Evidence is mounting that the answer is “YES”!

In the recent past, we knew little about psoriasis, other than it was a potentially debilitating skin-problem. We never understood why some people had severe and life-altering psoriasis, yet other people had mild psoriasis that they could hide and that rarely got worse.

In the early part of my 30+ year career in dermatology, the best lifestyle advice we could offer psoriasis patients was to moisturize their skin. The rest was up to luck and prescription medicines such as cortisone creams, or oral medicines that had huge side-effects like methotrexate or retinoids.

Now, we know that psoriasis is an inflammatory disease, and lifestyle can intercede to either help or hurt the skin problem. We also know that psoriasis is often genetic, and that some genetically-predisposed people have worse cases of psoriasis, and others don’t. Like other inflammatory diseases (such as heart disease, metabolic syndrome, rheumatoid arthritis, and inflammatory bowel disease), diet and lifestyle are hugely important.

The exciting news is that psoriasis patients can take some measure of control of their skin with lifestyle choices, such as diet.

In a new scientific study, the severity of psoriasis was directly correlated with diet; people on an anti-inflammatory Mediterranean diet had less severe psoriasis compared with people on a more traditional, Western diet.

A true anti-inflammatory Mediterranean diet is a daily diet that emphasizes:

  • Mostly fruits and veggies;
  • Followed by:
    • beans;
    • whole grains;
    • fish;
    • nuts; and
    • extra-virgin olive oil.

Meat, dairy, eggs, sugar, and alcohol are eaten rarely and sparingly as treats, not diet staples. Of course, the modern Western diet is exactly the opposite.

Study authors go on to say:

“One possible explanation for the Mediterranean diet’s ability to reduce chronic, systemic inflammation relates to the anti-inflammatory properties of dietary fibers, antioxidants, and polyphenols – all significantly present in the Mediterranean diet.”

A Mediterranean diet has been proven to help other, chronic inflammatory diseases such as heart disease, rheumatoid arthritis and Crohn’s disease.

Evidence is mounting – we are what we eat, even in dermatology, which long-held that diet and skin diseases were unrelated!

I’ve bucked that doctrine for years because of the observations I’ve made of my patients. Diet and lifestyle mattered. Psoriasis severity was, and is, associated with obesity, heart disease, metabolic syndrome, smoking, and alcohol consumption. My psoriasis patients have always gotten lifestyle and diet counseling from me throughout my career. Now, scientific evidence is proving the connection.

When my psoriasis patients made lifestyle changes, their skin improved.

In addition to following a true Mediterranean diet – my recommendations for this are outlined in my FREE Ebook here – other, anti-inflammatory lifestyle choices to incorporate include:

  • Exercise (ideally, 150 minutes of cardiovascular exercise per week in divided sessions);
  • Sleeping enough (the average adult needs a sleep routine of around 7-8 hours a night, but this varies);
  • Modulate stress and avoid living on the adrenalin or depressive edge. For each of us, what this means is a unique and personal issue. The point is, ask yourself if you are overly stressed, and if so, what do you need to do to reduce and balance that?

What might make the Mediterranean Diet so effective for fighting psoriasis and other inflammatory health problems?

Some of this is speculative, based on mounting evidence. Others, are proven:

Dietary Fiber:

It is important for more than just preventing constipation! Your digestive health, and the population of the specific microorganisms living in your intestines (your intestinal microbiome), depend on fiber from your diet. The health promoting microbes need real, plant-based fiber.

You need a healthy microbiome population to keep your gut healthy. Your gut is the biggest lymphoid organ in your body and holds the most immune cells. The health of your gut depends on fiber, and a healthy gut is important to the health of your entire body, including your skin.

Study authors emphasized this point in their speculation about the connection between psoriasis and an anti-inflammatory, Mediterranean diet. They say that the gut immune system is, “directly influenced by the environment in general and food in particular.” I know that bypassing real dietary fiber with the use of fiber supplements is not the same.

You can’t fool Mother Nature. Nope. You need to eat your beans, greens, veggies, fruit, and whole grains because your intestinal microbiome and your gut immune system need them.

Omega 3 fatty acids, polyunsaturated fatty acids and vitamins like A, D, E, and folates are anti-inflammatory:

Again, you can’t game the system with supplements. A Mediterranean Diet provides these nutrients in ample amounts and in digestible and absorbable forms.

Plus, the monounsaturated fatty acid (MUFA) found in extra-virgin olive oil, “may act as an adjunctive mechanism to decreasing inflammation in patients with psoriasis,” according to study authors.

Anti-oxidants, and specifically polyphenols, are rich in the Mediterranean Diet and proven over and over to reduce physiologic inflammation.

Get my Healthy Diet Guide, that includes recipes and explanation for how to start eating an anti-inflammatory Mediterranean diet, by clicking here

Over the years, along with diet and lifestyle counseling, the other, self-care recommendations I’ve given my psoriasis patients include skin-care advice.

To see the skin care advice I give my psoriasis patients, and the products we use in my practice, click here.

Top products include:


Céline Phan, MD; Mathilde Touvier, MD, PhD; Emmanuelle Kesse-Guyot, MD, PhD;Moufidath Adjibade, MD, PhD; Serge Hercberg, MD, PhD,; Pierre Wolkenstein, MD, PhD,; Olivier Chosidow, MD, PhD; Khaled Ezzedine, MD, PhD; Emilie Sbidian, MD, PhD, et. al., Association Between Mediterranean Anti-inflammatory Dietary Profile and Severity of Psoriasis, Results From the NutriNet-Santé Cohort, JAMA Dermatol. 2018;154(9):1017-1024. doi:10.1001/jamadermatol.2018.2127 https://jamanetwork.com/journals/jamadermatology/article-abstract/2687981

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