Healing From the Inside Out: An Integrative and Functional Nutrition Approach to Psoriasis 

August 21st, 2025

Psoriasis, an immune-mediated skin disease, impacts around 3% of US adults (1). And although the prevalence is low in children, more kids are being diagnosed with psoriasis each year (2).

Although conventional medications can be an excellent way to control symptoms, they don’t often address the underlying causes of psoriasis. An integrative and functional nutrition approach can offer hope for healing from the inside out. For those living with psoriasis, the journey goes far beyond dry, itchy skin. Flare-ups can bring intense discomfort, emotional distress, and a deep sense of embarrassment that affects daily life and mental well-being.

What is Psoriasis?

Psoriasis is a chronic, inflammatory skin disease with autoimmune features. Although it manifests on the skin and nails, psoriasis has a body-wide impact increasing the risk of cardiometabolic and mental health diseases, psoriatic arthritis, inflammatory bowel disease, sleep disorders, and eye and thyroid dysfunction (3, 4).

Psoriasis is generally divided into two main classifications: mild and moderate-to-severe (3). Most cases are the result of psoriasis vulgaris (plaque psoriasis), which causes red, itchy plaques covered in silvery scales usually on the trunk, limbs, and scalp (3).

Other psoriasis types include (3):

  • Inverse
  • Guttate
  • Pustular
  • Erythrodermic
  • Palmoplantar

 

What Causes Psoriasis?

Chronic inflammation from abnormally activated dendritic cells triggers uncontrolled and dysfunctional keratinocyte (skin cell) growth in people with psoriasis (3,4). There isn’t one root cause of plaque psoriasis, rather multiple immune system triggers upregulate the release of pro-inflammatory cytokines such as TNF-α, INF-γ, IL-17, IL-22, and IL-23 (3, 4).

As with other immune-mediated disorders, psoriasis has a genetic component. More than 80 psoriasis susceptibility genes have been discovered, but having a gene variant doesn’t guarantee psoriasis development (5).  Other known psoriasis triggers include (3,4):

  • Gut dysbiosis and increased intestinal permeability
  • Infections, including Streptococcus pyogenes and Malassezia (a yeast)
  • Diet
  • Alcohol
  • Stress
  • Smoking
  • Medications
  • Skin injury
                       (click on image for better view)

Psoriasis pathogenesis (3)

Understanding the Psoriasis Gut-Skin Connection

Research is elucidating the connection between gut health and the rest of the body, and the skin is no exception. Increased intestinal permeability, gut dysbiosis, and gut-derived inflammation have all been linked to skin barrier dysfunction in psoriasis and other skin conditions (6).

Gut dysbiosis and increased intestinal permeability can activate the IL-17/IL-23 inflammatory pathway, driving keratinocyte overgrowth in psoriasis (6). Additionally, increased intestinal permeability is associated with higher psoriasis disease activity, greater levels of systemic inflammation, and more gut symptoms (24). And further evidence of a compromised gut barrier and systemic inflammation in psoriasis are elevated fecal calprotectin (a gut inflammation marker) levels, increased blood lipopolysaccharides, and even bacterial DNA from gut microbes in the bloodstream (24).

 

Conventional Versus Integrative Psoriasis Treatment

Topical vitamin D, medicated creams, and light therapy are commonly prescribed for mild psoriasis, and these treatments can have tremendous benefits (7). However, those with moderate-to-severe disease tend to need much stronger pharmaceuticals that target the immune system (7).

In addition to creams and immune-modulating medications, people with psoriasis are educated to (7):

  • Lose weight, if needed
  • Keep their skin moisturized appropriately
  • Stop smoking
  • Avoid alcohol
  • Get healthy sun exposure
  • Avoid psoriasis triggers
  • Seek mental health counseling, if needed

Conventional pharmaceuticals can be necessary and life-changing. However, psoriasis creams and medications don’t cure psoriasis, they don’t address root causes, and some of them can come with serious side effects (4).

