Experiencing both itchy, scaly skin from psoriasis and digestive problems from celiac disease may not be just a coincidence — these conditions have a research-backed connection. Psoriasis, a chronic inflammatory skin disease, is linked with a higher risk of other autoimmune disorders, including celiac disease. Celiac disease is characterized by an allergy to gluten, a protein found in wheat, barley, and rye, and can damage the small intestine.

On MyPsoriasisTeam, members have discussed having both psoriasis and celiac disease. They’ve also shared how a gluten-free diet has helped their psoriasis symptoms. One member said, “I went gluten-free because of celiac disease, and my scalp psoriasis disappeared for over a year now.”

Although there’s an association between the two conditions, not everyone with psoriasis will develop celiac disease — and not everyone with celiac disease will develop psoriasis. However, if you have both conditions, there are effective ways to manage each of them.

Psoriasis and Celiac Disease: What the Research Says

A 2019 systematic review of 18 studies confirmed an association between psoriasis and celiac disease. The results showed that people with psoriasis had twice as many cases of celiac disease as people without psoriasis. Another review of studies, which together included more than 37,000 participants, found that three times as many people with psoriasis had celiac disease compared to people without psoriasis.

Celiac disease is thought to be a complication of psoriasis. This means that having psoriasis increases your risk of developing celiac disease.

What’s Driving the Link?

The connection between celiac disease and psoriasis isn’t well understood. Researchers have a few hypotheses (proposed explanations) about why the conditions may be linked.

One hypothesis is that the two disorders share genes. Researchers have found shared genes between celiac disease and type 1 diabetes. Could celiac disease and psoriasis also have genes in common?

A second hypothesis suggests that the body’s immune response in psoriasis predisposes people to the gastrointestinal inflammation that’s characteristic of celiac disease.

The last hypothesis is that psoriasis is actually a complication of celiac disease. Celiac disease is commonly misdiagnosed, and people can experience delays in getting a proper diagnosis. Could the intestinal dysfunction from celiac disease increase the risk of autoimmune conditions like psoriasis? In some cases, celiac disease occurs before psoriasis. As one member recently shared, “Diagnosed with celiac disease in 2013. Diagnosed with psoriasis two weeks ago.”

When Celiac Disease Resembles Psoriasis

Several symptoms of celiac disease are similar to symptoms of psoriasis or psoriatic arthritis, a type of arthritis that affects some people with psoriasis. About 10 percent to 15 percent of people with celiac disease will develop an itchy, bumpy rash called dermatitis herpetiformis, which is caused by ingesting gluten and isn’t related to psoriasis.

Joint pain, swelling, and stiffness are the main symptoms of psoriatic arthritis. Joint pain is also a lesser-known symptom of celiac disease — it’s caused by inflammation from the immune system’s response to gluten. People with celiac disease are at greater risk of developing inflammatory arthritis than the general population.

Shared Causes and Risk Factors

Both psoriasis and celiac disease are related to the immune system and share some causes and risk factors. One risk factor is a genetic predisposition, or an increased chance of getting the condition if someone in your family has it.

Psoriasis Risk Factors

If you have a history of celiac disease or gluten intolerance, you may wonder, “Can gluten cause psoriasis?” The exact cause of psoriasis is unknown, but researchers believe that genetic and environmental factors contribute to its development. However, some people develop the condition even if they have no known family history of psoriasis.

Factors that affect how the immune system works may trigger psoriasis symptoms. Triggers vary from person to person but may include:

• Stress
• Illnesses, such as ear infections and strep throat
• Skin injuries, such as sunburns, bugbites, and scratches
• Tobacco use
• Weather, with symptoms worsening in winter but improving in warmer seasons
• Allergies, alcohol, and other environmental factors

Celiac Disease Risk Factors

In people with celiac disease, ingesting gluten causes an immune system response that damages the small intestine and affects its ability to absorb nutrients. This damage can lead to complications such as anemia (low red blood cells), osteoporosis (bone weakening), migraines or epilepsy, and infertility.

Celiac disease is diagnosed with blood tests that look for genetic markers and antibodies that show an immune response to gluten. A diagnosis is usually confirmed by a small bowel biopsy, an examination of tissue in the small intestine.

Like psoriasis, celiac disease doesn’t have a clear cause. The condition is hereditary (passed through families), but not all people with a genetic predisposition develop celiac disease. According to Mayo Clinic, factors such as infant-feeding practices, gut bacteria, and gastrointestinal infections may contribute to the development of celiac disease. In some cases, celiac disease doesn’t become active until after an event such as:

• Surgery
• Viral infection
• Severe emotional stress
• Pregnancy
• Childbirth

Risk factors for celiac disease include having a family member with celiac disease or having type 1 diabetes, an autoimmune thyroid disease, or Down syndrome.

Living With Psoriasis and Celiac Disease

Living with both psoriasis and celiac disease may be more challenging than having just one of these chronic conditions. You may need to seek health care from two types of medical specialists — a dermatologist and a gastroenterologist — and try different treatments for each condition.

The good news is that both psoriasis and celiac disease are treatable and manageable conditions. While having psoriasis may raise your chances of having celiac disease, having psoriasis doesn’t appear to worsen symptoms of celiac disease.

Managing Psoriasis and Celiac Disease

Psoriasis and celiac disease treatments target the symptoms of each condition.

Psoriasis has several treatment options, depending on the condition’s severity and how well it responds to therapy. Treatments include corticosteroid creams, vitamin D supplements, other topical creams, and injected medications such as biologics. Because they don’t contain gluten, psoriasis treatments don’t increase the risk of celiac disease.

Celiac disease is treated with a gluten-free diet. Some people with psoriasis find that a gluten-free diet also improves their psoriasis symptoms. The reason isn’t fully understood, so there’s no clear answer to questions like “Can gluten cause psoriasis symptoms?” You may need to experiment on your own to determine if gluten is a trigger for you.

The National Psoriasis Foundation recommends that adults with psoriasis who test positive for gluten intolerance or gluten sensitivity experiment with a gluten-free diet. Doing so can help you see whether your symptoms improve and decide if it’s worth making this lifestyle change.

Some MyPsoriasisTeam members have found a gluten-free diet helpful in managing their symptoms. “If I accidentally eat some gluten, my skin turns red and blotchy and breaks out again,” wrote one member, “but when I don’t eat gluten, my skin starts healing like crazy.”

“I’ve noticed that keeping my diet gluten-free has reduced the frequency of plaques randomly appearing,” another member said.

It’s important to focus on what you can control when treating and managing these conditions. Lifestyle factors like quitting smoking tobacco and reducing stress may be helpful for managing both psoriasis and celiac disease.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. On MyPsoriasisTeam, more than 125,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

Do you have psoriasis and celiac disease? If so, how significant is the role of a gluten-free diet for you? Share your experience in the comments below, or start a conversation by posting on your Activities page.