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What should I eat if I have psoriasis?


When it comes to treating psoriasis, no one treatment plan works for everyone. Now research suggests that this may also apply to what you eat. Here’s what dermatologists discovered about three different diets.

Dermatologists recommend following a healthy, well-balanced diet

For some patients who have psoriasis, adding another type of diet, such as a weight loss diet, may help.

Healthy foods on countertop

Weight loss diet can help if you’re overweight

If you have psoriasis and are overweight, losing weight can:

  • Lead to less psoriasis on your skin

  • Decrease the severity of your psoriasis

  • Make psoriasis medication more effective

These effects can happen quickly, according to studies. In one small study of patients with psoriasis who were overweight, half of the patients followed a low-calorie diet. In just 16 weeks, the patients following the low-calorie diet had less psoriasis than the non-dieting group of patients with psoriasis.

By week 24, many (66%) of the patients following the low-calorie diet had 75% decrease in psoriasis on their skin. By comparison, only 29% of the non-dieting patients saw this 75% reduction.

During a clinical trial, dermatologists saw similar results. In this trial, dermatologists enrolled 303 patients with long-term plaque psoriasis. All patients were overweight and receiving treatment for psoriasis. Even with treatment, all continued to have psoriasis on their skin.

In this clinical trial, half the patients were given a diet to follow and advice about the importance of exercising. The other group of patients was given information about how weight loss could be helpful. All patients were asked to lose 5% of their body weight within 20 weeks.

Patients in both groups lost weight. Those who lost 5% of their body weight had far less psoriasis on their skin. This trial shows that even a small amount of weight loss can reduce the amount of psoriasis on your skin.

Weight loss can help because both psoriasis and being overweight increase inflammation in your body. When you reduce inflammation, it can lead to less psoriasis on your skin.

Before starting a weight loss diet, talk with your dermatologist

Studies have found that weight loss diets which require you to get most of your calories from fat can worsen psoriasis, leading to more flare-ups.

Healthy foods, measuring tape on dermatologist’s desk

Takeaway: If you are overweight, continuing to treat your psoriasis and following a healthy, balanced diet that allows you to lose weight could lead to fewer flare-ups and less severe psoriasis.

Gluten-free diet may help if you’re sensitive to gluten

Small studies suggest that if you have psoriasis and a gluten sensitivity, following a gluten-free diet may help reduce psoriasis flare-ups.

People who have a gluten sensitivity have one of the following:

  • Celiac disease: Symptoms include frequent diarrhea, belly pain, passing gas often, and feeling tired most of the time

  • Gluten sensitivity: You test positive for celiac antibodies, but you don’t have celiac disease

Here’s what happened during studies that looked at the effects of following a gluten-free diet.

In one study, 39 patients with psoriasis followed a gluten-free diet. Of these patients, 33 had a gluten sensitivity, and six patients did not have this sensitivity. After following the gluten-free diet:

  • 73% of the patients with a gluten sensitivity had less psoriasis

  • None of the patients without a gluten sensitivity had less psoriasis

In a very small study of seven patients who had psoriasis and a gluten sensitivity, all had completely clear skin after following a gluten-free diet. Six of the patients had plaque psoriasis, and one had palmoplantar psoriasis.

Takeaway for people living with psoriasis: If testing reveals that you’re sensitive to gluten, following a gluten-free diet may reduce the amount of psoriasis on your skin.

Mediterranean diet requires more research

People who follow this diet get most of their fat from extra-virgin olive oil. They also eat at least two servings of vegetables and three servings of fruit every day. Each week, they eat at least three servings of fish or seafood, beans, and nuts.

All of these foods are rich in anti-inflammatory nutrients. Because psoriasis causes inflammation throughout the body, it’s believed that this diet could lead to less psoriasis on your skin.

It’s still too early to know whether this is true. However, one large study suggests a Mediterranean diet could help people with psoriasis. In this study, 35,735 patients were asked to answer surveys about what they ate. The researchers collected in-depth information, such as how much fresh fruit and vegetables, fish, and legumes they ate.

The patients answered these in-depth surveys three times over a six-month period.

After analyzing the results, the researchers found that the patients with severe psoriasis ate few — if any — foods found in the Mediterranean diet.

While this may suggest that following a Mediterranean diet can lessen the amount of psoriasis on your skin, it’s too soon to tell. Only about 2% of the patients in this study had psoriasis. The study also relied on people being able to recall what they ate. Sometimes, it can be difficult to remember what you ate yesterday let alone weeks ago.

Takeaway: More research is needed to know how the Mediterranean diet affects psoriasis.

Always talk with your doctor before changing your diet

While changing what you eat (and drink) may seem simple, some fad diets can worsen psoriasis. Your dermatologist and primary care doctor can help you find a diet that meets your individual needs and works well with the medication in your treatment plan.

Related AAD resources


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References
Bhatia BK, Millsop JW, et al. “Diet and psoriasis, part II: celiac disease and role of a gluten-free diet.” J Am Acad Dermatol. 2014;71(2):350-8.

Cazzaniga S, Conti A, et al. “Comments on "Diet and psoriasis, Part I: Impact of weight loss interventions.” J Am Acad Dermatol. 2014;71(4):829

Debbaneh M, Jillian W Millsop JW, et al. “Diet and psoriasis, part I: Impact of weight loss interventions.” J Am Acad Dermatol. 2014 Jul;71(1):133-40.

Elmets CA, Korman NJ, et al. “Joint AAD-NPF Guidelines of care for the management and treatment of psoriasis with topical therapy and alternative medicine modalities for psoriasis severity measures.” J Am Acad Dermatol. 2020 Jul 30;S0190-9622(20)32288-X. Online ahead of print.

Ford AR, Siegel M, et al. “Dietary recommendations for adults with psoriasis or psoriatic arthritis from the Medical Board of the National Psoriasis Foundation: A systematic review.” JAMA Dermatol. 2018 Aug 1;154(8):934-50.

Jesitus J. “Mediterranean diet may reduce psoriasis severity.” Dermatol Times. 2018 Sep;39(9). Last accessed Sep 24, 2020.

Ko SH, Chi CC, et al. “Lifestyle changes for treating psoriasis.” Cochrane Database Syst Rev. 2019 Jul 16;7(7):CD011972.

Locker F, Leitner J, et al. “The influence of ketogenic diets on psoriasiform-like skin inflammation.” J Invest Dermatol. 2020;140(3):707-710.e7.

Murzaku EC, Bronsnick T, et al. “Diet in dermatology: Part II. Melanoma, chronic urticaria, and psoriasis.” J Am Acad Dermatol. 2014;71(6):1053.e1-1053.e16.

Phan C, Touvier M, et al. “Association between Mediterranean anti-inflammatory dietary profile and severity of psoriasis: Results from the NutriNet-Santé Cohort.” JAMA Dermatol. 2018;154(9):1017-24.


Written by:
Paula Ludmann, MS

Reviewed by:
Erin Ducharme, MD, FAAD
Lucinda Buescher, MD, FAAD
Amanda Friedrichs, MD, FAAD

Last updated: 11/11/20

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