The Gut-Skin Axis: Exploring the Gut’s Role in Psoriasis

It is quite likely that a healthcare professional would’ve told you that most of our health problems start in the gut. So also is the case with our skin issues.

Science has established that there is a direct link between the gut and the skin. Both the gut and the skin contain microbial communities that interact with the immune system. The communication pathway through which this interaction takes place is referred to as the ‘gut-skin-axis’.

80% of our immune system lies in the gut. The gut microbiome support numerous processes throughout the body. Our skin is the first indicator of gut health. If our skin is healthy and vibrant, it implies that our gut is functioning optimally. If there is something wrong in our gut, we are likely to develop skin conditions.

One such skin condition that is a direct result of gut dysfunction, is Psoriasis. This skin condition affects millions in the country, including youngsters and adults. Conventional medicine has traditionally treated this disease superficially. However, it has now been scientifically established that one of the primary root causes of Psoriasis lies in gastrointestinal inflammation and dysbiosis of the microbiome that is linked to immune system activation.

An integrative and functional approach that involves dietary and lifestyle changes can address the root cause of Psoriasis and most other chronic skin conditions.

At Wellfinity, we use this approach for the root cause treatment of the inflammation, and to support gut health, cure infections and restore hormonal and other balances. Gradually, the skin problem also disappears.

In this blog, we delve deeper into understanding Psoriasis, the gut-skin connection, dysbiosis, and a holistic approach to treatment of Psoriasis.

Understanding Psoriasis: More Than Just Skin Deep

Psoriasis is an autoimmune skin condition that results in skin scaling and inflammation. It occurs when the immune system becomes overactive and speeds up the production of skin cells.

It manifests as patches of thick, inflamed red skin covered with silvery scales called ‘plaques.’ These patches are usually itchy or sore, and are commonly found on the elbows, legs, scalp, lower back, face, palms, and soles of the feet. However, they can also be found on other parts of the body.

Psoriasis symptoms may also show on the fingernails, toenails, soft tissues of the genitals, and the inside of the mouth. Often, the skin around affected joints may crack. In some cases, Psoriasis can lead to joint inflammation and cause arthritis-like symptoms, known as ‘psoriatic arthritis.’

Overall, Psoriasis symptoms results in a distressing and uncomfortable experience.

There are five types of Psoriasis:

• Plaque Psoriasis: This is the most common variety of Psoriasis and is found in 80% of all Psoriasis cases. It causes scaly red plaques, typically on scalp, face, knees, and elbows.
• Inverse Psoriasis: This type of Psoriasis affects 25% of Psoriasis patients and is typified by Psoriasis symptoms such as scaly red skin in the skin folds such as the underarms and genitals.
• Guttate Psoriasis: Typified by small, round, red spots, this is found in 8% of all Psoriasis cases.
• Pustular Psoriasis: This is a rare variety of Psoriasis found in just 3% of cases and is recognized by Psoriasis symptoms like white pustules on inflamed skin.
• Erythrodermic Psoriasis: This is the rarest and severest among the various types of Psoriasis and causes intense redness, itching, and shedding of large skin sheets.

Studies have also established that approximately 25% of people who have one autoimmune condition are likely to develop other autoimmune conditions. This means, if you have a pre-existing autoimmune condition, you are more likely to have another autoimmune condition like Psoriasis.

The Gut-Skin Axis: A Brief Overview

There is a direct link between gut health and skin conditions such as Psoriasis. In fact, a recent report indicates that small intestine bacterial overgrowth (SIBO), is 10 times more likely to be found in people who have Eczema or Psoriasis. The correction of SIBO in such cases has improved the skin condition as well.

The skin is our body’s first line of defense. It protects us from physical, chemical and antimicrobial invasions. But when we experience stress and gut inflammation, the protective epidermal barrier gets compromised. This effectively reduces the antimicrobial peptides produced in the skin and makes skin infections and inflammation more severe.

The gut and skin possess diverse microbiomes that collaborate to sustain overall well-being. An imbalance in these microbiomes is known as dysbiosis. Some of the factors affecting microbiome include diet, hygiene, stress, sleep, dehydration, heavy metal toxicity, and epigenetics, which alter immune response. When these factors alter the microbiome, they trigger an imbalance. Dysbiosis coupled with food sensitivities results in various chronic skin conditions.

Interestingly, the gut-skin axis operates bi-directionally. For instance, the gut plays a crucial role in metabolizing and absorbing crucial micronutrients that improve skin health. But certain diets can also cause leaky gut that potentially leads to skin disorders. On the other hand, skin exposure to UVB improves Vitamin D levels, which in turn enhances gut microbiome.

The Microbiome: Our Gut’s Diverse Ecosystem

The gut microbiome consists of trillions of microorganisms in the gastrointestinal tract. These are usually a mix of bacteria, viruses, protozoa, and fungi. Some of these microbes are beneficial, while others can be harmful for the body. When the microbiome consists of more good microbes, the gut functions optimally and the body is in good health. However, if the bad microbes outnumber the good microbes, there is said to be an imbalance. This imbalance can lead to health issues.

