Psoriasis, Gut Health, and Inclusive Care: A Functional Medicine Approach

Psoriasis is more than just a skin issue; it is a chronic autoimmune condition affecting millions worldwide, often causing uncomfortable red patches covered in silvery scales. It notably affects many people of colour, who may face additional challenges due to limited access to healthcare and cultural stigma.

While conventional treatments often target surface symptoms, functional medicine offers a broader perspective, emphasizing the crucial role of gut health in managing psoriasis. Exploring the gut-skin connection reveals actionable strategies that can lead to enduring relief.

Understanding Psoriasis

Psoriasis is not solely a skin-deep condition. It involves an immune system that mistakenly attacks healthy skin cells, triggered by a combination of genetic and environmental factors. Research suggests that individuals with a family history of psoriasis have up to a 40% risk of developing the condition if one parent is affected.¹

Among people of colour, the challenges can be more pronounced. Differences in how psoriasis appears on various skin tones, cultural expectations, and systemic healthcare disparities can contribute to misdiagnosis or delayed treatment. Providing culturally competent education and support can empower individuals to better manage their condition.

The Role of Gut Health in Psoriasis

Emerging research underscores a strong connection between gut health and inflammatory skin disorders like psoriasis.²The gut microbiome, consisting of trillions of microorganisms, plays a critical role in regulating immune responses and systemic inflammation.

An imbalance—sometimes leading to increased intestinal permeability (commonly referred to as "leaky gut")—can allow toxins and antigens to enter the bloodstream, potentially triggering autoimmune reactions, including psoriasis flares.

Functional medicine addresses this through targeted diet, lifestyle changes, and supplementation, all aimed at restoring microbiome health and reducing systemic inflammation.

Dietary Approaches to Support Gut and Skin Health

A nutrient-dense, anti-inflammatory diet is foundational to improving gut health and managing psoriasis symptoms. Key strategies include:

Focus on Anti-Inflammatory Foods

• Leafy Greens: Spinach, kale, and Swiss chard are rich in vitamins and antioxidants that reduce inflammatory pathways.

• Fatty Fish: Salmon, mackerel, and sardines provide omega-3 fatty acids, which studies suggest can lower psoriasis severity by up to 30%.³

• Colourful Fruits and Vegetables: Berries, sweet potatoes, and bell peppers are rich in antioxidants that help combat oxidative stress.

  

Embrace Probiotics and Fermented Foods

• Yogurt (with live cultures)

• Kefir, a probiotic-rich fermented milk drink

• Sauerkraut and Kimchi, fermented vegetables that support gut microbial diversity

Probiotics can help rebalance the gut microbiota, promoting reduced systemic inflammation.

Minimize Processed Foods and Sugar

High intake of processed foods and refined sugars is linked to worsening autoimmune activity. Replacing them with whole grains, legumes, and natural fiber sources supports a healthier gut environment.

Managing Stress for Better Gut and Skin Health

Chronic stress can worsen both gut dysbiosis and psoriasis. Incorporating stress-reduction techniques is vital:

• Mindfulness and Meditation: Regular practice improves gut health by modulating the gut-brain axis and lowering systemic inflammation.

• Physical Activity: Exercise not only enhances cardiovascular health but also reduces inflammation. Research indicates regular activity can decrease inflammatory markers by about 10%.

  
  

Cultural Competence in Treatment

Understanding cultural background profoundly shapes how individuals experience psoriasis. Historical mistrust of medical systems, cultural stigmas, and unequal access to care can all hinder effective treatment.

Functional medicine’s patient-centered model aligns naturally with culturally sensitive care. Incorporating familiar foods, respecting cultural dietary practices, and acknowledging lived experiences can significantly enhance adherence and outcomes.

Supplements to Support Gut and Immune Health

In addition to diet, certain supplements may support both gut and skin health:

• Zinc: Crucial for immune regulation and skin repair; deficiencies are common in psoriasis.

• Vitamin D: Low levels are frequently observed in psoriasis patients; supplementation can help regulate immune responses.

• Omega-3 Fatty Acids: High-quality fish oil supplements further enhance anti-inflammatory benefits.

Always consult with a healthcare provider for personalized dosing.

Functional Medicine Testing and Diagnosis

A functional medicine approach investigates root causes rather than just treating symptoms.Testing may explore:

• Gut microbiome composition

• Food sensitivities

• Inflammatory markers

• Vitamin and mineral status

  
  

Such personalized assessments guide targeted interventions, ensuring care is both scientifically grounded and culturally respectful.

Lifestyle Foundations for Healing

Lifestyle choices play a critical role in managing psoriasis:

• Adequate Sleep: Aim for 7–9 hours nightly to optimize immune function and reduce inflammation.

• Hydration: Proper water intake supports digestion and skin elasticity.

• Sunlight Exposure: Moderate sun exposure helps boost natural Vitamin D production, essential for skin health—just as plants thrive with sunlight, so too do human bodies in balance.

  
  

The Path Forward

Understanding the gut-skin connection reframes psoriasis as a systemic condition with actionable solutions. A functional medicine approach empowers individuals to address underlying drivers—through diet, lifestyle and emotional health.

For people of colour and others often overlooked by conventional models, integrating culturally sensitive strategies ensures a more holistic and effective path to healing.

As our understanding of the gut-brain-skin axis deepens, so too does our ability to offer innovative, inclusive, and empowering care for all individuals seeking to reclaim their health and quality of life.

Dr. Reuben Simmons

References:

1. Bowcock, A. M., & Krueger, J. G. (2005). Getting under the skin: the immunogenetics of psoriasis. Nature Reviews Immunology, 5(9), 699–711.

2. Salem, I., Ramser, A., Isham, N., & Ghannoum, M. A. (2018). The gut microbiome as a major regulator of the gut-skin axis. Frontiers in Microbiology, 9, 1459.

3. Upala, S., Yong, W. C., & Sanguankeo, A. (2017). Effect of omega-3 fatty acids on disease severity in patients with psoriasis: A systematic review. International Journal of Rheumatic Diseases, 20(4), 442-450.