulness meditation or yoga, and getting enough sleep to support the body’s natural healing processes.3
Addressing gut health is another step to take in getting down to the root cause of psoriasis and its prevention. The gut plays a crucial role in overall health and immune function, and research has shown that imbalances in gut bacteria can contribute to autoimmune conditions such as psoriasis.4 The gut microbiome has been proven to be essential in regulating gut permeability. If the gut has increased permeability, larger molecules can leak into the bloodstream and cause an increased immune response leading to more inflammation which could lead to psoriasis flare-ups. Leaky gut can also lead to food sensitivities. Luckily, there are food sensitivity tests available that can tell you what foods to avoid. Most of the time you only need to avoid these foods for a short time while rebuilding your gut barrier. Addressing gut health is an essential component of a functional medicine approach to psoriasis prevention. To support gut health, focus on eating a diverse range of nutrient-dense foods such as fruits, vegetables, whole grains, and healthy fats. Avoid processed and inflammatory foods such as refined sugars, trans fats, and artificial additives.5 You may also consider taking probiotics or other gut-healing supplements that a functional medicine practitioner can recommend to support a healthy gut microbiome. If you are interested in food sensitivity testing, this kit from KBMO is a great option.
Detoxification can help relieve some inflammation that cannot be prevented or has already occurred. Environmental toxins such as pesticides, heavy metals, and pollutants can contribute to inflammation in the body, which can exacerbate psoriasis symptoms.6 A functional medicine approach to psoriasis prevention may involve supporting the body’s natural detoxification processes to reduce the amount of toxins within it. This can include eating a diet rich in detoxifying foods such as cruciferous vegetables, drinking plenty of water, and incorporating practices such as dry brushing or saunas to support the body’s elimination pathways.5
By adopting a functional medicine approach to psoriasis prevention, individuals can take a proactive role in managing their condition and improving their overall health and well-being. By addressing these factors discussed above, you can help prevent flare-ups and manage symptoms to improve your quality of life. If you’re struggling with psoriasis, consider working with a functional medicine practitioner to develop a personalized plan to support your health and well-being.
Written by Patrick M Goodpaster, PharmD
Edited by Lindsey Dalton, PharmD
- Teng Y, Xie W, Tao X, et al. Infection-provoked psoriasis: Induced or aggravated (Review). Exp Ther Med. 2021;21(6):567. doi:10.3892/etm.2021.9999
- Bu J, Ding R, Zhou L, Chen X, Shen E. Epidemiology of Psoriasis and Comorbid Diseases: A Narrative Review. Front Immunol. 2022;13:880201. Published 2022 Jun 10. doi:10.3389/fimmu.2022.880201
- Griffiths K, Aggarwal BB, Singh RB, Buttar HS, Wilson D, De Meester F. Food Antioxidants and Their Anti-Inflammatory Properties: A Potential Role in Cardiovascular Diseases and Cancer Prevention. Diseases. 2016;4(3):28. Published 2016 Aug 1. doi:10.3390/diseases4030028
- Chen L, Li J, Zhu W, et al. Skin and Gut Microbiome in Psoriasis: Gaining Insight Into the Pathophysiology of It and Finding Novel Therapeutic Strategies. Front Microbiol. 2020;11:589726. Published 2020 Dec 15. doi:10.3389/fmicb.2020.589726
- National Psoriasis Foundation. Dietary Modifications. Accessed March 31, 2023. https://www.psoriasis.org/dietary-modifications/
- Bellinato F, Adami G, Vaienti S, et al. Association Between Short-term Exposure to Environmental Air Pollution and Psoriasis Flare. JAMA Dermatol. 2022;158(4):375-381. doi:10.1001/jamadermatol.2021.6019