Psoriasis is an autoimmune disease that speeds up the lifecycle of your skin cells. Its symptoms manifest on your skin yet it is caused by your immune system going rogue and attacking your own tissues.

When it comes to psoriasis treatment options, conventional medicine uses a “one-size-fits-all” approach to address psoriasis symptoms.

A Functional Medicine approach, however, will look at the bigger picture, addressing the lifestyle and environmental factors that may be causing your struggle with the condition. It can help you avoid the use of treatments such as Calcipotriol and Secukinumab, offering you a natural way to heal your psoriasis rash rather than just supress symptoms.

What is psoriasis?

Psoriasis can occur at any age and affects both males and females equally.

It often runs in families and is thought to have a genetic basis. The disease itself is caused a by a change in skin cell turnover. It’s not contagious and cannot be transferred from one part of the body to another.

Normally, skin cells take about three to four weeks to replace themselves, but in psoriasis, this process is greatly accelerated, with skin cells being replaced every two to six days.

This faster process means skin cells don’t have time to mature properly so they get to the surface and they’re not yet ready to be shed. This results in an accumulation of cells on the surface, which form a psoriatic plaque.

The plaques appear as raised red patches of skin, covered with silvery white scales. The silvery white scales are the accumulation of the skin cells waiting to be shed, and the redness is due to the increase in blood vessels required to support the increase in cell production.

The condition can range in appearance from mild to severe. The plaques can appear in a variety of shapes and sizes, varying from a few millimetres to several centimetres in diameter, but they all have a well-defined border from the surrounding skin. It also common for the complaint to be itchy, and it can sometimes feel painful or sore.

Psoriasis types

There are five types of psoriasis:

Plaque psoriasis is the most common form of the disease and appears as raised, red patches covered with a silvery white build-up of dead skin cells. These patches or plaques most often show up on the scalp, knees, elbows and lower back and are often itchy and painful, and they can crack and bleed. Scalp psoriasis is especially common.

Guttate psoriasis is a form of psoriasis that appears as small, dot-like lesions. Guttate psoriasis often starts in childhood or young adulthood and can be triggered by a strep infection. This is the second-most common type of psoriasis, after plaque psoriasis. About 10 percent of people who get psoriasis develop guttate psoriasis.

Inverse psoriasis shows up as very red lesions in body folds, such as behind the knee, under the arm or in the groin. It may appear smooth and shiny. Many people have another type of psoriasis elsewhere on the body at the same time.

Pustular psoriasis in characterized by white pustules surrounded by red skin. The pus consists of white blood cells. It is not an infection, nor is it contagious. Pustular psoriasis can occur on any part of the body but occurs most often on the hands or feet. Some people also suffer from nail psoriasis where there are changes in the appearance and texture of the nails, such as the development of ridges and pitting. In some cases, this condition can also cause joint problems that resemble rheumatoid arthritis.

Erythrodermic psoriasis is a particularly severe form of psoriasis that leads to widespread, fiery redness over most of the body. It can cause severe itching and pain, and make the skin come off in sheets. It is rare, occurring in 3 percent of people who have psoriasis during their lifetime. It generally appears on people who have unstable plaque psoriasis.

If you have an erythrodermic psoriasis flare, you should see a doctor immediately. This form of psoriasis can be life-threatening.

Psoriasis causes

In the past, this condition was thought to be a condition that existed purely within the skin. It is now understood that it is actually changes within the immune system that trigger the condition.

Psoriasis is frequently referred to as an ‘autoimmune’ or ‘T-cell mediated disease’. T-cells naturally circulate throughout the body waiting for other types of immune cells to alert them to a foreign substance. These foreign substances, called antigens, activate the T cell, which then initiates an immune response. The problem in psoriasis is that the T-cells end up in the skin and become overactive, producing excessive amounts of inflammatory chemicals and growth factors that can initiate the formation of a psoriatic plaque.

The cause of this overactivity is thought to be genetic but there are also links to digestive imbalances, stress, environment and diet.

Treating with Functional Medicine

A Functional Medicine approach to this condition looks at how digestive function, diet and stress are influencing the immune system and aims to address the root causes and return balance to the patients biochemistry.

It is widely accepted that stress has an impact on psoriasis and the condition often worsens during stressful life periods. When people with psoriasis are put under stressful conditions their immune system actually starts to make more T-cells ready to create an inflammatory response that could lead to a flare-up. Stress can also compromise digestion. If stress is a trigger factor for your psoriasis, a Functional Medicine health practitioner can also give you advice on natural stress management to allow you more control over your symptoms.

