Psoriasis is often thought of as a skin disease, but it is actually an autoimmune condition. It occurs when overactivity of the immune system causes skin cells to multiply rapidly, creating raised, thickened, dry, red patches.
The inflammation associated with psoriasis may cause psoriatic arthritis in some people, leading to painful and inflamed joints.
Psoriasis occurs when overactivity of the immune system causes a dysregulation of skin cell production. It is estimated that 1.6 million Australians are living with psoriasis, and the condition affects 125 million people globally. Psoriasis occurs in males and females equally, with peak onset between 16 and 22 years of age.
There are five variations of psoriasis, including:
Plaque Psoriasis: The most common type, affecting up to 80 percent of people with psoriasis. It causes red, scaly plaques that can occur anywhere on the body, but most commonly on the scalp, face, knees and elbows, abdomen or lower back. Psoriasis can also present on fingernails and toenails, which is often mistaken as fungus.
Inverse Psoriasis: Inverse psoriasis affects one-quarter of people living with psoriasis, and may appear as inflamed red skin, that is smooth rather than scaly. It often affects skin folds like underarms and the genitals.
Guttate Psoriasis: Appears as small, round, red spots, affecting around eight percent of people with psoriasis.
Pustular Psoriasis: Occurs as white pustules surrounded by inflamed, red skin, in three percent of people with psoriasis.
Erythrodermic Psoriasis: A rare but potentially life-threatening variation of psoriasis causing intense redness, itching, pain, dehydration and shedding of large sheets of skin.
Patterns have been discovered among people with psoriasis experiencing intestinal permeability, altered immune homeostasis and an imbalance of short and medium chain fatty acid producing bacteria.
The overactivity of the immune system and T-cell stimulation is thought to be genetic, but there are also other influential factors like digestive imbalances, stress, environment and diet.
Those with an existing autoimmune condition are at greater risk of developing another autoimmune condition like psoriasis. Around 25% of people with an autoimmune condition tend to develop three or more autoimmune conditions, likely due to a combination of genetic and environmental factors.
Guttate psoriasis, which presents as an abundance of small red scaly plaques on the trunk, often follows a streptococcal infection of the throat (strep throat).
Our skin health practitioner Rebecca Hughes can provide functional testing to determine the underlying cause and contributing factors of your psoriasis, to help tailor a psoriasis treatment plan for you.
Research has found people with the ‘atopic triad’ have a defective barrier of the skin and upper and lower respiratory tracts.
These genetic alterations cause a loss of function of filaggrin (filament aggregating protein), which is a protein in the skin that normally breaks down to create natural moisturisation and protect the skin from penetration by pathogens and allergens.
Filaggrin mutations are found in approximately 30 percent of people with atopic dermatitis, and also predispose people to asthma, allergic rhinitis (hayfever), keratosis pilaris (dry rough patches and bumps on the skin), and ichthyosis vulgaris (a chronic condition which causes thick, dry, scaly skin.)If one parent carries this genetic alteration, there is a 50 percent chance their child will develop atopic symptoms. And that risk increases to 80 percent if both parents are affected.
The connection between the gut microbiome and skin health is complex, however, research has found the microbiota contributes to the development, persistence, and severity of atopic dermatitis through immunologic, metabolic and neuroendocrine pathways.
Deficiency of Omega-6 essential fatty acids (EFA) has been linked with the increased incidence of atopic dermatitis, along with the inability for the body to efficiently metabolise EFA’s to gamma linoleic acids (GLA) and arachidonic acids (AA).
Changing weather conditions can certainly aggravate eczema symptoms, but the triggers are subject to change among individuals.
Mould exposure and susceptibility to mould can cause Chronic Inflammatory Response Syndrome (CIRS), of which dermatitis is a manifestation.
Aside from only providing a short-term solution that doesn’t treat the underlying cause of psoriasis, conventional medicine can cause undesirable side effects.
Current conventional treatment of psoriasis is most likely to include topical treatments and systemic drugs such as methotrexate, cyclosporin, acitretin and ultraviolet B phototherapy.
A report by leading Australian dermatology specialists states these therapies ‘help most people with severe psoriasis’, but toxicity limits the dose and duration of treatment.
The side effects of these drugs are many and varied. Methotrexate often causes nausea, vomiting and increased liver enzymes, acitretin carries many side effects including elevated liver enzymes and blood lipids, renal impairment and teratogenicity, and cyclosporin is associated with high blood pressure and kidney failure.
Six reports have been made to the Adverse Drug Reactions Committee of serious consequences resulting from the use of methotrexate, a chemotherapy and immune suppressant drug, and three of these patients died from complications of bone marrow suppression.