The gut microbiome supports digestion, absorbs vital vitamins and amino acids, and boosts the immune system. Short-chain fatty acids (SCFAs) produced in the large intestine from the digestion of high-fiber foods, serve as nutrients and aid physiological processes. Each person’s gut microbiota is unique and is influenced by genetics, environment, and diet. It plays a crucial role in defending against harmful organisms. Therefore, gut microbiome importance cannot be undermined if we want to comprehensively understand human health.

The skin is the largest organ of the body. A diverse range of microorganisms such as bacteria, fungi, viruses and mites live on our skin and form the skin microbiome.

The skin microbiome starts forming at birth and is influenced by various factors throughout life. It plays a crucial role in maintaining skin balance, protecting against harmful invaders, and regulating immune responses. Imbalances in this microbiome can contribute to various chronic skin conditions.

Dysbiosis: When the Gut Loses Balance

The first thing we ought to be clear about is – what is dysbiosis?

In layman’s terms, dysbiosis is simply imbalances in the gut microbiome. It can manifest in the following scenarios:

• The diversity in the type of microbes inhabiting the gut is reduced
• The number of good microbes in the gut is reduced
• There is far too much growth of bad bacteria
• The gut becomes leaky causing toxins to enter, leading to inflammation
• The immune system becomes overactive and speeds up production of skin cells

There can be a number of signs and symptoms of gut dysbiosis and inflammation, varying from person to person. Since the microbiome and gut lining have a direct or indirect impact on every system in the body, these signs and symptoms can be found in various parts of the body.

Some of the obvious symptoms of gut dysbiosis are bloating, belching, constipation, acid reflux, diarrhea, bad breath, abdominal pain, and the presence of mucous in stool. Apart from these, mental health and brain-related issues may manifest as anxiety, difficulty in focusing or concentrating, depression, chronic fatigue or sense of mental fog.

On the skin, the symptoms of dysbiosis appear as acne, eczema, dark circles under the eyes, psoriasis, dandruff, autoimmunity and inflammation.

There is a direct relation between diet and gut health. A diet rich in fiber has a crucial role to play in correcting dysbiosis. When our gut breaks down fibers, it produces short chain fatty acids (SCFAs). These SCFAs enhance the number of good bacteria on the skin. The more the number of good bacteria, the stronger will be our skin’s immune defense system.

Probiotics and prebiotics can also help in improving the gut flora, which affects the skin. Studies have shown how deterioration in gut bacteria have caused skin conditions such as acne and Seborrheic Dermatitis.

Research Insights: The Gut and Psoriasis

Now that we know that there is a direct link between gastrointestinal (GI) disorder and the skin, let’s elaborate on how gut disorders lead to Psoriasis.

Psoriasis can start off as a result of leaky gut that allows bacteria and other substances to pass into the bloodstream. Through our blood, these bacteria and substances reach our skin and cause problems with our skin’s balance. In fact, researchers have found DNA from gut microbes in the blood of Psoriasis patients.

When a person develops Psoriasis, his skin swells and becomes thicker in the affected area due to uncontrolled growth of skin cells. This swelling or thickening is due to the impact of special cells called ‘T-cells’ that not only transform, but also outnumber the other cells.

Many things can make Psoriasis symptoms worse. Infections, the food we eat, stress, poor sleep, things that irritate our skin (like chemicals and sunlight), and unhealthy habits (like smoking and drinking), dehydration, exposure to toxins, are some such factors.

Our gut microbiome also has a role to play in how our immune system reacts to various types of Psoriasis. Studies have shown that a certain type of bacteria (Firmicutes) is present more prominently in the gut of Psoriasis patients. Too much of these bacteria affects how the body uses carbohydrates and makes certain fatty acids. This causes continual swelling, hurts the gut lining and messes up the immune system.

There is also a strong link between Psoriasis and gut inflammation. About 7-11% of people with inflammatory bowel disease (IBD) also have Psoriasis.

Functional Medicine: A Holistic Approach to Psoriasis

The problem with the current conventional medicine approach is that it addresses diseases individually, without digging into the root cause. The treatment protocol therefore, is topical and involves the application of creams, harmful steroids, antibiotics and other short-term solutions. This protocol may be successful in providing temporary relief, but recurrence is quite likely as the root cause treatment has not been done.

The functional medicine approach is a holistic, integrated, scientific approach that focuses on the root causes of diseases such as Psoriasis, rather than treating the symptoms. The treatment goes beyond focusing on the skin and involves a specific diet for psoriasis and addressing the imbalances in the gut, cleansing the infections, reducing inflammation and toxins, and other areas. The skin condition gradually shows improvement and is eventually cured sustainably.

