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 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.