Exploring Diets for Psoriasis Management: Mediterranean, Elimination, Keto, and More
Disclaimer: This article shares general insights and common experiences from people living with psoriasis. It is not medical advice—always consult your dermatologist or healthcare provider before trying new approaches, as diets can interact with treatments or health conditions.
Psoriasis management often extends beyond topical treatments or medications, with many people exploring dietary changes to reduce inflammation and flares. While no diet cures psoriasis, evidence suggests certain eating patterns can support symptom relief by influencing immune responses and gut health. Here, we'll dive into popular options like the Mediterranean diet, elimination diets, and keto, based on studies and shared experiences.
The Mediterranean diet stands out as one of the most researched and recommended for psoriasis. Rich in anti-inflammatory foods like fruits, vegetables, whole grains, fatty fish, extra-virgin olive oil, nuts, and herbs, it emphasizes heart-healthy fats and antioxidants. The landmark 2025 MEDIPSO randomized clinical trial (conducted from February 2024 to March 2025 in Madrid, Spain) involved adults with mild-to-moderate psoriasis on stable topical therapy. Participants following a 16-week, dietitian-guided Mediterranean diet showed significant improvements: nearly half achieved at least a 75% reduction in symptoms (PASI 75), with many seeing at least 50% improvement, better quality of life, and metabolic benefits (like reduced HbA1c) compared to a control group on standard low-fat advice. These results highlight its potential as an adjunctive therapy, independent of weight loss, due to reduced systemic inflammation.
Elimination diets involve temporarily removing potential trigger foods to identify sensitivities. Common culprits for psoriasis include gluten, dairy, nightshades (tomatoes, peppers, eggplant), processed foods, and alcohol. The Autoimmune Protocol (AIP)—a structured elimination diet—focuses on nutrient-dense whole foods while avoiding grains, legumes, eggs, and more during the initial phase. Shared stories from patient communities (e.g., forums and recovery accounts) often describe gradual reductions in itch, scaling, and plaques after 3–12 months of strict adherence, followed by careful reintroductions to pinpoint triggers. For example, some report significant clearing by eliminating gluten/dairy and addressing gut health, though results vary and it requires patience (often months) plus tracking. Evidence is mostly anecdotal or from small studies/case reports, but it can empower people to discover personal triggers.
The keto diet, high in fats, moderate in protein, and very low in carbs, has mixed results for psoriasis. Some older studies and reviews suggest low-calorie keto versions can reduce inflammatory markers (e.g., IL-1β, IL-2) and improve symptoms, possibly through weight loss, ketosis, and anti-inflammatory effects. A 2025 review on ketogenic diets and skin health notes potential benefits for inflammatory conditions like psoriasis via reduced cytokines and gut microbiota shifts (e.g., higher Bacteroidetes/Firmicutes ratio aiding fat loss). However, risks include worsening in some cases—especially diets high in medium-chain triglycerides (MCTs from coconut oil), which may exacerbate inflammation in psoriasis models (e.g., when combined with omega-3s). It's not ideal for everyone (e.g., those with heart concerns), but a modified approach blending keto with Mediterranean principles may offer balance.
Remember, track changes in a journal and consult pros—diets work best as part of a holistic plan.
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