Psoriasis — a chronic inflammatory skin disease characterized by raised, itchy, scaly patches — is associated with a higher risk of other autoimmune disorders, including celiac disease. Celiac disease is characterized by an allergy to gluten, a protein found in wheat, barley, and rye.

On MyPsoriasisTeam, members have discussed having both psoriasis and celiac disease. Members have also shared how a gluten-free diet has helped their psoriasis symptoms. One member said, “I went gluten-free because of celiac disease, and my scalp psoriasis disappeared for over a year now.”

While there is an association between the two conditions, not everyone with psoriasis will develop celiac disease. Not everyone with celiac disease will develop psoriasis either. If you have psoriasis and celiac disease, there are effective ways to manage both conditions.

Psoriasis and Celiac Disease: What the Research Says

A 2019 study confirmed an association between psoriasis and celiac disease. Researchers found a two-fold increase of celiac disease in people with psoriasis. In this study, people with psoriasis had twice as many cases of celiac disease as people without psoriasis.

Another study found that three times as many people with psoriasis had celiac disease compared to people without psoriasis.

Celiac disease is thought to be a complication of psoriasis. This means that if you have psoriasis, you are at a greater risk of developing celiac disease than someone without psoriasis.

What’s Driving the Link?

The reason for the connection between celiac disease and psoriasis is not well understood. Researchers have several hypotheses (proposed explanations) about the connection.

One hypothesis is that the two disorders share genes. Researchers have found shared genes between celiac disease and type 1 diabetes. Could celiac disease and psoriasis also share genes?

A second hypothesis suggests that the body’s immune response in psoriasis makes people more susceptible to the gastrointestinal (GI) inflammation that is characteristic of celiac disease.

The third hypothesis is that psoriasis is actually a complication of celiac disease. Celiac disease is commonly misdiagnosed, and people can experience delays in getting a proper diagnosis. Could the intestinal dysfunction from celiac disease increase the risk of autoimmune conditions like psoriasis? In some cases, celiac disease may come before psoriasis. As one member recently shared, “Diagnosed with celiac disease in 2013. Diagnosed with psoriasis two weeks ago.”

When Celiac Disease Resembles Psoriasis

Several symptoms of celiac disease are similar to symptoms of psoriasis or psoriatic arthritis, a type of arthritis that affects some people with psoriasis.

About 10 percent to 15 percent of people with celiac disease will develop an itchy, bumpy skin rash called dermatitis herpetiformis. This rash is caused by eating gluten. It is not related to psoriasis.

Joint pain, swelling, and stiffness are the main symptoms of psoriatic arthritis, another autoimmune disease. Joint pain is also a lesser-known symptom of celiac disease. It is caused by inflammation from the immune system’s response to gluten.

Shared Causes and Risk Factors

Psoriasis and celiac disease are both conditions related to the immune system. They share some causes and risk factors. One risk factor is a genetic predisposition — that is, an increased chance of getting the condition if someone in your family has it.

Psoriasis

The exact cause of psoriasis is unknown. Researchers believe that genetic and environmental factors contribute to developing the condition. But genetics aren’t always the cause; a person could develop psoriasis even if they have no known family history of psoriasis.

Factors that impact how the immune system works may trigger psoriasis symptoms. Triggers vary from person to person, but they may include:

• Stress
• Illnesses, such as ear infections or strep throat
• Skin injuries, such as sunburns, bug bites, and scratches
• Tobacco use
• Weather (winter weather may cause flares, while warmer weather can help improve psoriasis)
• Allergies, alcohol, or other environmental factors

Celiac Disease

In people with celiac disease, ingesting gluten causes an immune system response that damages the small intestine and affects its ability to absorb nutrients. This damage can lead to complications such as:

• Anemia (low red blood cells)
• Osteoporosis (bone weakening)
• Migraine
• Epilepsy
• Infertility

Celiac disease is diagnosed with blood tests that look for genetic markers and antibodies that show an immune response to gluten. A diagnosis is usually confirmed by a small bowel biopsy, an examination of tissue in the small intestine.

Like psoriasis, celiac disease does not have a clear cause. The condition is hereditary (passed through families), but not all people with a genetic predisposition develop celiac disease. According to the Mayo Clinic, factors such as infant-feeding practices, gut bacteria, and infections in the GI system may contribute to the development of celiac disease. In some cases, celiac disease doesn’t become active until after one of the following events:

• Surgery
• Viral infection
• Severe emotional stress
• Pregnancy
• Childbirth

Risk factors for celiac disease include having a family member with celiac disease or having type 1 diabetes, an autoimmune thyroid disease, or Down syndrome.

Living With Psoriasis and Celiac Disease

Living with both psoriasis and celiac disease may be more challenging than living with just one of these conditions. You may need to seek health care from two different types of medical specialists — gastroenterologists and dermatologists. You may also need to try different treatments for each condition.

The good news is that psoriasis and celiac disease are both treatable and manageable conditions. Although having psoriasis may raise your chances of having celiac disease, having psoriasis does not appear to worsen symptoms of celiac disease.

Managing Psoriasis and Celiac Disease

Psoriasis and celiac disease treatments target the symptoms of each condition.

Psoriasis has several treatment options depending on its severity and how well it responds to treatments. Treatments include vitamin D supplementation, corticosteroid creams, other topical creams, and injected medications such as biologics. Psoriasis treatments do not contain gluten, so they do not affect or increase the risk of celiac disease.

Celiac disease is treated with a gluten-free diet. Some people with psoriasis find that a gluten-free diet also improves their psoriasis symptoms. The reason why is not fully understood. The National Psoriasis Foundation recommends experimenting with a gluten-free diet for adults with psoriasis who test positive for gluten intolerance or gluten sensitivity.

Some MyPsoriasisTeam members have found a gluten-free diet helpful in managing their symptoms. “If I accidentally eat some gluten, my skin turns red and blotchy and breaks out again … but when I don’t eat gluten, my skin starts healing like crazy,” wrote one member. Another said, “I’ve noticed that keeping my diet gluten-free has reduced the frequency of plaques randomly appearing.”

It’s important to focus on what you can control when treating and managing these conditions. Lifestyle factors like quitting smoking tobacco and reducing stress may be helpful for managing both psoriasis and celiac disease.

Talk With Others Who Understand

When managing psoriasis and celiac disease, joining a support group and talking about your experiences may be helpful.

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. More than 103,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

Do you have psoriasis and celiac disease? Share your experience in the comments below, or start a conversation by posting on your Activities page.