• A new study examined the relationship between psoriasis symptoms, alcohol misuse, and obesity in 266 people with psoriasis.
• Results showed that biologics and systemic therapies yielded fewer symptom improvements in participants who misused alcohol or were obese.
• Past research has found alcohol can trigger psoriasis symptoms and that people living with psoriasis are more likely to drink heavily.

Certain psoriasis treatments may be less effective for people who drink too much alcohol, according to a study published in June in the British Journal of Dermatology. Researchers also found that obesity may lead to a decrease in the effectiveness of treatments.

“Alcohol abuse and obesity were both associated with poorer responses to treatment in patients with moderate to severe psoriasis receiving systemic therapies … and the newer biologic treatments,” said Dr. Ireny Iskandar, lead author of the study.

The Centers for Disease Control and Prevention (CDC) recommend that men consume no more than two alcoholic drinks per day and that women drink no more than one — but people living with psoriasis are advised to be especially careful. Alcohol is thought to be a psoriasis trigger, according to past research. It may increase inflammation, reduce the immune system’s ability to kill infections, and increase the proliferation of skin cells, leading to more skin lesions. Previous studies also have found that people living with psoriasis may be more likely to drink heavily.

For the recent study, researchers recruited 266 people with psoriasis from dermatology centers across England. About half (132 participants) took traditional systemic therapies such as cyclosporine, Soriatane (acitretin), and methotrexate. The other half (134 participants) took biologics like Humira (adalimumab), Stelara (ustekinumab), and Enbrel (etanercept).

The authors measured the severity of participants’ psoriasis symptoms with a scoring system called the Psoriasis Area and Severity Index (PASI). They also used a questionnaire called Cut down, Annoyed, Guilty, Eye opener (CAGE) to determine whether participants had a problem with misusing alcohol.

Overall, most of the participants experienced an improvement in psoriasis symptoms once they started taking biologics. However, traditional systemic therapies were less effective at helping treat the disease. One of the reasons for this may be that participants were less likely to take these medications consistently.

Among key findings, researchers determined that psoriasis treatments are less likely to work in people who misuse alcohol. They also found that obesity led to decreased treatment effectiveness.

People living with psoriasis who drink frequently or who struggle with controlling alcohol use should speak with their health care provider. “Providing advice on lifestyle behaviour change and screening for alcohol misuse should form an important component of treatment of psoriasis,” said Dr. Iskandar.

Various programs, support groups, and resources are available to help people reduce their alcohol intake.