Should I Try to Boost My Immune System Because I Have Psoriasis?

The Relationship Between Psoriasis and Your Immune System

Psoriasis is thought to be an inflammatory skin disease, because, with it, your immune system goes into overdrive, mistaking bodily processes for foreign invaders. Then, the body has an inflammatory response, overproducing skin cells that contribute to psoriasis plaques, pustules, and other symptoms, depending on the type of psoriasis.

This overactivity may affect the immune system’s ability to function properly. As a result, something that would normally trigger immune-system activity, like a respiratory infection, can also bring on a psoriasis flare.

Meanwhile, the overactive immune system that is triggering inflammation in the skin is occurring in other parts of the body, as well, which may increase risk of comorbidities like heart disease, diabetes, and high blood pressure, known collectively as cardiometabolic syndrome.

Even still, “There's not really a need to boost your immune system, because the immune system is already pretty active,” says Frank Wang, M.D., a professor of clinical dermatology and the assistant program director of the Dermatology Residency Program at Michigan Medicine in Ann Arbor.

How Psoriasis Treatment Impacts Your Immune System

While psoriasis can be treated with options like topical medications and phototherapy, for the up to 20 percent of those who have moderate to severe psoriasis, they’ll likely need systemic therapy to help control their disease. These drugs, including oral medications like methotrexate or injectable medications like biologics, work by suppressing this overactive immune-system activity.

“This is a scary part for patients. They say, ‘I don’t want to take a biologic because that suppresses my immune system,’” says Neil Korman, M.D., Ph.D., clinical director of the Murdough Family Center for Psoriasis at University Hospitals in Cleveland, Ohio.

But Korman says this shouldn’t be a huge concern. In fact, he shares an analogy with his patients to reassure them. “I show people, ‘Here's the ceiling, and here's the floor.’ You want your immune system to be halfway between the ceiling and the floor,” he says. “But if you have really bad psoriasis, your immune system is on the ceiling. By giving you a biologic, we’re ‘suppressing your immune system,’ but, in reality, we’re just taking your immune system halfway—normalizing or regulating your overactive immune system.”

That said, a common side effect listed by many systemic medications is an increased risk of infection, like upper-respiratory tract infections, such as the common cold, which may present with symptoms like fever or cough. According to Korman, though, this risk is very low. He recommends continuing to see your dermatologist regularly to monitor your condition and to report any changes you are experiencing. “Generally speaking, the majority of my patients who take these drugs do great and don’t have any issues,” he says.

How to Stay Healthy with Psoriasis

While you don’t have to go out of your way to boost your immune system, there are steps you can take to promote an overall healthy lifestyle. These will help you stay in your overall best health and may even help you manage your symptoms.

The best strategies to help you stay healthy when you have psoriasis are those anyone should be using for optimal health, explains Wang. They include:

• Eating a healthy, balanced diet
• Exercising regularly
• Maintaining a healthy weight
• Prioritizing quality sleep
• Reducing alcohol intake
• Quitting smoking
• Wearing a mask in crowded places
• Washing your hands regularly
• Avoiding those with active symptoms of infection (such as a cough, runny nose, or fever)
• Staying on top of your psoriasis treatment
• Getting screened for other health issues regularly, like diabetes and high blood pressure

“There’s nothing more specific for psoriasis patients—there’s no magic bullet,” explains Korman. “All of these things that may seem like a broken record are actually really true. Taking care of yourself makes quite a difference.”

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