Leaky gut

Increased intestinal permeability and abnormalities in the lining of the gut have both been demonstrated in psoriasis patients. If the gut lining becomes leaky, the passage of antigens into the bloodstream increases, creating a situation called autointoxication. The immune system then reacts to the antigens, producing inflammation. In psoriasis, the deposit of excess antigens in the skin is thought to be one possible trigger for the development of a plaque.

Poor digestion

When protein digestion is poor, gut bacteria can start to break down the undigested proteins and produce toxic substances. One group of toxins are polyamines, which have been found to be higher in people with psoriasis than in the average population. Polyamines blocking the production of a substance that helps to stop skin cells going into division overdrive. Since protein digestion occurs in the stomach and the small intestine, low levels of stomach acid or reduced digestive enzymes levels may be to blame.

SIBO overgrowth

Imbalances in friendly bacteria levels, as well as overgrowth of bad bacteria or yeast, can also exacerbate psoriasis. This is because gut flora imbalances can lead to excess toxin production in the intestines as well as interfering with the processes that keep the gut lining healthy.

Food sensitivities

Food sensitivities can also be an underlying cause in psoriasis, compromising gut integrity and triggering inflammation. A Functional Medicine health practitioner will be able to identify those foods that are worsening your symptoms and design you a personalised low-reactive diet.

Find out more about how gut health can affect your skin here.

Strategies to heal naturally

Leaky gut, gut flora imbalances and problems with digestive function can be identified by a comprehensive functional stool analysis and SIBO test and then targeted with a specific rebalancing protocol.

Heal your gut

Your gut plays a significant role in skin health. Repairing your gut is essential to restoring your immune system and your health. Removing the bad bacteria and replacing with good bacteria will ensure a host of benefits, including the healing of your skin. Sounds simple, but there are often underlying triggers, intestinal permeability, digestive complications, blocked detoxification pathways and other issues that need addressing. That’s where an experienced practitioner can greatly assist.

Eat a whole food, anti-inflammatory diet

Focus on anti-inflammatory foods including wild fish and other sources of omega-3 fats, red and purple berries (rich in polyphenols), dark green leafy vegetables, orange sweet potatoes, nuts and seeds. Add anti-inflammatory herbs and spices, including turmeric (a source of anti-inflammatory curcumin), garlic, oregano, ginger, rosemary, holy basil and turmeric, as well as green tea to your daily diet. Eliminate inflammatory foods such as refined, omega-6 and inflammatory oils including corn, soy and safflower oils.

Remove food sensitivities

A review of research from 2008 strongly recommended gluten-free for people with this condition and celiac disease, but not for people without a celiac diagnosis or gluten sensitivity.

In addition to removing all grains and legumes form your diet, it is recommended to remove corn, soy, dairy and nightshades. This is not only because they’re inflammatory themselves — they can also cross-react with gluten. This cross-reactivity causes the immune system to fire up, as these foods trigger can trigger the body to upregulated the immune response and further progress autoimmune conditions including psoriasis.

Test for heavy metal toxicity

Mercury and other metals trigger or exacerbate psoriasis.

Cadmium, an environment pollutant, increases the levels of inflammation markers and influences the immune system. In one study, participants with severe psoriasis have higher blood cadmium leading to the theory that environmental exposure to cadmium can predispose to the worsening of psoriasis. Ensuring detoxification pathways are open, optimising methylation and balancing minerals and nutrients are key in allowing the body to not accumulate metals.

Use supplements

Nutrients like fish oil, vitamin D and probiotics can help eliminate psoriasis. Also consider anti-inflammatory nutrients like quercetin, grape seed extract and rutin. Find out more about supplement use for this condition here.

Exercise regularly

Regular exercise is a natural anti-inflammatory. One study found increased physical exercise along with dietary intervention reduced psoriasis severity in systemically treated overweight or obese patients with active psoriasis

Limit alcohol

Alcohol is a gut irritant and can cause damage to the liver, both of which can affect the immune system. While there is no definitive link between alcohol and this condition, studies have shown people who drink alcohol have more flare ups than people who don’t.

Practice deep relaxation

Studies show chronic stress can influence the development of this condition. The proportion of psoriasis patients who believe stress affects their skin condition ranges from 37 to 78 percent, and researchers believe stress may worsen psoriasis severity and may even lengthen the time to disease clearance.

Sleep for 8 hours every night

Studies show patients with psoriasis suffer from disturbed sleep.

Get in touch with us at Advanced Functional Medicine

Living with psoriasis is an everyday struggle for many, but by investigating the root causes of your skin condition and implementing many of the above changes in lifestyle and diet, you may be able to heal your skin naturally, without the use of harsh treatments and steroid creams.

At Advanced Functional Medicine, we have extensive experience working with psoriasis. s

Types of psoriasis and how your gut health could be the underlying cause