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Psoriasis and Alcohol

Posted on February 18, 2021
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Bethany J. Sanstrum, Ph.D.

For some, alcohol may be an enjoyable part of life and a way to celebrate special occasions. For others, it may be a way to cope with stress. Regardless of your relationship with alcohol, consuming it comes with its own precautions. If you’re living with psoriasis, there are other health considerations to be mindful of, including its effect on your symptoms and treatment.

Psoriasis is a skin disease that occurs when the immune system attacks healthy skin tissue, leading to overactive skin production and buildup. The cause of this response is unknown, although many experts believe that environmental factors can trigger or worsen psoriasis — including alcohol.

What Is the Relationship Between Alcohol and Psoriasis?

Research studies have shown that people with psoriasis consume more alcohol than the general population. The prevalence of alcohol-use disorder — the consumption of alcoholic beverages at a harmful level or a dependence on alcohol — is significantly higher in people with psoriasis and other skin diseases compared to people with a noninflammatory disease.

There appears to be a back-and-forth relationship between alcohol consumption and psoriasis. Stress caused by psoriasis may increase alcohol intake, but alcohol use may also increase psoriasis symptoms.

How Does Alcohol Make Psoriasis Worse?

Alcohol is thought to be a psoriasis trigger. Drinking alcohol increases the release of cytokines, which are inflammatory molecules. Because psoriasis is caused by the overactivation of the immune system and high levels of inflammation, the inflammation caused by alcohol may make psoriasis worse.

Alcohol can also reduce the immune system’s ability to kill infections. When you develop an infection, your immune system becomes more active, which can aggravate psoriasis symptoms.

Alcohol may also directly contribute to skin lesions in psoriasis by further increasing the proliferation of skin cells.

Many MyPsoriasisTeam members have observed a link between alcohol and flare-ups or worsening of their symptoms. “I have drunk so much alcohol, and I know I will pay the price with itchy skin,” one member shared after attending a party.

“Alcohol makes mine worse too!” another member replied.

Alcohol intake may also be a risk factor for developing psoriasis. One research study found that drinking beer increased the risk of psoriasis in women. However, the researchers did not find other types of alcohol had a similar effect. Other studies have found that women who drank more alcohol were more likely to develop psoriasis.

Does the Amount You Drink Matter?

Alcohol has been shown to worsen flare-ups and skin lesions. A study of more than 1,000 people with psoriasis found a direct relationship between the amount of alcohol they consumed and their psoriasis area severity index (PASI) score. The more a person drank alcohol, the larger their skin lesions were. The connection between alcohol and psoriasis symptoms seems to be stronger in women; however, the association has also been found in men.

More research is needed to determine if any types or amounts of alcohol are safe for people with psoriasis.

Can Alcohol Affect Psoriasis Treatments?

There are a few ways that alcohol may interact with psoriasis treatment. It is best to consult your dermatologist or health care provider for medical advice on alcohol consumption for your psoriasis maintenance and treatment plan.

Liver disease is more common in people with psoriasis than in the general population. Alcohol is processed in the liver, and excessive alcohol intake can cause liver damage, called cirrhosis. Many psoriasis treatments — including methotrexate and acitretin — can sometimes cause liver damage. Alcohol may increase their harmful effects on the liver. Alcohol intake should be monitored closely when used in combination with these medications.

Additionally, alcohol changes how your body processes acitretin and reduces the medication’s ability to treat psoriasis symptoms.

Avoiding triggers like alcohol is recommended as a part of the treatment plan for psoriasis. Due to the effects of alcohol on psoriasis symptoms, treatments, and treatment side effects, alcohol use is generally discouraged for people with psoriasis.

Find Your Support

When you’re navigating lifestyle changes or flare-ups in your symptoms, it can help to have the support of people who understand your unique circumstance living with psoriasis. MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. More than 88,000 members come together to ask questions, give advice, and share their stories with others who understand.

Have you noticed that alcohol triggers your psoriasis? Do you have tips for cutting back? Share your experience in the comments below, or start a conversation by posting on MyPsoriasisTeam.

References

  1. High Prevalence of Alcohol Use Disorders in Patients With Inflammatory Skin Diseases — British Journal of Dermatology
  2. Alcohol-Related Mortality in Patients with Psoriasis — JAMA Dermatology
  3. Alcohol, Psoriasis, Liver Disease, and Anti-psoriasis Drugs — International Journal of Dermatology
  4. Psoriasis and alcohol — Psoriasis: Targets and Therapy
  5. Alcohol Intake and Risk of Incident Psoriasis in U.S. women – JAMA Dermatology
  6. Alcohol Consumption and Psoriasis: A Systematic Literature Review — Journal of the European Academy of Dermatology and Venereology
  7. Alcohol and Psoriasis: Sobering Thoughts — Clinical and Experimental Dermatology
  8. Psoriasis — Diagnosis and Treatment — Mayo Clinic
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Bethany J. Sanstrum, Ph.D. holds a doctorate in cell and molecular biology with a specialization in neuroscience from the University of Hawaii at Manoa. Learn more about her here.

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