An integrative and functional approach to psoriasis employs the signature IFN Academy STAINTM methodology to identify and address the root causes of psoriasis (i.e. Stress, Toxins, Adverse food reactions, Infections, and Nutritional imbalances) in a specific individual. This approach often allows for the reduction, and even elimination, of conventional medications, while at the same time decreasing the likelihood of psoriasis comorbidities and medication side effects, and improving overall health and quality of life.

Creating an Integrative Psoriasis Care Plan

IFNCP functional nutritionists compile root cause data, information gathered from the HANDS ONTM assessment, and known systems imbalances to create a comprehensive plan for healing.

What is the Best Psoriasis Meal Plan?

Food and alcohol are major drivers of inflammation, gut microbiome imbalances, and increased intestinal permeability (8,9). Research has shown that ultra-processed and otherwise pro-inflammatory foods and alcohol can trigger and worsen psoriasis (4).

Limited data (mostly observational studies, cases reports, and case series) exists on diet therapy for psoriasis (4,15).  In a 2017 survey, psoriasis sufferers reported the greatest improvements in their skin when they reduced alcohol, gluten, and nightshades, and increased omega-3 fatty acids and vegetables (25). In this survey, the Pagano diet, a vegan diet, and a paleo diet had the most patients reporting a favorable skin response (25). Research also suggests that Mediterranean, gluten-free, plant-forward, and ketogenic diets are beneficial for people with psoriasis (4,15).

Although there isn’t one specific psoriasis diet, overall goals to consider when developing a therapeutic psoriasis meal plan include (4):

  1. Controlling inflammation
  2. Balancing blood sugar
  3. Addressing adverse food reactions
  4. Promoting gut microbiome balance

An alcohol- and gluten-free Mediterranean diet may be an effective initial option (10,11). This anti-inflammatory dietary pattern may help reduce the number and severity of psoriasis flares, support blood sugar control, and improve the gut microbiome profile (10,11).

Foods to Highlight Foods to Limit or Avoid
·        Fruits and vegetables

·        Olive oil

·        Omega-3 fatty acids

·        Herbs and spices

·        Green tea

·        Fiber-rich foods

 ·        Ultra-processed foods

·        Added sugar(s)

·        Artificial Sweeteners

·        Refined carbohydrates

·        Potentially inflammatory fats (excess omega-6 oils)

·        Alcohol

If adverse food reactions are suspected, a tailored elimination diet may be warranted.

Psoriasis Lifestyle Interventions

In addition to the conventional recommendations listed above, consider integrating the following lifestyle therapies for people with psoriasis:

  1. Stress management: The stress response seems to be altered in people with psoriasis, which can upregulate the release of mast cells and proinflammatory cytokines triggering or worsening psoriasis flares (18). Unmanaged stress can also contribute to gut dysbiosis and increased intestinal permeability (19). Stress management techniques such as relaxation, biofeedback, cognitive behavioral therapy, and hypnosis have been found to improve psoriasis (20).
  2. Sleep optimization: Poor sleep is common for people with psoriasis often related to painful, itchy psoriasis lesions (21). Sleep issues can also contribute to psoriasis comorbidities. Educating clients on enhancing sleep quality and quantity can improve psoriasis outcomes.
  3. Exercise: Moderate intensity exercise may help improve psoriasis severity, and is also protective against psoriasis comorbidities (22). It may be wise to caution against extreme exercise without appropriate rest and recovery, which can alter the gut environment and contribute to leaky gut (23).

Foundational Psoriasis Supplements*

In addition to a personalized meal plan, nutritional supplements must be tailored to the individual. Foundational dietary supplements to consider for those with psoriasis include:

  • Vitamin D3: People with psoriasis tend to have lower levels of vitamin D possibly due to the disrupted epidermal layer (12). One study found vitamin D supplementation improved psoriasis severity scores (13).
  • Multi-strain probiotics: People with psoriasis tend to have gut dysbiosis (6). Multi-strain probiotics can reduce gut inflammation and leaky gut, promote a healthy immune system response, increase gut microbial diversity, and fight gut pathogens. Probiotics have been found to improve psoriasis severity scores (14).
  • Omega-3 Fatty Acids: People with psoriasis who have a higher omega-6 to omega-3 fatty acid ratio have more severe psoriasis symptoms (15). Omega-3 fatty acids can reduce inflammatory cytokines and supplementing with fish oil has been found to improve psoriasis symptoms (16,17).

