It sounds plausible: If psoriasis is causing dry, scaly patches on your skin, couldn’t drinking more water — hydrating from the inside out — improve symptoms or prevent a flare?
Dermatologists aren’t buying it.
Yes, psoriatic skin has hydration issues. “Because the skin barrier in psoriasis is abnormal, you can lose water through the skin,” says Steven Feldman, MD, PhD, a dermatologist who specializes in psoriasis treatment at Atrium Health Wake Forest Baptist in Winston-Salem, North Carolina. Applying moisturizer to damp skin, he says, is important for hydrating psoriasis plaques.
But drinking water “is a different kind of hydrating,” Dr. Feldman says. “There isn’t any evidence that we know of that suggests drinking more water improves psoriasis.”
By the way, there isn’t much research to indicate that drinking extra water (more than the recommended daily intake) has any impact on skin hydration or appearance in individuals with healthy skin either.
Certainly staying hydrated by drinking plenty of water is good for overall health, whether a person has psoriasis or not. Your cells, tissues, and organs need water to function properly: It’s a key component in the regulation of body temperature and the removal of waste from the body, according to the American Academy of Family Physicians.
The National Academy of Sciences determined that women and men need about 11.5 and about 15.5 cups of fluid a day, respectively. That recommendation covers fluids obtained from water, other beverages, and food (about 20 percent of daily fluid intake comes in the form of what you eat, not what you drink). If your urine is colorless or light yellow and you rarely feel thirsty, that’s an indication that you’re hydrating appropriately.
People with psoriasis can follow the same hydration guidelines as everyone else, says Feldman. “They don’t need to drink more water because of their condition, and there isn’t any evidence that drinking more will improve psoriasis symptoms or prevent flares,” he says. “Just make sure you’re drinking enough water to support your overall health while limiting sweetened drinks and alcohol,” he says.
Topical ointments with vitamin D are sometimes used to treat psoriasis, but there isn’t strong evidence to indicate that drinks fortified with vitamin D can help with psoriasis symptoms, according to the National Psoriasis Foundation.
But people with psoriasis often have lower than normal levels of vitamin D, a problem that can worsen as hours of daylight wane in the fall and winter. (Skin naturally produces vitamin D in response to sunlight.) Vitamin D is important to overall health for a host of reasons, including helping the body absorb calcium to build bone and maintaining immune function.
If you do want to increase your vitamin D intake through beverages, milk and orange juice fortified with vitamin D are good sources. Soy, almond, and rice milk are also often fortified with comparable amounts of vitamin D. Talk with your doctor before taking vitamin D supplements: Too much can be harmful.
Note that for people with psoriasis who are lactose intolerant or otherwise have trouble digesting dairy products, milk can be problematic because it can irritate the gut, worsening inflammation throughout the body. In some cases, people with psoriasis who cut out dairy see an improvement in their skin symptoms, according to Johns Hopkins Medicine. However, many studies show that milk and other dairy products have a significant anti-inflammatory effect in both healthy people and those with obesity, metabolic syndrome, or type 2 diabetes. Cutting out dairy isn’t necessarily appropriate for everyone.
There is currently no evidence that antioxidants in black, green, or herbal teas will improve psoriasis symptoms, says Feldman.
An animal study suggests that extracts of green, black, and white tea can fight skin inflammation and that white tea extract, in particular, “has potential as an anti-inflammatory material.” Although laboratory studies suggest that antioxidants may be beneficial at lowering inflammation, the high amounts that a person would need to consume make it unlikely that antioxidants in one’s diet would have any effect on psoriasis, experts note.
“Drinking too much alcohol isn’t a good idea — it probably has a direct effect on psoriasis,” says Feldman.
There is evidence to suggest that alcohol consumption may increase the risk of developing psoriasis and may worsen inflammation in people who already have the disease. This appears to be due at least in part to alcohol’s harmful effect on the gut microbiome. Research has shown an increase in psoriasis severity in patients who consume alcohol. One small study in Poland found that as the amount and frequency of alcohol consumed increased, psoriatic lesions worsened and quality of life decreased.
Consuming alcohol can create oxidative stress and inflammation. And alcohol can also negatively interact with psoriasis medications. Research has shown an association between alcohol misuse and poor response to conventional systemic treatments and biologic medications for psoriasis.
The U.S. Dietary Guidelines state that women should have one drink or less in a day and men should have two drinks or less in a day. But the National Institute on Alcohol Abuse and Alcoholism advises avoiding alcohol altogether if you take medications that interact with it or have a condition worsened by drinking, including liver disease, abnormal heart rhythm, diabetes, and hypertension. These are all conditions that people with psoriasis have an elevated risk of developing.
Additionally, some people with psoriasis have a sensitivity to gluten, which is found in some types of alcohol, such as beer. Research suggests that for those who have the sensitivity, avoiding gluten can improve psoriasis symptoms, though it may not help much (if at all) in people without the sensitivity.
High-calorie beverages with added sugars, such as juice and sodas (as well as alcoholic drinks and sweetened coffee concoctions), can contribute to weight gain. Evidence suggests that for people with psoriasis who are overweight or obese, treating the psoriasis and following a healthy and balanced diet that promotes weight loss could lead to fewer flare-ups and less severe disease.
Scientists have also linked overconsumption of sugar with chronic inflammation, which can make psoriasis worse.
While staying hydrated is crucial for your overall health, drinking more than the recommended daily amount of water won’t directly improve psoriasis symptoms.
Limiting alcohol and sugary beverages might help because too much can lead to inflammation, worsening psoriasis.
Try choosing antioxidant-rich drinks like green tea, which can support general well-being without harming your skin.
