If you or someone you know has psoriasis, you are likely familiar with the red, itchy patches of inflamed skin covered with silvery scales that the common skin condition inflicts upon sufferers.
Psoriasis is a chronic autoimmune disease that mainly affects the skin and is not contagious. Its signature scaly patches (also known as psoriatic plaques) can be found almost anywhere on the body, but typically appear on the scalp, elbows, knees, and in and around the ears. The name “psoriasis” is derived from the Greek word for “itch.”
It is estimated that 10 to 30 percent of people with psoriasis develop psoriatic arthritis.
The telltale scaly patches are areas of inflammation and excessive skin production. The skin cells in people with the ailment grow at an abnormally fast rate, and quickly build up in the affected areas because skin production is faster than the body’s ability to shed it.
Medical News Today provides a more in-depth explanation:
The human body produces new skin cells at the lowest skin level. Gradually those cells move up through the layers of skin until they reach the outermost level, where they eventually die and flake off. The whole cycle – skin cell production to skin death and flaking off – takes between 21 and 28 days. In patients with psoriasis, the cycle takes only between 2 to 6 days; resulting in a rapid buildup of cells on the skin’s surface, causing red, flaky, scaly, crusty patches covered with silvery scales, which are then shed.
Researchers still aren’t sure what causes psoriasis, but they do know that the immune system and genetics play major roles in its development.
From the Mayo Clinic:
More specifically, one key cell is a type of white blood cell called a T lymphocyte or T cell. Normally, T cells travel throughout the body to detect and fight off foreign substances, such as viruses or bacteria. If you have psoriasis, however, the T cells attack healthy skin cells by mistake, as if to heal a wound or to fight an infection.
Overactive T cells trigger other immune responses. The effects include dilation of blood vessels in the skin around the plaques and an increase in other white blood cells that can enter the outer layer of skin. These changes result in an increased production of both healthy skin cells and more T cells and other white blood cells. This causes an ongoing cycle in which new skin cells move to the outermost layer of skin too quickly — in days rather than weeks.
Just what causes T cells to malfunction in people with psoriasis isn’t entirely clear. Researchers have found genes that are linked to the development of psoriasis, but environmental factors also play a role.
There is currently no cure for psoriasis, so treatment options aim to manage symptoms and slow skin cell growth. It is often said, “It isn’t a drug if it doesn’t have side effects,” and that is definitely true for psoriasis medications.
The good news:
People who are prone to psoriasis outbreaks can do things to avoid flare-ups.
Psoriasis, like most autoimmune conditions, has triggers that can make symptoms begin or worsen. Scientists believe that at least 10 percent of the general population inherits one or more of the genes that create a predisposition to psoriasis. Thankfully, only 2 percent to 3 percent of the population develops the disease. Researchers believe that for a person to develop psoriasis, the individual must have a combination of the genes that cause psoriasis and be exposed to specific external factors known as “triggers.”
Triggers can vary from person to person, but there are some that are widely known to cause flare-ups. These include:
- Injury to skin: Psoriasis tends to appear in areas of the skin that have been injured or traumatized. This is known as the Koebner phenomenon, and it can be triggered by vaccinations, sunburns, and scratches.
- Certain medications: lithium, antimalarials, Inderal (a blood pressure medication), Quinidine (heart medication), and Indomethacin (a nonsteroidal anti-inflammatory drug used to treat arthritis), beta-blockers, and corticosteroids
- Alcohol consumption
- Cold weather
Another culprit that has been identified as a possible trigger for psoriasis flares: gluten.
Gluten is a protein found in wheat, barley, rye, and triticale (a combination of wheat and rye). It acts as a “glue” in foods such as cereal, bread and pasta, helping them hold their shape. Gluten consists of two proteins called gliadin and glutenin. It is the gliadin part that can cause health problems.
According to the National Psoriasis Foundation, new research estimates that up to 25% of people who have psoriasis may be sensitive to gluten.
While more studies are required to better understand the link between gluten and psoriasis, many patients report dramatic improvement in skin condition or joint pain when following a gluten-free diet. A 2010 study in the Journal of Clinical Laboratory Analysis found that psoriasis patients with the HLA CW6 gene, a gene linked to psoriasis, had an increased sensitivity to the gliadin protein (gluten).
Another study in the 2009 Brasilian Annals of Dermatology found that patients who had gluten sensitivity had an improvement in their psoriasis when they followed a gluten-free diet.
A Journal of the Academy of Nutrition and Dietetics article titled Is There Research to Support a Specific Diet for Psoriasis? states the following:
There are data that suggest that following a gluten-free diet may ameliorate symptoms in individuals with chronic autoimmune disease conditions such as psoriasis.
In some cases, eliminating gluten does seem to help reduce psoriasis. In a smaller number of cases, eliminating gluten can lead to dramatic improvements.
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Autoimmunity and Wheat
And, Dr. William Davis, cardiologist and author of the best-selling book Wheat Belly, includes psoriasis in a list of autoimmune diseases that have been associated with gliadin.
In an article titled Autoimmunity and Wheat, Dr. Davis explains that wheat consumption has been identified as both an initiating process in autoimmunity, as well as a perpetuating factor:
Autoimmunity is just one way that tells us that this “food” was never appropriate for human consumption in the first place. First consumed in desperation 10,000 years ago, after not consuming grains for the preceding 2.5 million years, then altered by the efforts of geneticists and agribusiness, increased wheat consumption accounts for the increasing landscape of multiple autoimmune conditions, especially type 1 diabetes in children (and, now, adults), Hashimoto’s, and inflammatory bowel diseases.
He goes on to explain that you don’t need to be diagnosed with celiac disease or gluten sensitivity to be adversely impacted by wheat consumption:
The abnormal intestinal permeability induced by gliadin, for instance, develops in 80-90% of people; the toxic effects of wheat germ agglutinin affect everybody.
Anyone diagnosed with an autoimmune condition should avoid wheat, as well as its nearly genetically identical brethren, rye and barley (identical gliadin and wheat germ agglutinin sequences), as well as corn (some overlap of corn zein with gliadin) and rice (identical wheat germ agglutinin).
While research hasn’t conclusively proven that gluten causes psoriasis flares, some studies and anecdotal evidence suggest the link is very plausible.It certainly couldn’t hurt to try a gluten-free diet to see if it works – after all, eliminating gluten from the diet has been shown to reduce inflammation and improve health overall.
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