Persistent Inflammation in Psoriasis : Causes & Management Strategies

Psoriasis is a chronic autoimmune skin disorder that affects millions of people worldwide. Characterized by the rapid buildup of skin cells, psoriasis leads to the formation of thick, red patches covered with silvery scales. This condition often goes beyond being a mere skin concern, as it can significantly impact an individual’s quality of life due to its potential for discomfort, pain, and social stigma.^(1,2)

While the precise origin of psoriasis remains uncertain, medical professionals classify it as an immune-mediated inflammatory disorder. This implies that inflammation plays a pivotal role in the development of this ailment.

Approximately three percent of adults in the United States alone are affected by psoriasis.⁽³⁾ This condition manifests through symptoms like raised plaques and changes in skin coloration, and it can extend its influence to various body components, including joints and eyes.⁽⁴⁾

All over the world, inflammation is perceived by experts as being the shared element that can exert an influence on these diverse areas. While there is no cure for psoriasis, various treatment options exist to manage its symptoms and help those affected lead healthier, more comfortable lives.

In psoriasis, inflammation is triggered by an overactive immune response. The exact cause of this immune dysregulation is not fully understood, but it involves a combination of genetic, environmental, and immune system factors.

Dysfunction in the immune system is believed to be what prompts the accumulation of inflammatory cells within the middle layer of the skin, referred to as the dermis. This malfunction also accelerates the growth of skin cells in the outer layer, known as the epidermis. Typically, the skin’s cellular turnover process spans approximately a month, with cells naturally shedding. However, in people with psoriasis, this cycle drastically shortens to a mere few days. As a result, skin cells accumulate on the skin’s surface instead of properly shedding. This buildup gives rise to uncomfortable symptoms like elevated plaques, scales, swelling, and redness or alterations in coloration.^(5,6)

Genetic predisposition is a significant contributor to inflammation in people with psoriasis. Certain genes related to the immune system are associated with an increased risk of developing psoriasis. However, having these genes does not guarantee the development of the condition; rather, they increase susceptibility.⁽⁷⁾

Environmental factors can also play a role in triggering inflammation in genetically predisposed individuals. Triggers may include infections, injuries to the skin, stress, and certain medications. These factors can activate the immune system, leading to an inflammatory response that accelerates the growth of skin cells.⁽⁸⁾

In a normal immune response, white blood cells (T cells) are responsible for protecting the body from infections. In psoriasis, T cells become overactive and mistakenly target healthy skin cells as if they were foreign invaders. This triggers a complex immune response that leads to the rapid growth of skin cells, causing the characteristic patches and scales seen in psoriasis.⁽⁹⁾

Additionally, there is an involvement of cytokines, which are signaling molecules that regulate inflammation. In psoriasis, there is an increased production of certain cytokines, such as tumor necrosis factor-alpha (TNF-alpha) and interleukins (IL-17 and IL-23). These cytokines promote inflammation and contribute to the ongoing immune response seen in psoriatic lesions.⁽¹⁰⁾

In summary, the inflammation in psoriasis is a result of a combination of genetic predisposition, environmental triggers, immune system dysfunction, and the production of specific inflammatory cytokines. This complex interplay leads to the chronic inflammatory skin condition observed in individuals with psoriasis.

While immune system dysregulation underlies inflammation in psoriasis, research indicates that individuals can potentially alleviate this inflammation by adopting lifestyle and dietary modifications.⁽¹¹⁾ These changes have the potential to mitigate symptoms and enhance overall quality of life.

By implementing these strategies, numerous individuals grappling with psoriasis can achieve remission, characterized by prolonged periods devoid of psoriasis symptoms. Moreover, specific medications designed to address psoriasis function by diminishing inflammation. This therapeutic category encompasses topical corticosteroids, injectable biologics, and oral medications.

It is important to note that the treatment approach may vary for each person with psoriasis. Some individuals might necessitate more comprehensive treatment regimens compared to others.

Managing inflammation associated with psoriasis requires a multifaceted approach, even though a definitive cure is currently unavailable. Embracing the following practices can potentially reduce psoriasis-related inflammation and enhance the likelihood of achieving remission. 

