7 Popular Diets for Psoriasis, Ranked Best to Worst
One of the first things people ask when diagnosed with psoriasis is whether a change in diet could help. The truth is, the jury is still out on that one—to date, there is only a little scientific evidence to suggest dietary changes may significantly improve psoriasis symptoms. Yet some patients swear by the difference their dietary choices have made, and plenty of doctors support trying a change to see if it could help.
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“Since psoriasis is an inflammatory skin disease linked with other internal inflammatory conditions, as well as obesity and other metabolic issues, seeking ways to address symptoms through diet change—either as a first-line treatment or in combination with other psoriasis treatments—is a very good consideration for many patients,” says board-certified dermatologist Todd E. Schlesinger, M.D., of Dermatology & Laser Center of Charleston in South Carolina.
But not all diets are created equal, especially when it comes to benefiting psoriasis. While some could potentially help ease psoriasis symptoms, including itching and scaling, others could possibly cause you to flare.
That’s why, here, we explore today’s most popular diets—and whether they might provide help in easing psoriasis.
Best Bet: Mediterranean Diet
The Mediterranean diet has been around since the 1960s. It’s not a strict diet but rather an eating plan high in plant-based foods and olive oil, with moderate amounts of fish and poultry and low amounts of dairy, sugar, and red or processed meats.
“Psoriasis is a chronic inflammatory disease,” notes Peterson Pierre, M.D., a board-certified dermatologist at Pierre Skin Care Institute in Westlake Village, California. “The Mediterranean diet has been shown to reduce chronic inflammation and lower the risk of metabolic syndrome and heart disease.”
Research suggests the Mediterranean diet can be protective against chronic inflammatory diseases. And a study published in JAMA Dermatology found that people who adhered to the Mediterranean diet were less likely to report having severe psoriasis than those who didn’t follow the diet. It’s also worth noting that the Mediterranean diet is pretty much the same as the anti-inflammatory diet recommended by the National Psoriasis Foundation.
“The Mediterranean diet emphasizes high consumption of fruits, vegetables, whole-grain cereals, and olive oil, leading to a diet which is high in monounsaturated fats, antioxidants, polyphenols, and fiber—all of which may contribute to its anti-inflammatory effects,” Pierre says. “Of all the diets out there, this is the one worth trying.”
Promising: Hypocaloric Diet
A hypocaloric diet really only has one rule: Consume fewer calories than you burn. This diet promotes weight loss, which research has found may improve the symptoms of psoriasis in people who are overweight and obese.
“Consistently adhering to a low-calorie diet in conjunction with an anti-psoriasis treatment has been proven in several studies to be a viable option to decrease the surface area and severity of psoriasis,” Schlesinger says.
He points to a study published in Archives of Dermatology that compared two groups of people with moderate to severe psoriasis. One group received only psoriasis medication, while the other received the same medication plus a low-calorie diet for 24 weeks.
Significantly more patients on the low-calorie diet achieved a decrease in body mass index (BMI). When their BMI decreased, they were also more likely to experience a decrease in their psoriasis symptoms.
A bonus is that people sticking to a hypocaloric diet tend to avoid calorie-dense foods that might typically increase inflammation, such as processed foods, refined sugars, and fatty red meats.
Anytime you embark on a low-calorie diet, it’s important to do so under the supervision of a medical professional. If this is a diet you’d like to try, you should first talk to your doctor about healthy ways to reduce calories while still ensuring you are getting the nutrients you need.
May Be Worth Trying: Pagano Diet
You may have never heard of this eating plan, but you may want to look into it: the diet endorsed by John O. A. Pagano, D.C., the author of Healing Psoriasis: The Natural Alternative.
“Pagano was a big proponent of healing psoriasis through diet by emphasizing fruits and vegetables, minimizing grain, seafood, meat, dairy, and eggs, and eliminating red meat, citrus fruits, processed foods, and nightshades, such as tomatoes, potatoes, eggplants, and peppers,” explains Pierre.
And there is some research to back up Pagano’s diet. In a survey of people with psoriasis published in Dermatology and Therapy, 72 percent of those who tried this diet reported having a positive skin response.
Helpful for Some: Gluten-Free Diet
The gluten-free diet is typically followed by people with celiac disease and gluten sensitivities. The idea is to avoid any foods that contain gluten, most notably: wheat, rye, barley, malt, and brewer’s yeast.
