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Myth or Medicine?

Here's your guide to what helps psoriasis — and what doesn't

A lot of advice for people with psoriatic diseases sounds like any blueprint to better health: Eat well, don't smoke, reduce stress, keep weight in check.

"We're always hoping to minimize lifestyle risk factors," said Dr. Abrar Qureshi, co-director of the Center for Skin and Related Musculoskeletal Diseases at Boston's Brigham and Women's Hospital.

But some lifestyle tips circulating in the psoriasis community tend more toward rumor than reality — and deciphering fact from fiction can be tricky. For help, we asked several medical experts to weigh in on six common psoriasis rumors.


The Rumor: Applying human breast milk to skin will improve psoriasis.

False.

Thank Kim Kardashian for this rumor, spawned when the reality star applied her sister's breast milk to her psoriasis in an episode of the E! television show Kourtney & Kim Take Miami earlier this year. While it may make for entertaining television, there's no scientific basis for the treatment, said Dr. April Abernethy, associate director of medical programs at the National Psoriasis Foundation.

Though colostrum — an antibody-packed form of breast milk that comes in right after delivery — has shown some skin-healing properties, Abernethy doesn't recommend it as a psoriasis treatment.

"I think when people are plagued with psoriasis, they are always looking for something and anything that will work," Abernethy said. But breast milk, it seems, is not the answer.


The Rumor: Going gluten-free can help your psoriasis.

True, for some people.

In patients with celiac disease, gluten triggers an immune response that can lead to inflammation. Given gluten's potential to provoke the immune system, some doctors have begun recommending gluten-free diets for their psoriasis patients in recent years.

"I have seen a few people do really well with gluten-free diets," said Dr. Jerry Bagel, a New Jersey-based dermatologist.

The downside: Avoiding gluten entirely is difficult — and psoriasis patients must do so for 24 weeks to discover any benefit. Even with total compliance, the percentage of people whose symptoms improve seems to be much smaller than Bagel initially hoped.

"I'm not as hyped up about it as I used to be," he said. "If someone really has bad psoriasis, the (chance) of it working is probably 5 percent. Maybe."


The Rumor: Vitamin D supplements reduce psoriasis plaques.

True, if used correctly.

"There's no good evidence that oral (vitamin D) supplements help patients with psoriasis," said Dr. Richard Gallo, chief of dermatology at the University of California, San Diego. Oral supplements provide vitamin D in its inactive state, which requires activation by the body's enzymes, while topical creams issue a high concentration of the active form of the vitamin onto the skin.

"The biological responses are very different," Gallo said. Topically, the vitamin does thin psoriasis plaques for many people, he said.

"I'd say it's common for it to help patients somewhat," Gallo said. "It's a nice extra tool to help things improve a little bit."


The Rumor: High-salt diets can worsen psoriasis and psoriatic arthritis

Perhaps.

Studies published earlier this year suggest that high salt intake may stimulate production in the immune system of the same type of helper T cells that have been linked to psoriasis and other autoimmune diseases. But it's still too early to say what the findings might mean for people suffering from such diseases, said Dr. John O'Shea, scientific director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

The results, based on experiments conducted in rodents with induced autoimmunity, must be replicated before researchers will know how significant they could be for human patients, O'Shea said.

"This is provocative and interesting," he said. "We need to see whether this is really applicable to people."


The Rumor: Drinking coffee will make your psoriasis worse.

False.

Go ahead, enjoy that cup of joe. Findings released last year by a team of researchers, including Qureshi, showed no connection between drinking significant amounts of coffee and risk for developing psoriasis.

"We didn't find any association at all," Qureshi said.

Though the study didn't specifically examine whether coffee has the potential to exacerbate existing cases of psoriasis, Qureshi said it's reasonable to surmise that the findings may also hold true for patients already diagnosed with the disease.


The Rumor: Drinking alcohol makes things worse, too.

True.

Another vice doesn't fare as well under scientific scrutiny: alcohol.

"Alcohol clearly makes psoriasis worse," Bagel said. By opening blood vessels in the skin, he explains, alcohol allows the T cells blamed for psoriasis to reach the skin more easily.

Qureshi also advises his patients to cut back or eliminate alcohol intake, based in part on his 2010 study that found an increased risk of developing psoriasis among people who drank non light beer.

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