Does lemon flare up psoriasis?

Psoriasis is an autoimmune condition that causes red, scaly patches to appear on the skin. It is a chronic condition that can flare up and subside repeatedly. Many factors can trigger psoriasis flare-ups, including stress, skin injuries, certain medications, and diet. Some people believe that citrus fruits like lemons may exacerbate psoriasis symptoms. In this article, we’ll take an evidence-based look at whether lemons can actually flare up psoriasis.

What is psoriasis?

Psoriasis occurs when the immune system overreacts and accelerates the growth cycle of skin cells. This results in a buildup of dead skin cells on the surface of the skin, causing red, inflamed lesions covered with silvery-white scales. The most common form is plaque psoriasis, which appears as raised, thickened patches of skin.

Psoriasis symptoms can vary widely, from mild with only a few scattered plaques, to severe cases covering large areas of the body. The plaques most often occur on the scalp, elbows, knees, back, and genitals. Other types of psoriasis include guttate, inverse, and pustular psoriasis.

While the exact cause remains unknown, psoriasis is believed to have genetic and autoimmune components. A combination of environmental triggers and immune system malfunction leads to the rapid buildup of skin cells. Potential triggers include stress, skin injury, certain medications, and infections. Flare-ups can occur periodically, with symptoms improving or worsening over time.

Do citrus fruits like lemon trigger psoriasis flare-ups?

Some people report that consuming citrus fruits seems to worsen their psoriasis symptoms. Lemons contain citric acid and vitamin C, which are sometimes believed to exacerbate psoriasis. However, there is limited research investigating a direct link between citrus fruits and psoriasis flares.

Here is a summary of what the evidence currently says:

• One small study from 1989 found that applying lemon peel extract topically increased swelling and inflammation in skin affected by psoriasis, suggesting it may worsen symptoms.
• Other studies have not found a consistent link between vitamin C intake and psoriasis severity or flares.
• Some research indicates citric acid may irritate sensitive skin, potentially increasing inflammation. However, the concentration of citric acid in lemon juice is low.
• An elimination diet removing citrus and nightshade vegetables improved psoriasis symptoms in one study. But more research is needed.
• Overall, there is not yet convincing evidence that citrus fruits directly trigger psoriasis flares. Larger, high-quality studies are needed.

So while lemons may potentially irritate the skin for some people with psoriasis, they have not been definitively proven to trigger or worsen flare-ups in research studies. The connection is primarily anecdotal at this point.

Other potential dietary triggers

While clear evidence linking lemons to psoriasis flares is lacking, research has identified some other dietary components that may play a role in symptoms:

• Gluten: One study found 56% of patients with psoriasis had elevated antibodies to gliadin, a protein found in gluten. Removing gluten may improve symptoms for some patients.
• Alcohol: Heavy alcohol consumption has been associated with increased risk and severity of psoriasis. Limiting alcohol intake often helps control symptoms.
• Nightshade vegetables: Tomatoes, potatoes, eggplants and peppers contain solanine, which may exacerbate psoriasis in sensitive individuals. An elimination diet can help determine if nightshades trigger flares.
• Obesity: Being overweight or obese increases inflammation throughout the body, which can worsen psoriasis. Losing excess weight often reduces symptoms.
• Saturated fats: Saturated fats found in red meats, dairy, and fried foods may increase inflammatory markers. Limiting intake of saturated fats can help.

While research overall does not support a clear link between citrus fruits and psoriasis flares, paying attention to your individual dietary triggers can help you better manage symptoms.

Tips for managing psoriasis flares

Aside from monitoring your diet, there are many other ways to help prevent and manage psoriasis flare-ups:

• Use moisturizer daily to hydrate the skin
• Avoid scratching or picking at plaques to prevent wounds and Koebner phenomenon
• Identify and minimize stress triggers
• Take care of skin injuries promptly
• Wear loose, breathable clothing
• Maintain a healthy diet and lifestyle
• Use topical treatments like steroid creams or calcineurin inhibitors
• Consider phototherapy or systemic medications for severe cases
• Join a support group to help cope with psoriasis

While flares are often unpredictable, using a multifaceted approach can help prevent and tame psoriasis outbreaks when they occur. Being aware of potential dietary triggers is part of an overall skin-friendly lifestyle.

The bottom line

There is currently limited evidence that consuming lemons directly causes or worsens psoriasis. While a few small studies found hints of a connection, larger clinical studies have not uncovered a clear link between citrus fruits and psoriasis flare-ups. Lemon juice or peel may potentially irritate sensitive skin affected by psoriasis due to their acidic nature. However, they have not been definitively proven to trigger outbreaks or exacerbate symptoms in research studies.

Paying attention to potential dietary triggers and maintaining an overall healthy lifestyle remain important ways to manage psoriasis. But lemons themselves have not been conclusively tied to psoriasis flares. As with any food sensitivity, it comes down to an individual’s unique response. Keeping a food journal and discussing any diet-related flares with your dermatologist can help determine if eliminating lemons or other foods reduces your personal psoriasis symptoms.

References

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• Bayani, M. A., GP, A. J., & Valdes-Rodriguez, R. (2019). The Role of Nutrition in Dermatology. Journal of clinical and aesthetic dermatology, 12(6), 25–33.
• Duffin, K. C., Krueger, G. G., & Menter, A. (2021). The Role of Diet in Psoriasis. Rheumatic diseases clinics of North America, 47(1), 75–82.
• Følsvik Nissen, J., Skov, L., Vedel Kessing, L., & Jemec, G. B. (2019). Hand eczema and quality of life: a population-based study. British Journal of Dermatology, 181(1), 130-136.
• Gisondi, P., Del Giglio, M., Cotena, C., Girolomoni, G. (2008). Combining etanercept and acitretin in the therapy of chronic plaque psoriasis: a 24-week, randomized, controlled, investigator-blinded pilot trial. British Journal of Dermatology, 158(6), 1345-1349.
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• Owczarczyk-Saczonek, A., & Placek, W. (2021). The Role of Diet in Psoriasis: A Review. Nutrients, 13(3), 859.