Best Probiotic For Psoriasis, According to a Gastroenterologist

Last updated on July 27, 2023

Psoriasis is an autoimmune condition characterized by the rapid multiplication of skin cells, leading to thick, dry skin patches covered with silvery scales that are known as plaques. 3% of US adults over the age of 20 are thought to have Psoriasis according to NIH.

Probiotics are live microorganisms that, when consumed in adequate amounts, confer health benefits by promoting a balanced gut microbiota and supporting overall digestive and immune system health. 8-weeks of probiotic supplementation can significantly improve psoriasis according to US Pharmacist.

What Is Psoriasis?

Psoriasis is a chronic skin disease characterized by itchy, scaly patches, commonly found on the knees, elbows, chest, abdomen, genitals, back and scalp. It is an autoimmune condition caused by the immune system's abnormal response, leading to an overproduction of skin cells. Psoriasis is a long-lasting condition with no cure, and it can cause discomfort and inflammation.

Psoriasis affects around 125 million people worldwide according to Pfizer and is associated with what looks like patches of abnormal, red, pink, or purple skin covered with dry, scaly plaques. Psoriatic arthritis is a potential complication of psoriasis, affecting around 10% to 20% of patients according to a 2022 study authored by V Tiwari.

The 5 types of psoriasis according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases are Plaque Psoriasis, Guttate Psoriasis, Pustular Psoriasis, Inverse Psoriasis and Erythrodermic Psoriasis.

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Plaque Psoriasis: This type of psoriasis is an autoimmune condition defined by thick patches (plaques) on the skin, often accompanied by what looks like gray or silver scales. It is the most common form of psoriasis and may appear differently depending on skin color. Plaque psoriasis is a chronic, long-lasting condition with no cure, but treatments can help alleviate related symptoms such as itchiness and pain. The plaques typically appear on the elbows, knees, and lower back, often presenting as well-defined, erythematous patches with silvery scales.
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Guttate Psoriasis: This type of psoriasis is a skin disease that manifests as small, red scaly patches that look like teardrops. It is a distinct variant of psoriasis that often appears suddenly and is commonly triggered by an infection, such as strep throat. Guttate psoriasis is more prevalent in young adults but can also occur in adults. While there is no cure, various treatments are available to manage the symptoms. It can affect various parts of the body, including arms, legs, and torso.
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Pustular Psoriasis: This type of psoriasis defined by reddish, scaly patches of skin with pus-filled blisters or pustules. These pustules can be painful and sore if they break open. It is an immune-mediated skin disorder and can be life-threatening when widespread. Treatment options are available to manage the symptoms, but there is no cure for pustular psoriasis. It is a rare and severe form of psoriasis that can affect various parts of the body, including the palms of the hands and soles of the feet.
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Inverse Psoriasis: This type of psoriasis define by the rapid reproduction of skin cells in areas where the skin rubs against itself, such as skin folds. These areas can include the armpits, belly button, and below the breasts. Inverse psoriasis may appear as lesions of purple-ish, brown, or darker than the surrounding skin on skin of color, while on Caucasian skin, it appears as bright red lesions in body folds. The condition can be painful and difficult, especially in body areas like the armpits, genitals, and under the breasts. It does not have any odor.
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Erythrodermic Psoriasis: This type of psoriasis is a rare and severe skin condition defined by a widespread red rash covering most of the body. This rash resembles a burn and can be as dangerous as one, leading to symptoms such as chills, fever, and dehydration. Erythrodermic psoriasis is considered a medical emergency and requires immediate medical attention. It disrupts the body's normal temperature and fluid balance.

6 Best Probiotics For Psoriasis

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The 6 best probiotic strains for Psoriasis are Bifidobacterium infantis 35624, Lactobacillus, Lactobacillus paracasei CNCM I-2116 (ST11), Lactobacillus rhamnosus, Lactiplantibacillus plantarum L-137 and Saccharomyces cerevisiae according to research.

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Bifidobacterium infantis 35624: A 2013 study authored by D Groeger, found this strain has the ability to reduce systemic pro-inflammatory biomarkers in psoriasis patients. The study involved oral administration of B. infantis 35624 for 6-8 weeks in patients with psoriasis, and it resulted in reduced plasma levels of C-reactive protein and pro-inflammatory cytokines, including tumor necrosis factor α and interleukin-6. This strain has immunomodulatory effects beyond the gut, and it could potentially contribute to alleviating the inflammatory processes associated with psoriasis.
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Lactobacillus: A 2012 study authored by M Vijayashankar, found that this probiotic for psoriasis was successful in the treatment of pustular psoriasis. A patient, who had been suffering from psoriasis for 15 years and did not respond to conventional treatments, showed significant improvement after being put on probiotic supplementation. The pustular lesions reduced, fever subsided, and blood sugar levels dropped. The probiotics were well-tolerated, and the patient remained lesion-free during the six months of follow-up.
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Lactobacillus paracasei CNCM I-2116 (ST11) : A 2010 study authored by A Gueniche found that this strain inhibits substance P-induced skin inflammation and accelerates skin barrier function recovery. This indicates that it can help reduce inflammation and improve the skin's ability to repair and maintain its protective barrier, potentially providing relief and management for psoriasis symptoms. It also displayed immune-modulatory properties at the skin level, reducing vasodilation, edema, mast cell degranulation, and TNF-alpha release induced by substance P. This is highly relevant and beneficial for psoriasis as it suggests it can help regulate the immune response in the skin, potentially alleviating inflammation and symptoms associated with psoriasis.
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Lactobacillus rhamnosus: A 2023 study authored by IO Gilli found that this strain used as an adjuvant therapy resulted in a significant improvement in the clinical presentation of psoriasis. Patients who used the probiotic showed reduced Psoriasis Area Severity Index, Body Surface Area, and Dermatology Life Quality Index scores, indicating an improvement in disease severity and quality of life.
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Lactiplantibacillus plantarum L-137: A 2022 study authored by R Yoshitake, found that daily intake of this heat-killed strain can improve dry skin. Participants who consumed HK L-137 showed greater increases in skin water content at the forearm and larger decreases in transepidermal water loss at the face. The probiotic's ability to increase skin water content and reduce transepidermal water loss may help alleviate the dryness and improve the overall skin barrier function in individuals with psoriasis. This improvement in skin hydration and barrier function could contribute to better skin health and potentially alleviate some of the discomfort and symptoms associated with psoriasis
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Saccharomyces cerevisiae: A 2017 study authored by H Eppinga, found that psoriasis patients showed a decreased abundance of the baker's yeast Saccharomyces cerevisiae in their gut compared to healthy controls. When treated with dimethylfumarate, the levels of S. cerevisiae were restored, indicating an interaction between DMF and the yeast. Dimethylfumarate is a compound used in medicine for its immunomodulatory properties and is being investigated as a potential treatment for certain inflammatory conditions.

