Psoriasis – more than skin deep

psoriasis on neck

‘Breaking barriers’ is this year’s theme for World Psoriasis Day, which falls on October 29th. The day is dedicated to people with psoriasis; it’s a global event that sets out to give an international voice to the more than 125 million people around the world with psoriasis, and its aims include raising awareness to let those suffering with the condition that they are not alone, and to raise the profile of this devastating skin condition and the misery it can cause.

There are around 8 million people in the UK affected by psoriasis, a painful, debilitating and disfiguring skin condition that can also affect nails.  Characterised by red or pink patches called ‘plaques’, with silvery scales on the skin, psoriasis can develop just about anywhere on the body, and if severe can cause painful bleeding fissures on the skin.

Many of those suffering from the condition tolerate constant pain from cracking and bleeding skin. They bear the humiliation of continually shedding scales that litter their clothes and surroundings. They also struggle with the disappointment of treatments and the lack of a cure. Some wrestle with a crippling form of arthritis. More than anything, they sometimes bear the brunt of public rejection because of the misunderstanding surrounding the disease and the appearance of their skin. People see lesions and speculate that they are contagious, which they are not. It is not uncommon for psoriasis sufferers to experience feelings of social isolation, depression and low self-esteem.

Psoriasis is an auto-immune skin disease, affecting men and women equally, of all ages, with no known cure. In primary and secondary care, management of symptoms is offered, including emollient creams to keep the skin soft and prevent the painful fissures from developing, as well as ultra violet light, tablets and injections. However, some of the tablets and injections can come with serious side effects.

Around one in three psoriasis sufferers will go on to develop psoriatic arthritis, where joints become inflamed and painful.  According to the British Association of Dermatology, there is no known cure for psoriasis.  However, it is interesting to note that people with psoriasis notice an improvement in their condition when they go on holiday, and their skin is exposed to fresh air and sunlight.

There is strong evidence to suggest that psoriasis, like eczema, is linked to the balance of gut flora and there is much research being done on the gut-skin axis. We know that in dermatitis and rosacea, there is evidence that the gut barrier has been breached, with ‘toxins’ spilling out of the lumen (bowel) into the blood circulation, creating a huge immune inflammatory response, that can manifest itself as a skin irritation or skin disease.

Altered gut microbiota is indicated in inflammatory bowel disease and coeliac disease, and these are often associated with skin inflammation.  What is also interesting is that gut dysbiosis can also be found it people with psoriatic arthritis.*

I’ve known, for the best part of my 25 years complementary medicine career, that the causes of psoriasis are to be found in the gut. If your intestines are not able to contain endo-toxic material, including bacteria and parasites, and are spilling out toxins into your bloodstream, then, good heavens – what do we think is going to happen to the skin?!  It isn’t exactly going to look glowing with health and vitality.  There is going to be a huge battle going on in the intestines as the immune system valiantly tries to stop the stem of poisonous wastes getting into the bloodstream and travelling around the body, potentially causing havoc along the way.

The first rule of thumb for any natural therapist, including naturopaths, nutritional therapists and medical herbalists, when working with someone who has psoriasis, is to fix the gut. Stop the tide of toxins breaching the intestinal wall, and heal and repair the intestinal wall.  A good therapist will have her/his own tried and tested protocols to achieve this aim, including looking at diet and introducing key supplements like probiotics, digestive enzymes, omega 3 essential fatty acids and anti-microbials.

If you’ve had psoriasis for some considerable time, and you have seen little or no improvement under your current conventional treatment plan, then I would urge you to get a second opinion from a member of the natural health community, preferably someone who has had experience working with digestive and intestinal health, and psoriasis.

The following quote harks back to Victorian times. No-one quite knows where it originated, but I feel it is still as apt today as it was then, possibly even more so:

“The colon is a sewage system, but by neglect and abuse it becomes a cesspool. When it is clean and normal we are well and happy; let it stagnate and it will distil the poisons of decay, fermentation and putrefaction into the blood, poisoning the brain and nervous system so that we become mentally depressed and irritable; it will poison the heart so that we are weak and listless; poison the lungs so that the breath is foul; poison the digestive organs so that we are distressed and bloated; and poison the blood so that the skin is sallow and unhealthy.

In short, every organ of the body is poisoned, and we age prematurely, look and feel old, the joints are stiff and painful, neuritis, dull eyes and a sluggish brain overtake us; the pleasure of living is gone.”

The psychological toll of psoriasis can be very heavy indeed.  If you are affected, or know someone who is, don’t suffer in silence – if one kind of treatment doesn’t work, my advice is to move on to the next line of attack; effective treatments can be found – it might take time, and it might well mean looking below the surface, and treating what’s going on inside too.

The evidence and information that indicates a strong link between the gut microbiota and the health of our skin can be found in this article: