Coffee is one of the most popular drinks in the world and may even offer some health benefits. However, it’s not necessarily a harmless substance — the caffeine in coffee can worsen many conditions. As members of MyPsoriasisTeam have wondered, could coffee trigger psoriasis flares?

Some members of MyPsoriasisTeam stopped drinking coffee to help avoid flare-ups. Others say they can’t properly wake up without their daily dose of caffeine: “I have to do at least one very large coffee just to get dressed.” Many others are left wondering, “Should I cut down on coffee?”

“Caffeine is cited by many folks with psoriasis as a trigger, but it doesn’t bother everyone! You could try cutting it and see if you notice any improvement,” wrote one member, adding, “Caffeine makes my anxiety worse, which in turn makes my psoriasis worse, so I try to have less of it and do tea instead of coffee.”

It might take some trial and error to determine if — and how much — coffee might be a psoriasis trigger for you, causing symptoms such as thick, discolored, itchy or painful patches of skin. Meanwhile, understanding the research into caffeine and psoriasis might help guide you to an answer.

Coffee and Caffeine

Caffeine is a major component of coffee. Caffeine is an antioxidant, a substance that prevents cell damage caused by oxygen. This property of caffeine may potentially help fight inflammation caused by psoriasis, which leads to flares. Caffeine can also help maintain the balance of an important molecule used for cell communication, called cyclic adenosine monophosphate (cAMP). Lack of cAMP in skin cells is associated with psoriasis flare-ups.

Paradoxically, along with its anti-inflammatory effects, caffeine may have a pro-inflammatory impact, as shown in experiments with rats. It may seem contradictory, but caffeine also has different effects on different autoimmune disorders, seeming to protect against some but raising the risk of others. Psoriasis is an autoimmune disease that some researchers found has no significant link with coffee — but studies show that caffeine may either prevent or worsen flares, depending on the amount.

Caffeine Ointments for Psoriasis

Researchers report that caffeine has beneficial effects on psoriasis when applied topically (directly to the skin). Creams and ointments that contain caffeine are being developed as psoriasis treatments. Some people make their own coffee scrubs, but there’s no research on how well these do-it-yourself treatments work.

Coffee and Psoriasis: What Research Tells Us

Applying caffeine in a topical treatment may help your psoriasis — but does drinking it in coffee also offer benefits?

Researchers continue to look into the effects of coffee on psoriasis, but the results of past studies provide some insight. For example, a 2012 study tracked more than 82,000 healthy people (participants in the Nurses’ Health Study II) and their habits, such as smoking and drinking coffee, for 15 years, with the goal of understanding which factors influence psoriasis development. Although smoking was found to be a risk factor, consuming coffee didn’t have the same effect, regardless of the amount.

Drinking coffee may not lead you to develop psoriasis, but what if you already have this skin condition? A 2018 study of 221 people with psoriasis showed that coffee drinkers had less severe flare-ups compared with those who didn’t drink coffee. Sipping 3 cups of coffee a day — the most common amount among the participants — was found to be the most beneficial.

But here’s that paradox: The results also showed that drinking too much coffee may worsen psoriasis. Participants who averaged 4 or more cups daily had the most severe flare-ups.

Caffeine and Psoriatic Arthritis

Little research exists on how coffee affects psoriatic arthritis. When it comes to arthritis in general, most experts agree that moderation is key. While it’s believed that coffee consumption may have an antioxidant effect — which means it can prevent cells from damage — studies have been inconclusive regarding the risk of arthritis and coffee consumption. For people with arthritis symptoms, the Arthritis Foundation advises limiting coffee intake to about 2 cups a day.

Risks of Coffee

When consumed in moderation, coffee can have beneficial effects on your psoriasis. But it’s also important to consider other increased risks associated with this beverage.

Caffeine Overdose

Caffeine, which is found in plants but can also be synthesized, is a stimulant (making you more alert) and a diuretic (making you urinate more). If you get more than the usual or recommended amount of this substance, you may be at risk of an overdose. Caffeine overdose occurs when you consume too much caffeine from coffee, other caffeinated drinks or foods, or medications. Symptoms of caffeine overdose include:

• Anxiety or agitation
• Sleeping problems
• Diarrhea, nausea, or vomiting
• Trouble breathing
• Rapid or irregular heartbeat
• Increased thirst and urination
• Dizziness
• Confusion
• Hallucinations
• Seizures

Caffeine isn’t only in coffee, so to prevent an overdose, be sure to account for other sources that could add up to a dangerous amount. For example, you might want to consider drinking less coffee when you’re taking pain medication that contains caffeine.

Caffeine Addiction

Caffeine addiction is medically known as caffeine use disorder. You might have caffeine addiction if you regularly consume coffee or other caffeinated substances, such as soda or tea, and have experienced these three criteria of caffeine use disorder:

• A persistent desire or unsuccessful attempts to cut down on caffeine
• Use of caffeine despite having a condition (physical or psychological) that caffeine worsens
• Caffeine withdrawal symptoms (such as headaches, fatigue, irritability, or difficulty concentrating)

It’s hard to know just how many people have caffeine addiction. However, a 2020 study estimated that up to 8 percent of its 1,006 coffee-consuming participants, who were chosen to reflect the U.S. population, were affected by caffeine use disorder.

Who Should Avoid Caffeine

You should avoid or limit caffeine as much as possible if you:

• Are pregnant or breastfeeding
• Have a sleep disorder
• Get migraine headaches or other chronic headaches
• Experience anxiety
• Have other medical conditions such as ulcers, heart issues, or high blood pressure
• Take certain drugs such as stimulants and asthma or heart medications

Although psoriasis isn’t on this list, be sure to speak with your health care provider regarding the effects of coffee consumption on your health and your particular situation. Your doctors, nutritionist, or dietitian will also be able to help if you have caffeine use disorder.

Coffee Intake Recommendations

U.S. adults consume an average of 135 milligrams of caffeine a day, which translates to roughly 1.5 cups (12 ounces) of coffee. The U.S. Food and Drug Administration (FDA) considers up to 400 milligrams of caffeine (about 4 cups of coffee) per day safe. However, many soft drinks and foods, such as chocolate, contain caffeine, so be sure to factor those sources into your daily total.

There are no specific recommendations on caffeine intake for people with psoriasis. However, given the study results showing that moderate amounts of caffeine might be beneficial for some people with psoriasis but too much can worsen flares, it’s best to generally limit yourself to 2 to 3 cups a day.

One MyPsoriasisTeam member suggested spreading out daily coffee intake: “If you have to have coffee, then split it in half: 8 ounces in the morning, then 8 ounces later.”

Every condition is unique, and general recommendations may not apply to everyone. Be sure to get medical advice from your primary care doctor, dermatologist, nutritionist, or dietitian regarding the safe daily amount of caffeine for you or a loved one.

The Effects of Decaf

Decaffeinated coffee, or decaf, has the same ingredients as regular coffee, except caffeine. Decaf coffee contains:

• Antioxidant molecules called polyphenols
• Magnesium
• Vitamin B2

Decaf offers health benefits similar to those of regular coffee and may be a good choice for people who enjoy this beverage but are sensitive to caffeine. If it seems that the caffeine in coffee worsens your symptoms of psoriasis, you might see if a switch to decaf leads to fewer flare-ups.

Talk to Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. On MyPsoriasisTeam, more than 125,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

Do you enjoy drinking coffee? How does caffeine affect your psoriasis? Share your experience in the comments below, or start a conversation by posting on your Activities page.