It just won’t quit!
Redness. Itching. Bleeding. Pain. Scaly patches that come and go and come and go—mostly they come and keep on coming.
Everyone’s skin cells renew themselves. That’s just their nature. Every 28 days, give or take a day or two, old skin cells slough off and new skin cells take their place. It’s like clockwork. But in people who have psoriasis, the clock’s hands are turning faster than normal. They produce new skin cells in less than a week. And the skin cells pile up so quickly that they don’t have time to shed normally.
Psoriasis is a skin disease with no known cause and no cure. Yet!
If that sounds hopeless and gloomy, listen up. It is possible to see remissions and dramatic improvements in people who have this condition. Along with the arsenal of helpful medications that dermatologists have to offer, here’s one more to add: dietary strategies, including several individual nutrients.
Psoriasis is a disease characterized by “a cascade of inflammation. If you block inflammation, you get improvement,” says Valori Treloar, MD, CNS, a dermatologist and certified nutrition specialist in private practice in Newton, Massachusetts, and coauthor of The Clear Skin Diet. Dr. Treloar treats many individuals who have psoriasis, so she makes it her business to watch the scientific literature for studies of dietary strategies that might prove helpful to these patients.
When you’re dealing with an inflammatory disease, it makes sense to pay special attention to the immune system and find out what substances might be triggering inappropriate reactions that lead to inflammation, says Dr. Treloar. Studies show that one likely culprit is a sensitivity to wheat, she says.
Gluten sensitivity is apparently much more widespread than previously thought. Gluten, the substance in wheat to which so many people are sensitive, is also found in rye, barley, and oats. (While oats don’t contain gluten themselves, they’re frequently contaminated with gluten when processed on the same machinery.) In the general population, 1 in every 100 to 125 people is sensitive to gluten, says Dr. Treloar. A dermatologist-researcher in Sweden did a study that showed that one in seven of her psoriasis patients were gluten sensitive, she adds.
When the Swedish researcher put her gluten-sensitive patients on a gluten-free diet, one in seven experienced dramatic improvement in their psoriasis. “I found that very compelling,” says Dr. Treloar. So she decided to test for gluten sensitivity in her own psoriasis patients and suggest a gluten-free diet for any who were sensitive. Lo and behold, a number of individuals experienced dramatic improvement.
One case in particular stands out in her mind: A woman in her seventies had psoriasis in the genital area for more than 20 years. Dr. Treloar did what she could to keep the woman comfortable, but the condition persisted. She gave the woman a blood test for antibodies to gluten. Bingo!
Not only did her psoriasis medications start working better when she went off gluten, but the woman reported having more energy. She also experienced unexpected improvements in other health conditions that had been plaguing her. For years the woman had experienced digestive troubles, even vomiting on a regular basis. The specialists she saw were unable to offer any relief.
“Guess what disappeared when she went off gluten?” Not only did her psoriasis improve dramatically, but her digestive complaints completely went away, says Dr. Treloar.
Are you, perhaps, sensitive to gluten? You could ask your doctor for a test. Or you could simply eliminate all foods containing wheat, barley, rye, and oats for 3 months and watch what happens. (For more information about gluten, see the chapter on Celiac Disease and Gluten Sensitivity.)
Although gluten is the most likely culprit, other foods may also be problematic. Pay attention to how you respond to different kinds of foods and try limiting those that cause you discomfort. You might want to elicit the aid of a nutrition specialist to help you ferret out any problem foods and see whether eliminating them helps improve your skin condition.
“It makes sense to me to eliminate inflammatory foods if you have an inflammatory disease,” says Dr. Treloar. “I have seen psoriasis go away. Have I seen people clear completely? No. Have I seen people happier? Yes. Have I seen people need less medicine? Yes.”
So which food choices help reduce inflammation?
Completely eliminate hydrogenated oils and high fructose corn syrup from your diet, advises Dr. Treloar, adding, “these are non-foods.”
You’ll need to become a careful label reader to accomplish this. High fructose corn syrup is, of course, found in sodas. But it’s all over the place as a sweetener in salad dressings, ketchup, jelly, cookies, baked goods, and even otherwise healthy whole grain breads. And watch out for other beverages besides sodas. High-fructose corn syrup is the sweetener of choice in many tea and juice drinks as well.
