Do smoking and drinking affect psoriasis?
It"s difficult to pick up a newspaper or turn on the
television without seeing the latest statistics regarding
the negative effects of alcohol and cigarettes on our health.
Though we hear these messages repeatedly, it is especially
important for people suffering from skin conditions like psoriasis
to heed the warnings. Recent studies have shown that not only
can alcohol and cigarettes worsen psoriasis symptoms, but
a number of researchers believe that they may actually cause
psoriasis in some patients. Additionally, alcohol in particular
can have very serious side effects when mixed with some psoriasis
medications, and both alcohol and tobacco may render some
medications ineffective. We have compiled information from
recent studies that illustrates just how negatively these
activities affect those suffering from psoriasis.
Tobacco and psoriasis
Numerous recent studies have linked cigarette smoking to
increased incidence of psoriasis, as well as to decreased
rates of recovery from psoriasis in smokers. An article in Psoriasis Advance cites a study by Luigi Naldi, MD
that identified startling correlations between smoking and
psoriasis. Dr. Naldi found that "Smoking about doubles
a person"s risk of acquiring psoriasis; the risk increases
with the number of cigarettes smoked per day, and is higher
in women than men. The risk for women who smoke more than
20 cigarettes per day is about 2.5 times greater than the
rate of nonsmokers, and in men the risk is about 1.7 times
greater than the rate of nonsmokers." Dr. Naldi"s
study hypothesized that nicotine has internal effects on the
immune system and skin cell growth, in addition to the external
irritation of cigarette smoke on the skin.
In 2005, SKINMed magazine printed an article by
Behnam, Behnam, and Koo that corroborated many of Naldi"s
findings, as well pointing out that, in addition to a greater
risk of developing psoriasis, those already suffering, especially
men, were more likely to experience more severe symptoms,
especially in their extremities. This study also found that
both men and women showed a much lower improvement rate than
non-smokers.
The findings of Naldi and of Behnam, Behnam and Koo are
echoed in the sentiments of Dr. Gerald Krueger, MD, at the
University of Utah, where he leads the Utah Psoriasis Initiative:
"If the disease is triggered by smoking, can we get
the disease back in the can by quitting? We just don"t
know yet. However, I tell people that if you need another
reason to quit, you've got one."
Alcohol and psoriasis
While some studies have been conducted on the effects of
alcohol on psoriasis, researchers note that the results are
a bit murkier than those for tobacco. One notable reason is
that patients often consume both alcohol and tobacco together,
and therefore it is difficult to control for the effects of
one or the other and thus to definitively attribute the symptoms
to one or the other. That said, evidence exists that points
to increased risks for those consuming alcohol as well. In
1986, Dermatologica published an article by Monk
and Neill, who were studying the relationship between alcohol
and psoriasis in 100 patients. They found that "in
male patients, heavy drinking, at a level liable to be detrimental
to health, was found significantly more commonly in those
with severe psoriasis, and alcohol-related medical or social
problems were frequent."
In her book Digestive Wellness, Elizabeth Lipski,
PhD, CCN concludes that not just heavy drinking but consuming
alcohol in even small amounts may greatly upset the liver,
and may also cause an overgrowth of Candida -
yeast believed to contribute to psoriasis symptoms.
As further studies are conducted, many specialists agree
that stronger links may be found between alcohol and psoriasis.
Of note is that the Psoriasis Advance article also
urges those taking drugs, especially methotrexate or acitretin
(brand name Soriatane) for treatment of psoriasis symptoms
to cease drinking alcohol because of the potential for very
serious side effects.
Psoriasis sufferers at increased risk
In addition to tobacco and alcohol use being mitigating factors
in increasing, and perhaps even causing psoriasis in some
cases, psoriasis sufferers are more likely to engage in these
potentially risky behaviors. Due to the often highly visible
plaques, redness, and other symptoms common in psoriasis sufferers,
compounded by frequently difficult treatment options, depression
and low self-esteem can develop as yet another undesirable
side effect of psoriasis. Unfortunately, when people are feeling
the effects of depression, they are more likely to self-medicate
with alcohol and cigarettes. It is crucial that people who
may be feeling depressed, for whatever reasons, speak to their
healthcare practitioner about healthier options.
Obviously, if you either smoke cigarettes or drink alcohol,
the healthiest choice is to quit as soon as possible. You
may start seeing improvements in your psoriasis right away.
It is also important to concentrate on participating in healthier
activities such as regular exercise, which, according to some
studies, may alleviate symptoms of depression. Equally if
not more important is eating a healthy diet, including abundant
fresh fruits and vegetables as well as eight glasses of water
per day. With many seemingly uncontrollable factors like heredity
that may contribute to psoriasis, eliminating these potentially
harmful activities is something well within reach that may
greatly improve symptoms.
Resources:
Behnam,
S., et al. 2005. Alcohol as a risk factor for plaque-type
psoriasis.
Cutis, 76 (3), 181-185. Review.
Behnam,
S., et al. 2005. Smoking and psoriasis. SKINMed, 4 (3), 174-176. Review.
Lipski, E. 2005. Digestive Wellness. New York: McGraw-Hill.
Monk,
B., & Neill, S. 1986. Alcohol consumption and psoriasis. Dermatologica, 173 (2), 57-60.
National Psoriasis Foundation. January/February 2005. Time
to kick the habit? Thinking twice about alcohol and cigarettes. Psoriasis Advance. URL: http://www.psoriasis.org/publications/advance/200501_alcohol.php (accessed electronically October 12, 2007).
Principal Authors: M. Smith, Nurse Practitioner;
& K. Kastelein, Editor-in-Chief
Date of Publication: 10/18/2007
Updated: 10/28/2007 |
