Psoriasis is a chronic autoimmune condition where the immune system triggers an accelerated life cycle of skin cells, leading to rapid buildup on the skin’s surface. This process results in thick, inflamed, scaly patches, which are driven by systemic inflammation. Because diet can modulate inflammation, many people living with psoriasis question whether common foods and beverages, such as coffee, might act as triggers for flare-ups. The relationship between coffee consumption and psoriasis severity is complex, balancing the beverage’s beneficial compounds against its stimulating effects.
Coffee’s Dual Role: Anti-inflammatory Compounds vs. Stimulants
Coffee contains hundreds of biologically active substances that can affect the inflammatory pathways involved in psoriasis. Its anti-inflammatory potential comes from its high concentration of polyphenols and antioxidants. Chlorogenic acids (CGAs), a major class of polyphenols, mitigate oxidative stress and suppress pro-inflammatory cytokines (like TNF-α, IL-1β, and IL-6) that are overexpressed in psoriasis. Caffeine itself also exhibits anti-inflammatory properties by inhibiting the enzyme that degrades cyclic adenosine monophosphate (cAMP). By raising cAMP levels, caffeine helps suppress inflammatory pathways and reduce cell proliferation, which are key issues in psoriasis.
Conversely, certain components of coffee can introduce a stimulating element. Caffeine is a central nervous system stimulant that elevates stress hormones, such as cortisol, which may exacerbate existing inflammation. High caffeine intake can also contribute to sleep disruption and increased anxiety, both known triggers for psoriasis flares.
Diterpenes, cafestol and kahweol, are present in unfiltered coffee types like French press or Turkish coffee. While they have antioxidant properties, they are primarily known for raising serum cholesterol and lipid levels. Elevated lipids and related metabolic issues are closely linked to the comorbidities seen in people with psoriasis, suggesting unfiltered coffee could indirectly worsen the overall disease state.
Reviewing the Research: Coffee and Psoriasis Severity
Scientific studies investigating the direct link between coffee consumption and psoriasis severity have yielded mixed results, largely due to differences in study design, population size, and varying levels of coffee intake. Epidemiological studies offer some insight, often suggesting a dose-dependent effect, though large-scale clinical trials isolating coffee as the sole variable are lacking.
A 2018 study found that individuals consuming a moderate amount of coffee (up to three cups per day) reported lower scores on the Psoriasis Area and Severity Index (PASI) compared to non-drinkers. This moderate consumption was also associated with a lower prevalence of metabolic syndrome, a condition frequently comorbid with psoriasis. This suggests the protective effects of coffee’s antioxidants are most prominent at moderate intake levels.
The findings shift when consumption is higher. Participants averaging four or more cups of coffee daily often reported more severe flare-ups. This worsening might be attributed to the pro-inflammatory effects of excessive caffeine or the metabolic burden of diterpenes in unfiltered preparations. Overall, most research indicates that the amount consumed may influence the severity of existing symptoms, rather than coffee causing psoriasis.
Practical Steps for Determining Personal Triggers
Because psoriasis is highly individualized, the effects of coffee can vary significantly from person to person, making personal tracking the most reliable method for identifying triggers. One structured approach involves a temporary elimination period, where coffee is completely removed from the diet for two to four weeks. During this time, maintain a symptom journal, noting the frequency and severity of skin plaques, itching, and overall energy or anxiety levels.
After the elimination phase, coffee can be slowly reintroduced, starting with a moderate amount, such as one cup of black, filtered coffee daily. Continue the symptom journal for several days following reintroduction to monitor for any corresponding flare-ups or worsening of symptoms. This reintroduction is best done with black coffee, as additives like high amounts of sugar, cream, or artificial sweeteners are often greater inflammatory triggers than the coffee itself.
If a reaction is suspected, consider switching to decaffeinated coffee or herbal teas. These alternatives still contain beneficial polyphenols without the stimulating effects of caffeine. Before initiating any significant changes to a long-term diet, consult with a dermatologist or a registered dietitian. They can provide personalized guidance and ensure the diet remains nutritionally adequate.