Coffee is linked with many health benefits, including protection against certain types of cancer, heart disease, type 2 diabetes, and Alzheimer’s disease. But for people living with psoriasis, the pros and cons of coffee are more nuanced.
Given that java is generally considered good for so many aspects of health, why would it be any different for people with psoriasis? Research suggests that it’s because of the overactive immune response of psoriasis. Anything that may impact the immune system could potentially worsen or improve disease activity.
Coffee may also impact other conditions that people with psoriasis are more likely to have, like heart disease and depression.
“Studies looking at psoriasis and coffee or caffeine have shown potential benefits and disadvantages,” says Steven Daveluy, MD, an associate professor and the associate program director of dermatology at Wayne State University School of Medicine in Detroit. “It really comes down to how much coffee you're drinking, and what you're putting in it.”
Learn more about how coffee may impact psoriasis, expert advice on the best way to take your coffee, and how much is too much when it comes to America’s favorite drink.
Although many of us see coffee as synonymous with caffeine, it’s much more than that. Coffee contains a variety of biologically active compounds, including polyphenols, diterpenes, and antioxidants — all of which may play a role in immune function and inflammation.
Potential to Reduce Psoriasis Disease Activity
“Both caffeine and antioxidants have effects that reduce inflammation and calm the immune system,” says Dr. Daveluy. “In psoriasis, parts of the immune system are overactive, so in theory, these compounds could be helpful.”
In the research that suggests coffee could help reduce disease activity, the key seems to be moderation. People who were moderate coffee drinkers — meaning they drank between one and three cups a day — had milder psoriasis symptoms and a lower risk of metabolic syndrome, a cluster of health issues including high blood pressure, obesity, and insulin resistance.
Metabolic syndrome increases your risk of cardiovascular problems, like heart attack and stroke. Because people with psoriasis have a higher risk of metabolic syndrome, this is a positive finding, says Daveluy.
But drinking more — especially four cups or more per day — appeared to worsen psoriasis and raise the level of pro-inflammatory chemicals.
“It's also important to note that the participants in the study drank black coffee, with no cream, milk, or sugar,” he says. Adding in those extras could potentially cancel out the benefits.
Increasing Energy Levels
Caffeine is well-known for its stimulating effects. For people managing the physical and mental fatigue that often accompanies psoriasis or psoriatic arthritis, coffee may offer a modest energy boost. It enhances alertness by blocking adenosine receptors in the brain and increasing the release of neurotransmitters like dopamine and norepinephrine.
Coffee can help people feel more awake and focused, which could be helpful in managing fatigue, which is often cited as one of the more bothersome symptoms of psoriasis.
Mood Improvement
There’s some evidence that regular, moderate caffeine intake can improve mood and even reduce the risk of depression in the general population. That’s because caffeine stimulates dopamine, which is a chemical in your brain that plays a role in motivation and learning.
Caffeine also has benefits in terms of exercise — it can improve your performance and reduce your perception of fatigue. Exercise is also associated with improved overall mood.
While these improvements have been found in the general population, they may be especially important for people with psoriasis, who are at a higher risk of depression.
There can be a flipside to coffee’s stimulating effects. While this holds true for everyone, with or without psoriasis, coffee may exacerbate some symptoms that are more common in people with the inflammatory condition.
Jitteriness
Caffeine is a stimulant, and consuming too much can cause restlessness, anxiety, increased heart rate, and even tremors — symptoms often referred to as the "jitters." These effects can be uncomfortable and may even exacerbate stress, which is linked to an increased risk of psoriasis flares.
It can also increase respiratory rate, heart rate, and blood pressure, which may be an issue for people with psoriasis, especially if they have heart disease.
Sleep Disruption
As many as 40 percent of people with psoriasis have trouble sleeping.
Consuming too much caffeine, especially late in the day, may exacerbate those issues. Caffeine can remain in your system for hours after you drink it, making it harder to go to sleep (insomnia) and stay asleep.
“Caffeine has been shown to help a couple of our older psoriasis pills work better, specifically methotrexate and sulfasalazine,” says Daveluy.
“With the availability of newer medications that are more effective and safer, we don't use these pills much anymore, but we still need them for some patients,” he says.
When it comes to coffee and psoriasis, one size does not fit all. Although the research is limited, the evidence from the available studies suggests that the benefit or risk depends on the quantity, says Daveluy.
For his patients with psoriasis who are coffee drinkers, Daveluy recommends up to three cups of black coffee a day, pointing out that more than that may actually cause problems.
“I also emphasize that we're talking about black coffee. Sugar, milk, and cream are all pro-inflammatory foods that can make your psoriasis and heart disease risk worse. If you want the benefits of coffee consumption, skip the sugar and milk, or you can add a plant-based milk,” he says.
Moderate coffee consumption — up to three cups of black coffee per day — may lower psoriasis severity and the risk of related conditions like metabolic syndrome.
Coffee may improve mood and energy, but it can also cause anxiety or sleep issues in some people.
Four or more cups per day may increase inflammation and worsen symptoms, especially if the coffee includes sugar, milk, or cream.
If you have psoriasis, consider keeping your coffee black, drinking it earlier in the day to avoid sleep problems, and talking to your doctor if you have questions about how it might interact with your medications or symptoms.
