A new study reveals that people with psoriasis can still experience inflammation throughout their bodies even after their skin clears up with medication. This hidden inflammation may increase their risk of other health problems.
Researchers analyzed data from about 200 psoriasis patients in the United States, Spain, and Sweden. These patients had mild or no symptoms after using biologic drugs for one year. Despite improved skin, 36 percent of them showed signs of residual inflammation. This type of inflammation can contribute to various health issues, according to findings published in the Journal of Investigative Dermatology.
Those with residual inflammation were more likely to have obesity, extra fat around their waist, and a chronic liver condition called metabolic dysfunction–associated steatotic liver disease (MASLD). MASLD occurs due to fat buildup in the liver caused by abnormal metabolism.
“When a patient’s skin looks clear after treatment, we might think everything is fixed,” said Dr. Faranak Kamangar, a dermatologist and chair of dermatology at the Palo Alto Medical Foundation in California, who was not involved in the study. “However, this research shows that invisible inflammation can still be present in the bloodstream even when the skin improves.”
Psoriasis is a chronic autoimmune disease that causes itchy, scaly patches on the skin, commonly affecting the knees, elbows, trunk, and scalp. Besides skin symptoms, people with psoriasis face higher risks of other health problems such as obesity, type 2 diabetes, and heart disease. This is because psoriasis involves inflammation throughout the body, not just on the skin.
Doctors often use biologic drugs to reduce this inflammation and clear skin symptoms, especially for moderate to severe cases. But as Dr. Danilo Del Campo, a dermatologist at the Chicago Skin Clinic in Illinois, explains, biologics may not fully eliminate inflammation. “I see patients whose skin is well controlled but who still have metabolic issues caused by ongoing, unseen inflammation,” he said. “This shows that psoriasis is a systemic disease affecting many organs and systems, not just the skin.”
The study’s limitations include its small size and one-year follow-up period. It is possible that the effects of biologics on skin and inflammation may change over time.
Still, the research highlights the importance of maintaining a healthy lifestyle even when biologics effectively manage skin symptoms. Dr. Del Campo recommends regular exercise, a balanced diet rich in anti-inflammatory foods, maintaining a healthy weight, and avoiding smoking and excess alcohol.
Dr. Kamangar adds that a Mediterranean-style diet, including olive oil, fatty fish, colorful vegetables, and nuts, can help reduce inflammation in people with psoriasis. Stress management techniques like meditation or yoga are also beneficial.
“It’s important for patients to have regular check-ups with their primary care providers to monitor overall health,” said Dr. Del Campo. “Early detection and treatment of related conditions can greatly improve long-term outcomes. Sometimes, I adjust a patient’s biologic treatment or add therapies if residual inflammation remains a concern.”
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