Effects and some information about cigarets and alcohol

How cigarettes and alcohol affect psoriasis

Quitting smoking and cutting down alcohol consumption can improve your psoriatic .

Most people believe they know all about the dangers of smoking and drinking. But there is growing evidence that people with psoriasis ought to think especially hard before lighting up or downing more than a few.

Smoking and alcohol use increase your risk of developing psoriasis and may make the disease significantly worse. Heavy drinking may also prevent your treatment from working or your disease from going into remission.

This is a particular problem since many people use alcohol or smoking to cope with the tough emotions—such as stress or anxiety—that psoriasis can cause.

Cigarette smoking—What's the risk?

One study led by Luigi Naldi, M.D, published in 1999, found a much higher risk of psoriasis in smokers. Dr. Naldi's group compared people with psoriasis to people with other skin conditions; as many as one in five cases of psoriasis were related to smoking.

According to Dr. Naldi, "We know that smoking affects the onset of psoriasis and its clinical appearance. Smoking about doubles a person's risk of getting psoriasis; the risk increases with the number of cigarettes smoked per day, and is higher in women than men. The risk for women who smoke more than 20 cigarettes per day is about 2.5 times greater than the rate of nonsmokers, and in men the risk is about 1.7 times greater than the rate of nonsmokers."

Studies have also found a very strong association between smoking and a type of pustular psoriasis called palmoplantar pustulosis.

How does it affect the body?

Studies of how smoking might affect psoriasis on a biological level are complicated by the thousands of ingredients in cigarette smoke. Dr. Naldi points to nicotine as a possible culprit in altering the immune system and possibly skin cell growth, as well as directly affecting skin inflammation.

Smoking and alcohol may also be associated with the same psychosocial factors that may drive psoriasis, such as stress, worry and poor coping skills.

How does lifestyle affect risk?

A 2000 study examined the effects of various lifestyle practices on psoriasis. The researchers first found that alcohol use and smoking have negative effects on psoriasis (as did emotional stress, obesity and lack of exercise).

Then the researchers split the study participants into two groups, based on whether they had ever had remissions or a time when the disease had disappeared completely.

The results were dramatic: 78 percent of people who had experienced remissions were nonsmokers, and only 22 percent were smokers. But of those who never experienced a remission, 66 percent were smokers, and only 34 percent were nonsmokers.

Alcohol

Alcohol appears to affect psoriasis in men more strongly than in women. One study found that heavy drinking actually lowered treatment response in men. Other studies have shown that men with psoriasis drink more than men without, that there is a significantly higher incidence of psoriasis in alcoholics, and that abstinence can improve the severity of the disease.

Dr. Naldi confirms that "data concerning alcohol consumption are less clear-cut. It seems that only young men who are heavy drinkers are at a higher risk for psoriasis, but other studies have shown that drinking alcohol has a negative effect on clinical response to treatment and on the likelihood of remission."

In addition, it should be noted that alcohol can have dangerous side effects when combined with certain psoriasis medications, such as methotrexate or acitretin (brand name Soriatane) in women of child-bearing potential.

What about psoriatic arthritis?

There is very little data available about the effects of alcohol or smoking on psoriatic arthritis. One small study published in 1996 looked at the effects of smoking on ankylosing spondylitis (AS), which is a type of arthritis of the spine and nec