Whether this diet will work to reduce psoriasis symptoms really depends on whether you have a gluten sensitivity. For those who do, the intake of gluten has been shown to increase inflammation. In fact, in a study published in the British Journal of Dermatology, 73 percent of people with gluten sensitivities were able to improve their psoriasis symptoms by sticking to a gluten-free diet. When they gave up that gluten-free diet? Their psoriasis got worse.
“For psoriasis patients with a gluten sensitivity, trying a gluten-free diet may show improvement in their symptoms,” Schlesinger says. But it won’t work for everyone. “For psoriasis patients who do not have a gluten sensitivity, there is no evidence at this time suggesting there would be a decrease in symptoms.” Schlesinger adds.
Shows Potential: Vegan Diet
While there is little research to back the benefits of vegan or vegetarian diets in the treatment of psoriasis, both have been said to be helpful by some people who’ve tried them. A vegan diet takes things a bit further than a vegetarian diet by not only omitting meat, but also honey, dairy products, eggs, and anything made with animal by-products.
“A vegan diet may benefit people with psoriasis because it eliminates meat and dairy, two food groups that can worsen psoriasis,” Pierre says. “It also emphasizes fruits, vegetables, and healthy oils, all of which have known anti-inflammatory effects.”
He points to a patient survey published in Dermatology and Therapy that showed favorable results for psoriasis patients who were on a vegan diet. But he cautions that “adherence can be challenging, especially if you like meat and dairy.”
Also Shows Potential: Paleo Diet
The Paleo diet is another that has grown in popularity in recent years, encouraging people to eat more like their ancestors once did—without dairy, refined fats, and processed sugars and a focus on wild meat and fish, eggs, fruit, vegetables, and nuts.
On the surface, this is a diet that seems promising for psoriasis patients, especially because it involves cutting out so many inflammatory foods.
“The Paleo diet aims to limit the foods to those things that would have been around as primitive cultures were beginning to hunt, gather, and cultivate their own food,” Schlesinger says. “Though there is little research on this diet's effects on psoriasis, one study showed at least 10 percent of patients experiencing an improvement in symptoms when removing junk foods and processed foods.”
Still, he says more research is required to prove how beneficial Paleo truly may be to psoriasis patients. And Pierre offers these words of caution: “Eliminating food groups can lead to a deficiency in the nutrients you need to stay healthy, such as calcium and vitamin D. You may consider working with a registered dietitian if you want to follow the Paleo diet.”
Worst Bet: Keto Diet
The ketogenic diet (otherwise known as keto) has grown in popularity in recent years. This high-fat, low-carb diet promises swift weight loss so long as you stay within your percentages; a daily balance between fat (60 to 75 percent of your diet), protein (15 to 30 percent of your diet), and carbs (5 to 10 percent of your diet).
If you’ve heard of the keto diet before, you’ve probably heard people praising it as a miracle diet that could benefit all kinds of conditions. But before you hop on that bandwagon, know that it’s not likely to help people with psoriasis. In fact, researchers say the keto diet may actually cause or exacerbate skin problems.
“The keto diet minimizes carbohydrates, which can lead to weight loss and a decrease in total body inflammation,” says Pierre. But people on keto eat fewer fruits and avoid some vegetables, which means they’re likely getting fewer anti-inflammatory nutrients.
Plus, he says keto emphasizes meat and fats, both of which could also increase inflammation. “Many have reported a flare-up of their psoriasis after starting a keto diet,” says Pierre. “This is an approach you may want to avoid.”
Always Important: Making Healthy Choices
Even if a strict diet isn’t for you, Pierre says there are dietary choices you can make to help improve your psoriasis symptoms. “Regardless of which diet you choose to follow, you should focus on lean meats, fruits, vegetables, monounsaturated fatty acids such as olive, coconut, and flaxseed oils, antioxidants, omega-3 fatty acids, and vitamin D, while minimizing dairy and gluten (if you're sensitive), processed foods, refined sugars, and alcohol.”
Schlesinger says adding fish oil, fruits, vegetables, and water to your diet can help improve symptoms, as can reducing junk foods, alcohol, gluten, and nightshades (for some).
What works for people with psoriasis can vary from person to person, and you should always discuss any new dietary choices with your physician before trying them. “Whether it’s psoriasis or any other inflammatory disease, do your research, discuss it with your physician, and, as a team, find the best combination to focus on improving your symptoms,” says Schlesinger.