Psoriasis and Alcohol: What Actually Happens in the Body

Psoriasis is more than just a skin condition—it’s a complex, chronic autoimmune disorder that affects how the body responds to inflammation. While genetics and immune system dysfunction play a major role, lifestyle factors such as diet, stress, and alcohol consumption can significantly influence the severity and frequency of flare-ups. Among these, alcohol is often a misunderstood but powerful trigger. Let’s dive into what actually happens in the body when someone with psoriasis drinks alcohol.

Understanding Psoriasis

Before exploring the effects of alcohol, it’s important to understand what psoriasis is. Psoriasis occurs when the immune system sends faulty signals that accelerate the growth cycle of skin cells. Normally, skin cells take about a month to regenerate, but in psoriasis, this process happens in just a few days. The result? Thick, scaly patches, inflammation, redness, and discomfort.

Psoriasis is also systemic—it doesn’t just affect the skin. It can contribute to chronic inflammation throughout the body, increasing the risk of conditions such as:

-Psoriatic arthritis

-Cardiovascular disease

-Type 2 diabetes

-Obesity

Because it is inflammatory in nature, anything that worsens inflammation—like alcohol—can exacerbate symptoms.

Alcohol and the Immune System

Alcohol impacts the immune system in multiple ways. When you drink:

1. Immune Dysregulation
   Alcohol alters the production and function of immune cells. In psoriasis, immune cells such as T-cells are already overactive. Alcohol can amplify this overactivity, leading to increased skin inflammation.

2. Cytokine Production
   Cytokines are proteins that signal inflammation in the body. Alcohol increases the levels of pro-inflammatory cytokines like TNF-alpha and IL-6, which are already elevated in people with psoriasis. This can trigger or worsen flare-ups.

3. Barrier Function Impairment
   Alcohol dehydrates the skin and weakens its barrier function. A compromised skin barrier makes it easier for irritants to penetrate, which can worsen psoriasis plaques and itching.

The Liver Connection

The liver is crucial for metabolising alcohol and regulating inflammation. Excessive drinking can strain the liver, causing conditions like fatty liver disease. In people with psoriasis:

-Impaired Detoxification: The liver’s ability to process inflammatory molecules decreases, leading to higher systemic inflammation.

-Medication Interactions: Many psoriasis treatments—like methotrexate—are metabolised by the liver. Drinking alcohol while on these medications can increase the risk of liver damage.

Essentially, alcohol not only worsens inflammation but can also complicate treatment.

Alcohol and Psoriasis Flare-Ups

Clinical studies have shown a clear link between alcohol consumption and psoriasis severity:

-Increased Risk of Flare-Ups: People who drink heavily are more likely to experience frequent and severe psoriasis episodes.

-Delayed Treatment Response: Alcohol may reduce the effectiveness of psoriasis medications, especially biologics and systemic drugs.

-Behavioural Triggers: Alcohol often impairs judgment, which can lead to poor diet, disrupted sleep, and stress—all factors that can trigger psoriasis.

Interestingly, research also suggests a dose-response relationship: the more someone drinks, the worse the psoriasis tends to be. Even moderate consumption may have subtle effects, particularly in those with sensitive immune responses.

Other Considerations: Types of Alcohol

Not all alcoholic beverages affect psoriasis equally:

-Beer: High in purines, which can increase uric acid and exacerbate gout in people with psoriatic arthritis.

-Spirits: May be less problematic than beer or wine in small amounts but can still impair liver function and immune response.

-Wine: Some compounds in wine (like tannins) can trigger inflammation in sensitive individuals.

Personal triggers vary, so keeping a detailed log of alcohol intake and flare-ups can help identify patterns.

Practical Tips for People with Psoriasis

If you have psoriasis and enjoy drinking, there are steps you can take to reduce risk:

1. Limit Alcohol Intake: Stick to moderation or abstinence, especially during flare-ups.

2. Stay Hydrated: Alcohol dehydrates the skin, so drink plenty of water.

3. Track Flare-Ups: Keep a journal linking alcohol, diet, stress, and symptoms to spot triggers.

4. Consult Your Dermatologist: Ask about safe alcohol limits, especially if you’re on systemic medications.

5. Focus on Anti-Inflammatory Habits: Exercise, diet rich in omega-3s, and stress management can offset some inflammatory effects.

Final Thoughts

Psoriasis is already a complex condition, and alcohol can act as a significant amplifier of its effects. From immune dysregulation to liver stress and skin barrier impairment, drinking alcohol creates a cascade of biological changes that can worsen flare-ups and complicate treatment. While occasional drinking might be tolerated by some, understanding the mechanisms behind alcohol’s impact can empower people with psoriasis to make informed choices about their lifestyle and health.