Some people tried cutting out certain foods and drinks to see if their psoriasis improved. Louie thought it helped if he avoided fizzy drinks as he says these make his skin flare up. Others, like Ella and Damini who had both tried stopping eating dairy, didn’t see a difference. Lisa considered avoiding gluten but her dermatologist didn’t think it would help. A few people warned about diet-related myths and scams. Sofia didn’t eat chocolate for a while but thinks it was a “silly rumour”. Steven says it’s frustrating when other people ‘blame’ his diet for his psoriasis.
Hannah finds biological injections are working well for her, but thinks diet and healthy living is important too.
Hannah finds biological injections are working well for her, but thinks diet and healthy living is important too.
Age at interview: 24
Sex: Female
Age at diagnosis: 16
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So I'm pleased to be on medication, but of course I'd rather be on something natural that was working. And I know that something that I should've tried for a longer time was the diet approach. Because there's a lot of stuff about, you know, the stuff that you eat basically triggering psoriasis. So like fatty stuff and dairy and processed foods. I found that really hard to try and like change my whole diet, but it's definitely something that I want to pursue again. This like idea of testing what might be making it worse.
It's difficult to do that when you’re actually on medication because, you know, you feel like if that's already helping it, it's hard to see what foods like, what foods are helping and what foods are making it worse. You'd have to sort of be on nothing to, to really test it. But I think it's always worth like trying to exercise more and trying to eat well with psoriasis. I definitely think that when my psoriasis was at its worst and I didn't want to do anything and I was less active and, you know, like was eating kind of like comfort eating – it was like probably at its worse. And it is just a vicious cycle like that. You want to get out and exercise and eat well; when your skin's better weirdly, you know, like you feel more in control of your life when your skin's better. So it all seems to come together like a good lifestyle and good skin, and like a bad lifestyle and your skin's bad. But I'll be interested to see whether there are some foods that are making it bad.
Adam came across scams online promising long-lasting ‘cures’ for psoriasis.
Adam came across scams online promising long-lasting ‘cures’ for psoriasis.
Age at interview: 24
Sex: Male
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I’ve paid money to fraudsters online for like dietary advice, exercise, health advice. So, which didn’t, well, it was just an absolute scam. And I knew it was a, as I was doing it I knew it was a scam. I was just so desperate, kind of like that. So I’ve tried to change my diet. That’s about it really. What else have I seen online? Ah things like “buy this kind of smoothie making guide. And if you put like all of this and this and this and this, then just live off olive oil, you’ll be fine” or something like that. Like really there’s stupid things that I’ve seen, that people kind of are desperate, like people really are. Like I was desperate. Do you know what I mean? I was so close to falling for a lot of them.
But I paid for this booklet that had like a guide. I think I paid like 20 dollars and it was just a PDF that was sent to me. And, and it was just basically like, “Follow these steps and you won’t have psoriasis.” This guy who apparently had psoriasis posted on the forum his like cure for psoriasis and it was a dietary cure. And, and it was basically like, “If you eat just this for the next like 40-odd days or something like that, then your skin will go from here.” And this guy had very severe plaque psoriasis to here. And he had an after picture. I don’t know if you’ve, if you’ve come across any of them. And I was like, “Oh, my God.” And I started emailing this guy. And I don’t know whether, like I feel he may have been genuine, like that happened to him. And I don’t, cos it didn’t come across at all like a scam. Like to me, he was emailing me back like decently. Like, without kind of being like, “What’s your credit card details?” or anything like that.
Abbie’s dermatologist talked to her about triggers like stress and suggested some foods to cut out.
Abbie’s dermatologist talked to her about triggers like stress and suggested some foods to cut out.
Age at interview: 20
Sex: Female
Age at diagnosis: 10
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The only main thing that I've always been told is like stress, and because when I was at high school, my first high school I went to, I didn’t really enjoy it which was why I had the IBS as well from the anxiety which then, they put that down to why it got worse as well, just being stressed out. And then when I saw the consultant this year they mentioned - , cos everyone's really said about stress and she mentioned again, "What's work like; how is it?" and I said, "look what I do is busy," so they did mention the stress. And then she also mentioned about different foods that can be triggers, so she give me so many to eliminate - so I don’t eat beef, don’t eat tomatoes, don’t eat dairy and I don’t eat oranges. And although when I've cut them out pretty much completely for the first month and a half or so, because I was doing phototherapy I didn’t really see much of a difference, whereas now because obviously I have my food all cooked for me, I still eliminate it but every now and then I will have naughty days, and I will eat some of those foods and I'll go have a burger, I’ll go drink proper milk, cos I drink goat's milk.