In recent times, the principles of functional medicine have altered our perception of how to approach medical problems. It has enabled us to unravel the origins of illness and pinpoint the disruptions in biology that manifest as symptoms. The excellent success ratio of this approach in permanently curing chronic skin conditions such as Psoriasis and other chronic illnesses has made it a popular choice today.

Much of our success at Wellfinity has also been due to the application of this approach. We have managed to help patients completely and sustainable get rid of their skin problems and other chronic conditions.

Dietary and Lifestyle Interventions for Psoriasis

Our diet has a massive impact on our general health. It also plays an important role in improving autoimmune conditions such as Psoriasis. A good diet for Psoriasis would include anti-inflammatory foods and foods high in healthy fiber and proteins can help manage flare-ups.

Inflammatory foods such as refined carbohydrates, sugar, dairy, gluten, white rice, night shades veggies, sweet fruits, processed foods and artificial ingredients can potentially worsen psoriasis. On the other hand, anti-inflammatory foods that contain healthy fats + proteins, such as extra virgin olive oil, A2 ghee, fish, leafy green, nuts, avocados, and fresh green organic vegetables and fruits can help to reduce the Psoriasis symptoms.

Along with a proper diet for Psoriasis, increased physical activity is a must for reduction the severity of Psoriasis. Regular exercise acts as a natural anti-inflammatory agent akin to anti-inflammatory foods and can be especially beneficial for patients dealing with both Psoriasis and obesity.

Psoriasis patients are typically sensitive to various fragrances present in skincare products, perfumes, cleaning agents, room sprays and laundry detergents. These artificial fragrances not only irritate the skin but may also accumulate as toxins in the liver and bloodstream.

Environmental toxins such as alcohol, smoke, fumes, heavy metals, plastic and dust can also cause flare-ups. Therefore, such toxins should be avoided.

The intestines influence skin health significantly. Intestinal permeability, yeast overgrowth and irregular gut flora can be causative factors for Psoriasis. Therefore, it is important to restore gut health. Consulting a specialist in functional medicine for Psoriasis, is advisable.

Numerous studies have also indicated that Psoriasis can also be triggered or worsened because of Stress. Therefore, Psoriasis patients are also advised to practice stress management techniques like yoga, deep breathing, biofeedback and massage.

Adequate sleep is vital for facilitating cellular repair and detoxification, which improve skin health. However, the discomfort caused by Psoriasis hinders good sleep. Thus, good quality sleep becomes a challenge.

Supplements such as fish oil, vitamin Bs, D, toxic cleaners, prebiotics and infection control protocols can be beneficial in managing Psoriasis. But one must consult a qualified healthcare professional or better a functional medicine doctor before using supplements.

Wellfinity’s Approach: Personalized Care for Psoriasis Patients

At Wellfinity, the treatment of Psoriasis begins with testing and analyzing the various factors that are causing the imbalance, infection, or inflammation. This includes microbiome analysis, heavy metal testing, inflammatory markers, and vitamin and mineral levels.

Once these factors have been thoroughly assessed, we start the process of restoring the body’s balance. This process follows a simple rationale of eliminating things that may be causing the problem, and adding those vital factors that may be missing.

Let’s take for an example, a patient success story.

Aditi is a 5 year old who came to us with Psoriasis. She had started to develop small boils that gradually turned into purple patches. There were white lines around the patches and black circles inside, which gave them a scaly appearance. These patches kept growing in size and number to an extent that Aditi had to cover her arms in legs for fear of social rejection. She visited numerous skin specialists, homeopaths, and ayurvedic doctors who prescribed harsh topical creams which were not of much help. Eventually, she found her way to Wellfinity.

We conducted a set of tests for inflammation, infections, toxicity, dehydration, nutritional deficiencies and insufficiencies, liver functioning and other imbalances. After understanding the issues specific to Aditi, we recommended a holistic protocol personalized to her requirement. The treatment started with reducing her inflammation and treating her infection and toxicity.

We brought about certain changes to her food and nutrition and brought her closer to the elements of nature. Gradually, the patches started to peel off and there was an overall improvement in Aditi’s health. She was generally in a better mood, was less irritable, and cried less. Her ear infection healed and she showed faster healing when bruised. Soon, we removed some of the food restrictions as well.

Today, Aditi is showing much more confidence as she plays with her friends in sun wearing shorts and tees like any other 5 year old.

Conventional medicine treats Psoriasis and all other chronic skin conditions symptomatically. The treatment most often involves application of topical creams in the affected area. However, Psoriasis like many other chronic skin conditions, has its root in our gut. A clear understanding of the gut and skin relationship and the causes of dysbiosis is of utmost importance if we are to restore the body’s balance, and cure Psoriasis sustainably.

A holistic, integrative and functional medicine approach understands this gut-skin connection and almost always begins the treatment of chronic ailments by correcting the gut.

At Wellfinity, we have been practicing this tried and tested approach, and have had success with hundreds of patients on whom conventional medicine has given up.

It wouldn’t be an overstatement to say that functional medicine is the hope for the hopeless.