1. Adopting a Nutritious Diet

Understanding the intricate connection between diet and systemic inflammation is pivotal. Research indicates that specific inflammatory dietary patterns can elevate the likelihood of developing psoriasis and exacerbate its symptoms.⁽¹²⁾  

Customizing a nutritious diet to individual preferences is essential, and this can involve: 

• Avoiding Inflammatory Foods: Steering clear of pro-inflammatory items like sugary beverages, ultra-processed foods (such as snacks high in salt and sweets), and processed meats is crucial as they can intensify inflammation and trigger psoriasis symptoms.
• Considering an Anti-Inflammatory Diet: Embracing diets rich in fruits, vegetables, and other nourishing foods consistently demonstrates effectiveness in alleviating psoriasis symptoms. For instance, a 2018 study involving over 35,000 participants revealed that adhering to a Mediterranean-style diet correlated with milder psoriasis symptoms.⁽¹³⁾
• Increasing Antioxidant Intake: Antioxidants found in fruits, vegetables, and whole grains have anti-inflammatory properties. They neutralize harmful molecules called free radicals that contribute to inflammation. Incorporating a variety of colorful fruits and vegetables can provide a range of antioxidants that support the body’s defense against inflammation.⁽¹⁴⁾
• Omega-3 Fatty Acids: Foods rich in omega-3 fatty acids, such as fatty fish (salmon, mackerel, sardines), flaxseeds, chia seeds, and walnuts, have been shown to have anti-inflammatory effects. These healthy fats can help balance the body’s inflammatory response and potentially alleviate psoriasis symptoms.
• Limiting Sugar Intake: High sugar consumption can trigger inflammation. Reducing added sugars in your diet can help maintain more stable blood sugar levels and lower overall inflammation.

2. Maintaining an Optimal Weight

Sustaining an optimal weight holds significance in managing psoriasis. Obesity is recognized as a risk factor for the onset of psoriasis, and individuals with psoriasis who fall into the overweight or obese category may encounter more pronounced symptoms compared to those within a healthy weight range.⁽¹⁵⁾

Striving for weight loss can yield substantial benefits for individuals grappling with excess body weight and psoriasis. Shedding those extra pounds has the potential to dampen the activity of inflammatory markers, subsequently leading to the alleviation of psoriasis symptoms.

In support of this, a study conducted in 2020 emerged with promising findings. This study focused on individuals with psoriasis who were also overweight or obese. These participants embarked on a 10-week weight reduction program that resulted in a noteworthy reduction of 12% in their body weight. The outcomes were impressive: a substantial 50–75% decrease in the severity of psoriasis was observed. On average, participants managed to shed 23 pounds during this period.⁽¹⁶⁾

The study underscores the pivotal role that weight management can play in influencing psoriasis symptoms. The potential for significant symptom reduction, as demonstrated by the considerable decrease in severity, is a compelling testament to the relationship between weight loss and inflammation control in the context of psoriasis. This reinforces the importance of addressing excess body weight as a complementary strategy for individuals striving to manage their psoriasis symptoms effectively. 

3. Other Helpful Tips

There are many other habits that can aid in reducing inflammation and improving psoriasis symptoms, including: 

• Hydration: Drink an adequate amount of water daily to support overall bodily functions and maintain healthy skin.
• Anti-Inflammatory Herbs and Spices: Integrate turmeric, ginger, garlic, and green tea into your diet for their anti-inflammatory properties.
• Regular Exercise: Engage in regular physical activity to boost circulation, enhance immune function, and promote overall well-being. Consult a healthcare professional before starting any new exercise regimen.
• Stress Management: Practice stress-reduction techniques like meditation, yoga, deep breathing, and mindfulness to curb inflammation triggers.
• Adequate Sleep: Prioritize getting 7–9 hours of quality sleep each night, as sleep deprivation can contribute to inflammation.
• Avoid Smoking: Quit or avoid smoking, as it exacerbates inflammation and negatively impacts overall health.
• Limit Alcohol Intake: If you consume alcohol, do so in moderation, as excessive alcohol intake can contribute to inflammation.
• Skincare Practices: Use gentle skincare products and moisturizers to prevent skin dryness and irritation.
• Limiting UV Exposure: Moderate sun exposure can sometimes help improve psoriasis symptoms, but always protect your skin with sunscreen and consult a dermatologist.
• Stay Hygienic: Maintain good hygiene to prevent infections that can trigger psoriasis flare-ups.

Remember that consistency is key. While adopting these habits may not provide immediate results, over time, they can contribute to reducing inflammation and improving psoriasis symptoms, enhancing your overall quality of life. It is important to know that you should always consult with healthcare professionals before making significant changes to your lifestyle or treatment plan.

In the pursuit of managing chronic inflammation in psoriasis, it is evident that a multifaceted approach is essential. The strategies outlined above emphasize the importance of addressing inflammation through a combination of lifestyle adjustments, dietary choices, proper skincare, stress management, and professional guidance.

By embracing these strategies, individuals can not only alleviate the discomfort caused by psoriasis but also foster an environment where inflammation is effectively controlled. As we continue to deepen our understanding of psoriasis and its links to inflammation, these strategies provide a promising pathway toward improved well-being and a better quality of life for those navigating the challenges of this condition.

At the same time, remember that professional guidance is also needed to ensure that the journey towards managing inflammation and enhancing well-being is informed and holistic.

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