And see, but I haven’t seen any effect that these, what I'm eating every now and then, it's flaring up my skin so I'm just every now and then I eat it in smaller doses just in case.
A few people had seen alternative therapy practitioners and were given dietary advice. Damini had been told to avoid sugary, spicy and salty foods as well as mangoes and bananas but found the restrictions hard to maintain. Russell cut down his intake of dairy, switching to coconut milk as an alternative, which he thinks helped a lot. He finds it “more difficult to control” his diet when back at home from university, as his parents usually cook the meals. People also found information about diet by looking online, talking to friends, asking their doctors and reading ‘psoriasis diet’ books.
Damini started using herbal medicine and following a diet when she visited India. She found it difficult to stick to the diet restrictions.
Damini started using herbal medicine and following a diet when she visited India. She found it difficult to stick to the diet restrictions.
Age at interview: 21
Sex: Female
Age at diagnosis: 4
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Yeah. I went to India to try some herbal remedies from there. But they gave me a list of dietary requirements that I had to follow and I did follow it too, for about six months to a year, but then after, it just got too much and it was, I did notice it was helping, but it just got too much and I couldn’t continue doing that.
Could you tell me a bit about what those dietary requirements were?
Yeah, they told me not to eat anything spicy, anything with salt in it, certain, certain fruits like bananas mangoes, I can’t remember the others. Certain-, I think wheat, they said no. That’s all I remember so far.
That’s quite a lot of restrictions then.
So, it was difficult to I just basically lived on pasta [laughs].
[Laughs]
But, yeah, it got too much. Yeah, so I stopped that. But it didn’t come back after, straight away. Patches came back, but it didn’t-, I wasn’t where I was at the start.
Russell saw a homoeopathist and was given advice on diet.
Russell saw a homoeopathist and was given advice on diet.
Age at interview: 20
Sex: Male
Age at diagnosis: 19
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And she sort of advised me to sort of speak to her speak to her homeopathic medicine man, so I went along one time and had a little chat, to see what he said like I said before about trying different creams and stuff I was quite open to any kind of suggestions and willing to hear anything. And I don’t eat badly but I could eat better kind of thing, like I know my housemates last year ate awfully, like really, really badly [laughs]. So in comparison I looked very, very good but in a wider comparison I’m probably more average. so went along to, to him and he said, after I explained sort of roughly what I ate and my diet and whatnot, it was dairy, too much dairy and too much yeast. ‘Cos thinking back on it, it is quite easy to see that I do eat quite a lot of bread and so much stuff has yeast in it without you even realising it. So I tried a bit to reduce my dairy intake so I try and eat less cheese which is heart-breaking as it is, probably did help. I switched to an alternative dairy for milk and still have, kind of, when you go out for a, for a coffee or something like that obviously you have dairy milk and that’s fine and I don't avoid it when I’m out but when I’m at home, I’ll have kind of like coconut milk or on cereal or something like that just an alternative. So I’ve cut back a lot on how much cheese I eat, how much milk I drink and I don’t eat yoghurts so much anymore. And I still eat bread but not nearly as much as I did before, it’s kind of like the occasional piece of toast when there's nothing else in the house so I kind of use it as emergency food or when you get back after a night out and you need something to eat and you can’t be bothered to cook chips or anything like that, so I have like a toasties from the toastie machine. so I do still eat bread but it’s, I still eat all of them, the foods that he said I should cut out, but in vastly less quantities and it really does help.
Rather than avoiding any particular foods, some said they try to have a ‘healthy’ diet overall. Lucy thinks this is hard when living away from home at university though. She was excited about all the foods she could eat but thinks an unhealthy diet showed in her psoriasis getting worse. Hannah says she used to “comfort eat” when she felt down about psoriasis. Some people talked about a ‘healthy lifestyle’ as being about diet but also exercise and mental health. Many people wanted to find a balance between managing their psoriasis but not missing out on things they enjoy. Abbie says she has some “naughty days”, like when she’s going out for dinner with friends and wants to order a meal with ingredients she would otherwise avoid.
Lots of people thought alcohol was bad for psoriasis because it dries the skin. Some people, such as Abbie, hadn’t noticed any difference. Neither had Damini but she says she tries to keep her alcohol consumption low. Lucy described drinking water as a genuine “beauty secret” and good for psoriasis.
Russell finds his university life involves a number of psoriasis triggers, including drinking alcohol when socialising.
Russell finds his university life involves a number of psoriasis triggers, including drinking alcohol when socialising.
