Psoriasis Flare-Ups and Alcohol

Alcohol can trigger or worsen psoriasis symptoms. Alcohol can also weaken the impact of treatments.

This article describes the link between psoriasis and alcohol and how drinking can worsen symptoms while also causing new problems for people to manage.

Alcohol, Inflammation, and Psoriasis

Psoriasis is a chronic inflammatory disease that occurs when your immune system attacks healthy cells in your body. That alcohol may work to trigger the immune dysfunction that results in inflammation is a common hypothesis.

Alcohol can induce persistent systemic inflammation. This may also increase the production of inflammatory triggers that cause the overgrowth of skin cells in psoriasis. An increase in inflammation can trigger psoriasis flare-ups and prevent psoriasis from going into remission.

The pain and appearance the inflammation in psoriasis causes can physically and emotionally impact people. It is not unusual for people to turn to alcohol to handle the stress of this disease.

However, short-term relief from alcohol can result in long-term consequences, including more severe symptoms and weakened treatments.

As a result, alcohol may work as both a trigger and consequence of the inflammation in psoriasis.

Is There a 'Safe' Amount?

Everyone reacts to alcohol differently. Factors such as gender, age, weight, body mass, medications, diet, and medical conditions can change the impact of even one drink. Any amount of alcohol can have an unpredictable effect on your body and the efficacy of the medications you take.

If you're not ready or willing to give up alcohol, ask your healthcare provider how much alcohol you can safely consume without serious outcomes for your condition and treatments. Find out what to expect from interactions between alcohol and any medications you take regularly.

As a guide, consider that the American Academy of Dermatology (AAD) reports that men who consume more than two drinks per day and women who have more than one drink daily may experience alcohol's negative effects, such as reduced efficacy of treatments.

Psoriasis and Types of Alcohol

There is little evidence about psoriasis and whether certain types of alcohol are better or worse for people with this condition. Most studies examine only alcohol consumption in general.

The AAD advises that women limit their alcohol consumption to one drink daily and that men reduce their consumption to two drinks per day to avoid complicating the treatment of psoriasis symptoms and disease management.

In the United States, one "standard" drink (or one alcoholic drink equivalent) contains about 0.6 fluid ounces or 14 grams of pure alcohol. The percentage of pure alcohol is expressed as alcohol by volume (ABV) and varies across beverage types. ABV is expressed by the number of milliliters of ethanol per 100 milliliters (or 3.4 ounces).

Compare the ABV found in the following drinks:

• 12 ounces of regular beer (about 5% ABV)
• 8–10 ounces of malt liquor or flavored malt beverages like hard seltzer (about 7% ABV)
• 5 ounces of wine (about 12% ABV)
• 1.5 ounces of distilled spirits like gin, rum, vodka, or whiskey (about 40% ABV)
• 1.5 ounces of brandy or cognac (about 40% ABV)
• 2–3 ounces of cordial, liqueur, or aperitif (about 24% ABV)
• 3–4 ounces of fortified wine like sherry or port (about 17% ABV)
  

Alcohol Alternatives

You likely consume alcohol for more than one reason, such as socializing or relaxing. If you reduce or stop your alcohol consumption, you may find that you want to replace alcohol with different types of alternatives to help you adjust to your new lifestyle.

Alcohol alternatives for drinking and socializing:

• Kombucha, a fermented tea beverage
• Non-alcoholic wine
• Non-alcoholic beer
• Mocktails (non-alcoholic cocktails)
• Half soda/half cranberry juice
• Berries in ice water
• Soda and fresh fruit

Alcohol alternatives for relaxing and relieving stress:

• Exercise
• Meditation
• Walking or hiking
• Reading a book
• Riding a bicycle
• Practicing mindfulness
• Starting a new hobby

Risks of Drinking Alcohol on Psoriasis Medication

Psoriasis medication is advisable when symptoms home remedies or topical ointments don't relieve symptoms. These medications can include both prescription and over-the-counter drugs.

Drinking alcohol while taking one or more of these drugs can increase your risk of the following problems:

• Reduced compliance with a prescribed psoriasis treatment plan
• Changes in the way that psoriasis treatment works so that the treatment is less effective or stops working
• Increases in the intensity of negative side effects, such as liver damage, of medications
• Fewer or no remissions (periods without psoriasis symptoms)
• Dehydration, which can dry out your skin and aggravate symptoms
  

Drinking alcohol may also limit your treatment options. Regular alcohol consumption can harm your liver function. Some psoriasis drugs may not be suitable for people who drink because they impact liver function. Other drugs are known to interact with alcohol and may compromise the efficacy of these drugs.

The following psoriasis medications are not recommended for people who consume alcohol:

• Soriatane (acitretin)
• Trexall (methotrexate)
  

Alcohol Use Disorder in People With Psoriasis

Alcohol use disorder is a medical condition in which the affected person cannot stop or control alcohol use despite damaging health, social, or occupational consequences. It can occur as a mild, moderate, or severe condition.

There is a strong link between psoriasis and alcoholism. People with inflammatory skin disorders, including psoriasis, are often heavy drinkers and have a higher risk of developing alcohol use disorders. Research shows that psoriasis patients consume alcohol more often and develop alcohol dependence more often than the general population.

Quality of life is often significantly affected in patients with psoriasis. This can be a catalyst for unhealthy lifestyles, including excessive alcohol use.

Effect on Mental Health

While triggers can vary by individual, stress is one of the most common triggers for psoriasis. At the same time, the pain and appearance of a psoriasis flare can cause stress, anxiety, and depression. For patients, it can be an endless loop of stress, which may make them more vulnerable to alcohol use disorder.

You have a higher risk of developing alcohol use disorder if you participate in binge drinking and/or heavy alcohol use over time. Dealing with emotional problems, such as depression, can trigger this type of alcohol abuse.

Summary

Alcohol can work to increase the inflammation that causes psoriasis. This can result in more flare-ups and more intense symptoms with fewer days of clear skin. Drinking too much can also reduce the effects of treatments proven to provide relief.

Patients who rely on drinking for relief may create a cycle in which their actions cause the problem they are trying to forget. The amount of alcohol that psoriasis patients consume aligns with the extent of their disease. This raises the risk of having an alcohol use disorder.

Patients with psoriasis may not have to give up drinking. Drinking within advised limits and knowing how alcohol affects certain drugs can help you drink safely. Consult your dermatologist for advice on how drinking can impact your disease symptoms and treatments.