Last night, in my latest REAL LIVES webinar we discussed Holly, a 9 year old with chronic psoriasis. If you missed it, I’ll be recording the information later this month and posting onto my website. To keep up to date on this please subscribe to my newsletter.
So last night we discussed these main important areas of focus (and so much more!)
What is psoriasis?
An auto-immune condition characterised by upregulated inflammatory *TH1 cytokines and growth factors stimulating overly rapid growth of immature skin.
What drives this condition?
Potentially infection: Activation of the innate immune system could be by streptococcal infection (which was the case for Holly) or as yet unidentified factors. Consider possible candida or systemic fungal infections.
What is the gut link?
Digestive problems are often present in psoriasis. These can range from poor protein digestion, constipation and increased intestinal permeability to inflammatory bowel disease.
Does stress need consideration as a driving factor?
Stress can exacerbate symptoms due to production of proinflammatory cytokines. Chronic stress reduces secretory IgA in skin inhibiting skin defense to pathogens
*TH1 cells are responsible for causing macrophages to attack invading organisms and infected cells.
We went on to consider the factors which may drive the immune system to malfunction as only by understanding this can we work on root causes rather than turning to reducing the inflammation by topical creams (with some very unwanted side-effects).
These include:
Environment – infections, UV radiation, cosmetics, solvents, detergents - Immune cells in the skin may react to constant sensitisation
Insulin resistance (high carbohydrate diet)
High levels of insulin like growth factor (dairy consumption) – can increase proliferation of keratinocytes
Vitamins A & D need focus due to roles in skin health, integrity, modulation of immune response and prevention of high keratinocyte production
Imbalance of omega 6/3 may lead to increased production of inflammatory prostaglandins
Disruption to the skin microbiome can impair integrity of epidermis (increases risk of translocation of toxins and microbes to deeper layers). Over-use of antibacterial products reduces sebum production. Sebum protects skin and acts as food for beneficial bacteria
Link to the microbiome due to C section and bottle feeding
Impaired protein digestion due to low stomach acid or digestive enzymes increase chances of intolerance reaction. Assess the stress link.
By working on the diet, understanding exactly what the skin needs to repair and what the immune system requires to modulate itself and individual factors which may be exacerbating the inflammation we were able to reach a point of vast improvement as pictured below:
Before and after shots ……
A main point to take from this webinar is the need to look in depth at each individual case. This condition appears to arise in genetically susceptible individuals who are exposed to environment triggers. So, uncover the triggers and work from there. Holly was saved a huge amount of steroid cream by changing her diet and identifying the gut link. In guttate psoriasis, as we discussed, the condition is self-limiting in 60% of cases but in 40% the condition reoccurs. 40% is a HUGE statistic so it is well worth understanding more about the skin and the immune system to avoid falling into this group.
If you are reading this and would like to understand more about your own psoriasis condition then get in touch, seize the moment. Email is best - bellenutrition@gmail.com
The webinar information was based on current research into this condition.
The research links discussed last night can be found below:
(1) https://pubmed.ncbi.nlm.nih.gov/29858350/
(2) https://www.sciencedirect.com/science/article/abs/pii/S0025619612606909
(3) 10 Majewski et al. Decreased levels of vitamin A in serum of patients with psoriasis. Arch Dermatol Res. 1989; 280 (8): 499-501.
(4) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4134971/
(5) https://www.sciencedirect.com/science/article/abs/pii/S0899900708004206
(6) https://www.mdpi.com/1422-0067/21/7/2582/htm
(7) https://pubmed.ncbi.nlm.nih.gov/26287637/
Plus an extra one I popped on there for added interest:
Reduced secretion of IgA to skin surface of patients with atopic dermatitis
https://www.sciencedirect.com/science/article/abs/pii/S0091674954000395