Methotrexate and acitretin, an oral retinoid, also have proven significant adverse effects on the foetus, so pregnancy must be postponed for several years after stopping treatment.
The report also found psoriasis often recurs after stopping these therapies, and the rebound is usually more severe than before treatment, spreading to other areas of the body and erupting as new varieties of psoriasis.
Interestingly, the report makes no mention of gut health, microbiome or probiotics, and only two brief mentions of prioritising a low-glycemic diet.
Listen to our skin expert Rebecca Hughes talk about the functional medicine approach to skin health and natural treatments for psoriasis
Our practitioner Rebecca first uses a range of functional testing like microbiome analysis, heavy metal testing, inflammatory markers, and vitamin and mineral levels to determine the underlying cause of your condition.
A psoriasis treatment plan will then be tailored just for you, which could include a combination of functional medicine approaches for psoriasis, including:
Bacterial dysbiosis of the gastrointestinal tract is associated with chronic inflammatory skin disorders including psoriasis. Research has found probiotics have the potential to treat psoriasis and other skin disorders, by restoring beneficial bacteria in the microbiome.
Conventional treatments overlook the significant therapeutic potential of nutrition, and a food's ability to have either a negative or beneficial impact on psoriasis. Inflammatory foods like refined carbohydrates, sugar, dairy, processed foods and artificial ingredients may have potential to worsen psoriasis. A Mediterranean diet has been shown to help reduce psoriasis symptoms, with foods high in healthy fats like extra virgin olive oil, fish, nuts and avocados, as well as fresh, organic vegetables and fruits. Rebecca will work with you to help you eliminate any foods that may be aggravating inflammation, while ensuring you have a diet rich in essential nutrients.
Healthy skin requires a delicate balance of nutrients and minerals, which can become depleted as a result of deficiencies, reduced digestive function, stress, sun damage, age, and microbiome imbalances. Sometimes the foods we eat simply aren’t enough to obtain all of the nutrients we need. Rebecca can assess individual nutrient levels and provide supplements to reduce psoriasis symptoms, such as essential fatty acids, zinc, vitamin D and vitamin C, or gastric support to improve digestion and enzymatic activity.
People with psoriasis are often very sensitive to fragrances, in everything from perfume and skincare to washing powder, room spray and cleaning products. Artificial fragrances are not only aggravating on the skin, but can cause toxic buildup in the liver and blood. Other environmental toxins that can potentially trigger psoriasis flares include cosmetics, alcohol, smoke, fumes, heavy metals, plastic and dust.
Stress creates an inflammatory response in the body, which can cause and trigger a range of skin eruptions including hives and eczema. Studies have found stress is a trigger for both the onset and exacerbation of psoriasis, and steps should be taken to reduce and manage stress levels. Your Melbourne Functional Medicine treatment protocol will include lifestyle and supplement support for healthy stress management.
Research has found people with psoriasis experience poor sleep quality more often than those without the condition. This creates a frustrating cycle as sleep is critical for cellular repair and detoxification processes that support skin health, but the discomfort of psoriasis can make it difficult to sleep. If sleep is a concern for you, Rebecca can help you create a healthy sleep schedule, and have a more comfortable night’s rest.
(Michaela is a real patient but we’ve changed her name and image to protect her privacy.)
Michaela came to us because she was suffering from psoriasis and it was having a significant impact on the way she was living her life. Being in her early 30’s, socialising was a big (and important) part of Michaela’s life. Going to music festivals was her outlet and most of her social interactions included drinking alcohol.
Read Michaela’s story by hitting the button below
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Diet can play a significant role in improving psoriasis.
Inflammatory foods like refined carbohydrates, sugar, dairy, processed foods and artificial ingredients may have potential to worsen psoriasis, whereas an anti-inflammatory Mediterranean diet has been shown to help reduce psoriasis symptoms, with foods high in healthy fats like extra virgin olive oil, fish, nuts and avocados, as well as fresh, organic vegetables and fruits.
Treating the underlying factors that cause Psoriasis to occur can lead to improvement or complete resolution of the condition. This approach involves a comprehensive assessment by a practitioner with a thorough understanding of the condition, including functional testing, nutrition and other natural interventions.
Psoriasis presents in five different ways, and requires diagnosis by a GP or dermatologist.
The most common type is Plaque Psoriasis that creates red, scaly plaques that most commonly occur on the scalp, face, knees and elbows, abdomen or lower back. Inverse Psoriasis presents as inflamed, smooth rather than scaly red skin. Guttate Psoriasis appears as small, round, red spots.
Pustular Psoriasis occurs as white pustules surrounded by red inflamed skin.
Lastly, a rare and potentially life-threatening form Erythrodermic Psoriasis creates intense redness, pain, itching, dehydration and shedding of large sheets of skin.
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