Do you have psoriasis? 125 million people worldwide, including 2% of the UK population, live with this condition, so you’re not alone!
To mark World Psoriasis Day, let’s look at how your gut influences the development of autoimmune conditions such as psoriasis,1https://www.nature.com/articles/s41392-022-01219-0 and what you can do to alleviate the symptoms.
What is Psoriasis?
Psoriasis is an inflammatory, autoimmune condition in which skin cells multiply much faster than usual. Normally, skin cells renew every three to four weeks however in psoriasis, they are replaced every two to six days. When new skin cells are produced too quickly, they are unable to mature and shed fast enough: this results in a buildup of thick, silvery scales and itchy, dry, red patches of skin (psoriatic plaques).2https://www.nature.com/articles/s41392-022-01219-0
Psoriatic plaques can cover large areas including the elbows, hands, knees, scalp, and lower back. 3https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9321451/ Dry, cracked skin can become very irritated and painful.
Around 30% of people with psoriasis develop psoriatic arthritis, a condition characterised by joint pain, stiffness, and swelling. Psoriatic arthritis can affect any joint, causing a significant impact on mobility and overall quality of life. 4https://www.mdpi.com/1422-0067/22/9/4529
- Raised red patches of skin covered in silvery scales
- Dry, itchy, cracked skin
- Burning and soreness
- Thickened, pitted nails
- Stiff, swollen joints
So, how is your gut health involved?
1. The immune system
The majority of our immune cells are located along the gut wall and gut bacteria are in constant communication with them. Disturbances within the gut microbiome (gut dysbiosis) can lead to an imbalance in the immune response and the production of inflammatory cytokines that promote an increase in the turnover of skin cells.5https://www.sciencedirect.com/science/article/pii/S2590097820300136
Certain gut bacteria influence the production of inflammatory and anti-inflammatory substances, which have systemic effects throughout the body, including the skin. 6https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9321451/ For example, when beneficial bacteria such as Faecalibacterium prausnitzii break down fibre, they produce short-chain fatty acids like butyrate which have potent anti-inflammatory effects. 7https://www.mdpi.com/1422-0067/22/9/4529
Reduced levels of Faecalibacterium prausnitzii have been observed in people with psoriasis which may contribute to the inflammatory nature of this condition. 8https://www.sciencedirect.com/science/article/pii/S2590097820300136
Equally, disturbances to the gut microbiome can result in higher levels of harmful bacteria (for example Escherichia coli and Salmonella) that lead to the release of lipopolysaccharides (endotoxins) and the promotion of inflammation. 9https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9321451/ 10https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6091223/
3. Intestinal permeability
Some studies have suggested that individuals with psoriasis may have increased intestinal permeability (where the lining of the gut loses its tight-knit structure and becomes more porous).11https://pubmed.ncbi.nlm.nih.gov/1911568/ This can allow bacteria and other harmful substances to pass through the intestinal lining and enter the bloodstream, potentially triggering immune responses that contribute to the development of autoimmune conditions such as psoriasis.
Butyrate (produced by beneficial bacteria) provides fuel for cells of the gut lining, helping to strengthen its barrier, lower inflammation and reduce intestinal permeability. 12https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916842/ A healthy microbiome also works to produce a thick layer of protective mucus along the gut wall. This serves as a second line of defence against unwanted substances crossing into the bloodstream. Akkermansia muciniphila is important for the maintenance of the protective mucus layer and studies show that levels of this helpful bacteria are reduced in people with psoriasis.13https://pubmed.ncbi.nlm.nih.gov/29130553/
How can you alleviate symptoms?
The long-term solution is to heal the gut! The aim is to replenish the gut with an abundance of friendly bacteria – these will help to:
- Reduce inflammation and balance the immune system
- Prevent the growth of harmful bacteria
- Produce a wealth of beneficial substances (postbiotics).
To do this, we recommend:-
- Taking Probiotic Kefir and eating other fermented foods like kimchi, sauerkraut, miso, tempeh, and probiotic yoghurt.14https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9321451/
- Adding in Complete Prebiotic powder and eating a diverse range of fibre-rich plant foods (pulses, legumes, nuts, seeds, whole grains, fruits, vegetables, herbs and spices). Prebiotic fibres provide the fuel for beneficial bacteria to thrive.15https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9321451/
- Taking Collagen, which has been shown to support a healthy gut lining.16https://pubmed.ncbi.nlm.nih.gov/28174772/
While the Probiotic Kefir works on the root of the issue, we recommend the use of Chuckling Goat natural skincare to improve the skin biome and help reduce redness and irritation.
As with any new skincare, please patch test first before using liberally.
Boswellia serrata has been trialled and found effective against skin inflammation, itching, and other symptoms of eczema and psoriasis. 17https://www.pubtexto.com/journals/global-journal-of-clinical-and-cosmetic-dermatology/fulltext/efficacy-and-safety-of-boswellia-serrata-extracts-in-the-treatment-of-eczema-and-psoriasis
Depending on the length and severity of your gut dysbiosis, improving your gut health, and therefore your skin, can be a slow and gradual process.
More detailed information about the gut-health protocol, including recipes, tips, and more explanatory science can be found in Shann’s books: The Good Skin Solution: Natural Healing for Eczema, Psoriasis, Rosacea and Acne.
Check out these similar articles – Signs of an unhappy gut – and what you can do about it!, Biofilm – The Beauty and the Beast, Meet your very own commensal bacteria!
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