Psoriasis—Alcohol, Tobacco & Psoriasis
Does 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
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.
How We Help
Visit DermaHarmony to learn more about our alternative, science-based approach to psoriasis and other common skin conditions. At DermaHarmony our goals are to educate chronic skin care sufferers about the latest alternative research in dermatology, encourage a holistic approach to healthy skin and wellness, and to support our readers in every way we can. Our programs promote healthy skin from the inside out—with pharmaceutical-grade nutritional supplements, topical treatments, expert dietary guidance, and a whole-person approach to health and wellness. Learn more about our programs or call us toll-free at 1-800-827-3730. Our support desk is open 9:00 a.m.–6:00 p.m. ET, Monday–Friday.
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Tobacco & Psoriasis—Reference Documents and
Principal Authors: M. Smith, Nurse Practitioner;
& K. Kastelein, Editor-in-Chief
Date of Publication: 10/18/2007