Can Probiotics Make Psoriasis Worse?

There is no evidence that shows probiotics can make psoriasis worse. Research shared previously, indicates a positive potential for probiotics in psoriasis treatment and not for worsening the symptoms of psoriasis. Probiotics have been shown to reduce inflammation and alleviate psoriasis symptoms but they cannot cure Psoriasis.

Is Psoriasis Curable?

There is no cure for psoriasis according to the National Psoriasis Foundation. Psoriasis is a chronic condition, and while treatments can help manage symptoms and induce remission, the disease cannot be permanently cured. Various treatments, including topical, oral, and systemic approaches, are available to improve the condition and provide relief, but psoriasis is considered a lifelong condition.

There is ongoing research and advancements in treatments, but as of now, a complete cure has not been found. Curable refers to a condition or disease that can be successfully treated and completely resolved, leading to a restoration of health and the absence of any symptoms or signs of the illness.

Is Psoriasis Linked To Gut Health?

Yes, there is a significant link between psoriasis and gut health according to research. The gut microbiota of psoriasis patients differs from that of healthy individuals, showing alterations in the abundance of specific bacterial groups according to a 2022 study authored by L Chen.

A different 2022 review authored by MC Buhaș, suggests that the gut microbiota plays a significant role in the pathogenesis of psoriasis, a chronic inflammatory skin disease with autoimmune characteristics. Maintaining a balanced gut microbiota through dietary interventions may help prevent disease aggravation in psoriatic patients.

Gut health refers to the overall well-being and balance of the gastrointestinal system, including the proper functioning of the digestive tract and a diverse and stable microbiome, which is essential for maintaining optimal digestion and overall health.

Is Psoriatic Arthritis Linked To Psoriasis?

Yes, psoriatic arthritis is a type of arthritis that is linked with psoriasis according to Johns Hopkins Medicine. Psoriatic arthritis shares similarities with rheumatoid arthritis in symptoms and joint inflammation, but it tends to affect fewer joints than rheumatoid arthritis. Not everyone with psoriasis get psoriatic arthritis.

Both psoriasis and psoriatic arthritis are immune-mediated conditions caused by inflammation. Psoriatic arthritis is a chronic inflammatory disease that affects the joints and connective tissues in individuals with psoriasis, a skin condition characterized by red, scaly rashes.

Is Psoriasis Bacterial Or Fungal?

Psoriasis is an autoimmune condition, not caused by bacteria or fungi. It is distinct from ringworm, which is a fungal infection. While infections, including bacterial, viral, and fungal, have been associated with psoriasis, the condition itself is considered an autoimmune disorder.

Certain types of bacteria in the microbiome, such as streptococcus, and skin microbiota, including Corynebacterium, Propionibacterium, and staphylococcus, have been associated with the development of psoriasis according to a 2018 study authored by F Benhadou.

Does Stress Make Psoriasis Worse?

Yes, stress can worsen psoriasis symptoms, leading to a cycle of increased stress and more prolonged and severe psoriasis plaques according to a 2021 study authored by S HÖLSKEN.

Stress is a physiological and psychological response to external challenges, and its role on the microbiome can lead to dysregulation and alterations in the gut microbial composition, potentially influencing various aspects of health and disease.

Does Leaky Gut Cause Psoriasis?

Yes, intestinal permeability also known as leaky gut, may play a role in the development of psoriasis according to research. A 2018 study authored by PH Ely, suggested that successful treatment of psoriasis may involve addressing Leaky gut.

Leaky gut, also known as increased intestinal permeability, is a condition in which the lining of the intestines becomes more porous, allowing substances like toxins, bacteria, and undigested food particles to leak into the bloodstream, potentially triggering inflammation and various health issues.

How To Take Probiotics For Psoriasis?

Taking probiotics for psoriasis is a long-term approach as they address the root cause of the condition. The time it takes for probiotics to show improvement in psoriasis symptoms can vary from person to person but as mentioned previously, it can take around 8-weeks or 2 months. You should take probiotics for psoriasis first thing in the morning before any meals to allow the probiotics to reach your colon.

Dr Sara Mesilhy

Dr. Sara Mesilhy has a Master’s degree in Gastroenterology and holds a membership with the Royal College of Physicians of the United Kingdom. She completed her Bachelor of Medicine, Bachelor of Surgery (MBBS) at Cairo University and is currently part of the ProbioticReviewGirl medical team.

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