Age at interview: 20
Sex: Male
Age at diagnosis: 19
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But also being a male student, beer as well is a big contribution of yeast and once I’d sort of spoken to him and had this conversation it made a lot of sense and I did start to see a difference and there’d be times last year if, perhaps I, I don’t go out sort of every night I’m not one of those people but I do like to go out occasionally and stuff. And of a week perhaps where you go out once or twice, I went out twice and our sort of my staple drink was, would be kind of beer. I could see it over the next couple of day’s I’d wake up and I could see like the beginnings of a patch and maybe it was because I was more sensitive to it in terms of I was watching more what I ate. Because previously I’ve had quite a fast metabolism, I do quite a lot of sport and I’m quite active so I don’t, I’ve never really watched what I ate and my weights never really fluctuated – I think I’ve been the same weight for about five or six years and I’ve never really paid much attention to it so it could just be the fact that I was now slightly more sensitive to what I was putting into my system but I’m convinced now if I have a couple of nights out in a row or a couple of late nights in a row with maybe a night out with drinking interspersed in that, I can see it in my hands. just either in the beginnings of kind of a dry spot or something and so again it’s a little bit of a kick to drink some more water, have a few nights off, get some early nights, try and eat some good food over the next few days and to start moisturising again. And invariably that kind of keeps it at bay. the only thing that doesn’t at that point is sort of stress is the only other input that I can’t really have too much, well I can but at the same time I can’t, have too much of an influence on because there just seems to be so much going on all the time.
So how ever early a night, however well you eat and whatnot – there’s only so much it can do ‘cos I’m one of those people that can’t really say no to doing stuff so I still run around like an idiot, trying to do everything that I can but I wouldn’t have it any other way – I’d take a little bit of dry skin to kind of enjoy my university experience a bit more.
Some psoriasis medicines impact on diet/alcohol consumption. Systemic non-biologicals like methotrexate and cyclosporine had side effects for some people, making them feel sick and queasy. Alcohol shouldn’t be drunk whilst taking methotrexate because of the risks of liver damage. For Lucy, the combination of the side effects from methotrexate and having to avoid alcohol had a big impact on her social life while at university. Another dietary issue for some systemic non-biological medicines is having to avoid grapefruit because of drug interactions. Sofia also tracks her calcium intake for a clinical trial that she’s taking part in.
Lucy says the side effects and restrictions when taking methotrexate outweighed the benefits for her.
Lucy says the side effects and restrictions when taking methotrexate outweighed the benefits for her.
Age at interview: 24
Sex: Female
Age at diagnosis: 11
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With the methotrexate cos I was given loads of information about it cos it’s such a strong drug, when I first started. And, with psoriasis it’s used in very low doses. But in higher doses it can be used for chemotherapy treatments and things like that. Which scared me a bit. But then I spoke to my dermatologist and he said, you know, “It’s in very low doses and because it can affect your liver.” I had to have blood tests every two weeks. So they were very, very good at monitoring the effect on me. But, I was in my final year of university and had final exams and essays and stuff. And, it made me feel sickly. I took it once a week. And I think I took it on a Monday and the Monday, Tuesday, Wednesday, I always felt really, really sickly and headache-y as well, which was strange. But things like going out for a meal. I’d go out for a meal with my boyfriend. I can remember one particular time, we went to this lovely Indian and I couldn’t eat anything. I had this sort of starter and I felt really sick and I love Indian food. And, so just, it affected me like that. And it was, it was a shame, really, cos my skin, I felt the best I felt, like I felt like I looked normal, you know what I mean? And but yet, I was feeling so sick and headache-y and quite tired, I think. And it just, it got to the point, I was on it for a good few months, and it got to the point where I thought, ‘I’d rather have a bit, a bit of psoriasis and keep it under control with topical things maybe, than feel like this all the time’. And like I say, it affected my social life as well. And I know it shouldn’t. It really shouldn’t have, cos you do not need alcohol to be sociable. But I think it’s [coughs] it’s quite a big aspect of uni life and things. And I did still go out and not drink and had a nice time. But I felt that my friends were thinking, ‘oh, she’s been boring, she’s not drinking’ and didn’t really understand how serious the medicine was, where you can’t drink on it, cos it can really affect your liver. So, it did come with, with a lot of problems in my experience. And unless it got very, very, very bad, I probably wouldn’t like to go on it again.
Some young people said they thought smoking would make psoriasis worse. Those who smoked pointed out that it wasn’t the cause of their psoriasis nor the only factor to affect it. Adam had psoriasis years before he smoked or drank alcohol. Adam tried to stop smoking with the help of a therapist using hypnosis. He had hoped to see “instant effects” and improvements in his psoriasis, but his motivation to quit dropped when this didn’t happen.
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