Psoriasis
Root-Cause Care for Psoriasis
Psoriasis is an internal immune condition that shows up on the skin, which is why the most lasting changes start inside the body.
The Basics
What psoriasis actually is
Psoriasis is a whole-body inflammatory condition. The immune system sends signals that tell skin cells to grow far faster than normal, and because they can't shed quickly enough, they pile up into thick, red, scaly patches called plaques.
Most people have plaque psoriasis, which often shows up on the scalp, elbows, knees, and nails. Guttate psoriasis appears as small, drop-shaped spots, often after strep throat. Inverse psoriasis affects skin folds, and other forms affect the palms and soles or cause small, sterile pustules. Psoriasis also shows up in places people don't expect, including the hairline, around the ears, the belly button, and the genital area.
Why psoriasis keeps coming back
If you have psoriasis, you have probably tried topical steroids, vitamin D creams, tar products, or light therapy. For more widespread psoriasis, biologic injections and oral medications that block specific immune signals can be very effective, and for some people they are the right choice. What they don't treat is why your immune system keeps sending those signals in the first place, which is why psoriasis so often returns when treatment stops. These medications also carry risks of their own, including a higher chance of infection.
What I Look For
What is often driving it
Psoriasis rarely has a single cause. These are the patterns I look for most often, some on the skin and some deeper inside the body.
On the Skin
Skin cells on fast-forward
In psoriasis, inflammatory signals push skin cells to multiply and move to the surface in days instead of weeks. Slowing down those signals is the goal, and much of what drives them starts elsewhere in the body.
Yeast on the skin
Malassezia, a yeast that normally lives on the skin, is often found in higher amounts on psoriasis plaques as part of a broader change in the skin's microbiome (Gupta, 2022). It can feed the same inflammatory pathway that drives psoriasis, which is why antifungal scalp and body washes can help.
From the Inside
Hidden strep
Strep throat can trigger guttate psoriasis and make plaque psoriasis worse. Strep can also hide in the tonsils inside a protective film called a biofilm, even when you have no sore throat and your blood tests look normal, which may explain some relapses.
Gut imbalance and leaky gut
People with psoriasis often have fewer beneficial gut bacteria and more of the bacteria and yeast, like Candida, that drive inflammation (Salem, 2018). When the gut lining becomes more permeable, bacterial toxins can slip into circulation and keep the immune system activated.
Food triggers
Gluten can increase gut permeability, and some people with psoriasis improve significantly when they remove it, especially if testing shows a gluten sensitivity (Ford, 2018). Alcohol also loosens the gut barrier, and nightshades and the emulsifiers in many processed foods can irritate the gut lining.
Vitamin D, sunlight, and toxins
Low vitamin D is common in psoriasis, and natural sunlight often helps more than supplements alone. Frequent exposure to environmental toxins can also add to the inflammatory load.
Sources:
Ford AR, Siegel M, Bagel J, et al. Dietary Recommendations for Adults With Psoriasis or Psoriatic Arthritis From the Medical Board of the National Psoriasis Foundation: A Systematic Review. JAMA Dermatol. 2018;154(8):934-950. PubMed 29926091
Salem I, Ramser A, Isham N, Ghannoum MA. The Gut Microbiome as a Major Regulator of the Gut-Skin Axis. Front Microbiol. 2018;9:1459. PubMed 30042740
Gupta M, Weinberg JM, Yamauchi PS, et al. Psoriasis: Embarking a dynamic shift in the skin microbiota. J Cosmet Dermatol. 2022;21(4):1402-1406. PubMed 34089221
C: Cut inflammatory foods. Removing gluten, alcohol, nightshades, and processed foods with emulsifiers, and adding more vegetables and omega-3 rich foods.
L: Lower toxic burden. Reducing everyday toxin exposures, choosing gentle skin products, and using soothing therapies like Dead Sea salt baths.
E: Eliminate gut pathogens. Testing for and treating gut overgrowths, looking for hidden strep, and using antifungal washes for yeast on the skin, at a pace that doesn't trigger a flare.
A: Absorb key nutrients. Checking and supporting vitamin D, adding omega-3s, and using targeted botanicals that help calm the immune pathways involved in psoriasis.
R: Rebuild and Restore. Repairing the gut lining, supporting digestion so bacterial toxins are cleared rather than absorbed, and calming a stress response that keeps the immune system on alert.
What to expect
Psoriasis can feel like a game of whack-a-mole, and it can suddenly flare all over. Sometimes the cause is a strep infection, sometimes treatment moved too fast, and sometimes there is no clear reason at all. That is why we go step by step, watch how your skin responds, and adjust as we learn what your body needs.
Ready to find out what is driving your psoriasis?
A free consultation is the best way to see whether this approach is the right fit for you.