To eliminate hydrogenated oils from your diet, steer clear of any products that contain trans fats as well as any that list hydrogenated or partially hydrogenated oil in the ingredients list.
What should you be eating?
To get more antioxidants and help reduce inflammation, says Dr. Treloar, you should be eating lots of colorful vegetables. “Ten servings of vegetables is not too many,” she says. There are literally hundreds of helpful phytonutrients in vegetables. “All work together, and vegetables work better than supplements,” she notes.
It’s also helpful, says Dr. Treloar, to keep your weight down to where it should be. One study, she says, showed that medications for psoriasis worked better in people who lost weight.
It’s helpful to take a multivitamin as insurance that you are getting all of the nutrients you need, says Dr. Treloar. And several individual nutrients are worth special consideration.
Antioxidants are nutrients that defend the body against free radicals, which are highly reactive, naturally produced molecules that do damage to the body.
“People with psoriasis generally have lower blood levels of antioxidants,” says Dr. Treloar. While studies looking at antioxidants as treatment for this skin disease have been disappointing, it makes sense to enhance your antioxidant protection anyway, she says. Why?
Studies have shown, explains Dr. Treloar, that people with psoriasis have an increased lifetime risk for a number of diseases and conditions that do respond to antioxidants, including cancer, metabolic syndrome, heart disease, high cholesterol, high blood pressure, depression, alcoholism, gastrointestinal disease, and arthritis.
She recommends several specific antioxidants in the following amounts: zinc, 20 milligrams; vitamin E, 200 IU of mixed tocopherols; vitamin C, 500 milligrams; and selenium, 100 micrograms. You can get this much selenium just by eating three Brazil nuts.
The inflammatory substance homocysteine is elevated in people with psoriasis, and B vitamins help bring that down, says Dr. Treloar. You can take a B-complex supplement to get all of your B vitamins, which work together. Follow the package directions.
The nutrient N-acetylcysteine (NAC) is a modified form of the amino acid cysteine. A precursor to glutathione, a powerful antioxidant that the body produces, NAC also helps support the liver, says Dr. Treloar. She recommends taking 500 milligrams.
“A number of studies show that fish oil supplementation is of benefit,” says Dr. Treloar. While the studies are not consistent, she notes that psoriasis is an inflammatory disease, and the omega-3 fatty acids in fish oil have a powerful anti-inflammatory effect. “So it just makes sense,” she says. The studies typically called for 6 to 10 grams of fish oil a day.
You might want to start with a lower amount and ramp up slowly if you can tolerate higher amounts. Some people find that fish oil makes them nauseated. You can take fish oil in either capsule or liquid form. Some people find that they can tolerate higher doses if they take capsules and store them in the freezer. Also, make sure you’re not taking cod-liver oil. This much cod-liver oil would provide toxic levels of vitamin A over time.
In psoriasis, the growth of skin cells known as keratinocytes is “out of whack,” says Dr. Treloar. “Vitamin A helps normalize that.” She suggests getting 5,000 IU daily.
The Gluten Connection: How Gluten Sensitivity May Be Sabotaging Your Health by Shari Lieberman, PhD
Dermatologists frequently use ultraviolet light therapy alone or in conjunction with certain medications as standard treatment for psoriasis. When skin is exposed to the ultraviolet light in sunlight, it produces vitamin D for the body. So there is a definite sunlight–vitamin D connection.
“That’s probably why phototherapy is effective,” says Dr. Treloar. “Vitamin D is probably a major player.”
She recommends getting at least 1,000 IU of vitamin D.
B vitamins |
Take a B-complex supplement. Follow the directions on the label. |
N-acetylcysteine |
500 milligrams |
Omega-3 fatty acids |
6 to 10 grams of fish oil* |
Selenium |
100 micrograms |
Vitamin A |
5,000 IU |
Vitamin C |
500 milligrams |
Vitamin D |
1,000 IU |
Vitamin E† |
200 IU of mixed tocopherols |
Zinc |
20 milligrams |
*This is a lot of fish oil. You might want to start with a smaller dose, such as 1 to 3 grams, and increase the dose slowly if you can tolerate it. In addition, be aware that fish oil has a blood-thinning effect. If you’re taking any kind of blood-thinning drug, talk to your doctor before taking fish oil supplements.
†Vitamin E has a blood-thinning effect. If you’re taking any kind of blood-thinning drug, talk to your doctor before taking vitamin E.