*These supplements should be tailored to the individual and ideally guided by lab assessment and practitioner oversight.

Psoriasis Labs and Care Team/Possible Referrals

Psoriasis Laboratory Assessment Care Team and Possible Referrals
  • Omega-3 index
  • High-sensitivity CRP and other inflammation markers
  • Comprehensive stool analysis
  • Liver function panel
  • Blood glucose and fasting insulin levels
  • Organic acids panel
  • Micronutrient panel
  • GGT
  • Nutrigenetic testing
  • Urine heavy metals

 

 ·       Integrative and Functional Nutrition Certified Practitioner (IFNCP)

·       Integrative dermatologist

·       Integrative rheumatologist

·       Herbalist

·       Acupuncturist

·       Mental health counselor

·       Support groups

Reverse Psoriasis Symptoms with An Integrative Approach

Psoriasis is more than skin-deep; it’s a reflection of underlying imbalances that need to be addressed before true healing can occur. Although immune-modulating medications can be necessary in severe cases, they don’t address the root causes of psoriasis such as stress, toxins, adverse food reactions, infections, and nutritional imbalances.

If you’re a practitioner ready to expand your toolkit of someone living with psoriasis seeking root cause support, functional nutrition offers a path forward.

IFNCP Functional Nutritionists create personalized plans that combine anti-inflammatory nutrition, targeted supplementation, gut-healing strategies, detoxification support, and mind-body practices to support whole-body health and foster long-term skin resilience.

Sign up for IFN Academy training today to learn more about using food and lifestyle to help your clients thrive!

By: Kellie Blake, RDN, LD, IFNCP

Co-Author of The Holistic Psoriasis Management & Nutrition Guide

 

References

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  2. Tollefson MM, Crowson CS, McEvoy MT, Maradit Kremers H. Incidence of psoriasis in children: a population-based study. J Am Acad Dermatol. 2010;62(6):979-987. doi:10.1016/j.jaad.2009.07.029
  3. Rendon A, Schäkel K. Psoriasis Pathogenesis and Treatment. Int J Mol Sci. 2019;20(6):1475. Published 2019 Mar 23. doi:10.3390/ijms20061475
  4. Robinson, M., Greenberg, J., Turegano, M., & Blake, K. The Holistic Psoriasis Management & Nutrition Guide.
  5. Delin Ran, Minglong Cai, Xuejun Zhang, Genetics of psoriasis: a basis for precision medicine, Precision Clinical Medicine, Volume 2, Issue 2, June 2019, Pages 120–130, https://doi.org/10.1093/pcmedi/pbz011
  6. Fritts, Haily & Frasier, Kelly & Herrick, Grace & Li, Vivian & Sebastiao, Elizabeth & Johnson, Aria & Saunooke, Jordan. (2024). The Gut-Skin Axis: Unraveling the Interplay between Gut Microbiota and Dermatological Health. International Journal of Immunology and Microbiology. 1. 1-7. 10.70977/IJIM/2024(1)101.
  7. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Psoriasis Diagnosis, Treatment, and Steps to Take. https://www.niams.nih.gov/health-topics/psoriasis Accessed August 1, 2025
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  10. Guasch-Ferré, M, Willett, WC. The Mediterranean diet and health: a comprehensive overview. J Intern Med2021; 290: 549– 566.
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  14. Zeng L, Yu G, Wu Y, Hao W, Chen H. The Effectiveness and Safety of Probiotic Supplements for Psoriasis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Preclinical Trials. J Immunol Res. 2021;2021:7552546. Published 2021 Dec 13. doi:10.1155/2021/7552546
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