More than 7.5 million American adults have psoriasis. Despite this, the condition remains poorly understood. Is psoriasis genetic? There are a lot of genes that may play a role in your skin health, but it’s more complicated than that.
Celebrities like Kim Kardashian have increased public awareness of the condition. Singer Cindi Lauper is a spokesperson for a psoriasis medication. This is to show that awareness has grown over the past couple of decades, but it remains a difficult condition to deal with, both medically and personally [1, 2].
A growing body of evidence suggests that the cause of the condition is partly genetic [3]. So, let’s look beneath the surface and find out how!
What is Psoriasis?
Psoriasis is a chronic skin condition, where patches of red and itchy skin build-up, often referred to as scales and flakes. [4]. It’s an autoimmune skin disease in which the body attacks its own skin cells. In response, skin cells begin to grow too quickly. New cells then begin to pile up on the skin’s surface, forming plaques. The result is itchy, inflamed, scaly skin — the hallmark of psoriasis [4, 5, 6].
Psoriasis patches can range from a few spots to major eruptions that cover large areas. The most commonly affected areas are the lower back, elbows, knees, legs, soles of the feet, scalp, face, and palms. There are 7 types of psoriasis, including [7]:
- Plaque psoriasis. The most common form, and usually appears on elbows, knees, lower back and scalp.
- Nail psoriasis. It can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration.
- Guttate psoriasis. This type primarily affects young adults and children. It’s usually triggered by a bacterial infection.
- Inverse psoriasis. It affects the skin folds of the groin, buttocks and breasts, causing smooth patches of red skin that worsen with friction and sweating.
- Pustular psoriasis. A rare form causing pus-filled lesions that occur in widespread patches or in smaller areas on the palms of the hands or the soles of the feet.
- Erythrodermic psoriasis. The least common type, it can cover your entire body with a red, peeling rash that can itch or burn intensely.
- Psoriatic arthritis. It causes swollen, stiff, and painful joints. At times only nail changes are seen. In serious cases, it may lead to permanent joint damage.
As there is no cure for psoriasis, treatment aims to manage symptoms. Your doctor may suggest [8, 9, 10]:
- Light therapy
- Coal tar
- Medications that block the immune response
- Topical vitamin D
- Retinoids
It’s worth noting that your genetics may play a role in how you respond to these techniques. Not only can psoriasis have a genetic component, but your genes may also help you find triggers and strategies to manage symptoms. For example, the effectiveness of light therapy may depend on which variant of the TP53 gene you carry [11].
Because psoriasis is an autoimmune disease, it is impacted by stress. Reducing stress may also help with symptom management [12]. People with a particular CRHR1 gene variant may be more prone to stress, so they may want to take special care to reduce it [13].
Psoriasis Triggers
One thing is clear from the variety of personal stories and research on the potential causes of psoriasis outbreaks: there is no “one” thing. A great deal of difference exists across individuals when it comes to psoriasis. What keeps it at bay for one person, can have zero effect on another, or a small outbreak from a particular trigger can be massive for someone else [14].
For the most part, due to this randomness, triggers can generally only be identified through elimination, and people predisposed to psoriasis don’t always have symptoms. Some common triggers include [7, 15]:
- Throat and skin infections
- Dry and cold weather
- Skin injuries (like bug bites and sunburns)
- Stress
- Cigarette smoke
- Alcohol abuse
- Topical steroid withdrawal
- Hormonal changes (puberty/menopause)
- Foods/nutrients
However, your genes may hold some clues to help figure out and manage the symptoms and triggers of psoriasis.
The Genetics Of Psoriasis
There have been a number of genetic studies for psoriasis done in the past decade with the advent of GWAS, which can examine thousands of genetic profiles at a time and compare for mutations common to people with a condition. These have determined that between 60-90% of differences in psoriasis may be attributed to genetics. So, if you’re wondering whether psoriasis is hereditary, the answer is a solid, “yes!”
To be clear, there are a lot of potential genes involved in psoriasis [16, 17, 18]. Anything involving inflammation and the immune system tends to have a lot of interconnected parts. Psoriasis is no different. We’ll focus on a major gene from each of these categories as an example.
For inflammation, IL23 (interleukin) likely plays one of the most important roles. It helps regulate the body’s inflammatory response and plays a key role in our immune system.
IL23 is made from two other proteins IL12B and IL23A. Variants in the genes of these two proteins can alter the normal expression of IL23, increasing the inflammatory response. Some of the newest, biologic, psoriasis medications work to block IL23, so this altered response can’t induce psoriasis symptoms.
For the immune response, there is the HLA-C gene. This protein is part of a group of proteins called the major histocompatibility complex or MHC. These proteins help our immune system differentiate between good cells and bad cells. Given that psoriasis is an autoimmune disease, where the body is attacking its own cells, you can see why variants in this gene could cause problems.
These are just some examples of how psoriasis and genetics are connected. It can be difficult to identify what triggers your psoriasis. Genetics may give you a head start to help you find potential triggers and techniques to manage your symptoms.
How Can Analyzing Your DNA Help You With Psoriasis?
Having your DNA analyzed can help you understand what risk factors are relevant to you based on your genes and what you can do to address them.
The SelfDecode Psoriasis Report allows you to optimize your health by uncovering what your genes are doing behind the scenes to affect your odds of struggling with psoriasis.
Above, we looked at a couple of genes more directly involved in the process, but we can always go behind the scenes a bit more, and find things like the STAT3 gene. This gene makes a protein that helps regulate the response of genes like IL23. A variant in this gene can imbalance STAT3’s response to increase the activity of IL23.
The research over the past several years in the genetics of psoriasis has greatly expanded our understanding of how the disease develops and what can influence its severity. There have been a number of advancements in medications focused on these problematic genetic factors. For example, some of the latest drugs target IL23, blocking its activation.
Knowing what your potential problem gene variants are can help direct your healthcare decisions, giving you more personal choice in the matter, and a greater understanding of why your doctor might want to prescribe specific medications. Your genes can also help you identify potential triggers and guide you into making lifestyle changes to manage your symptoms.
SelfDecode analyzes your genes to provide your genetic risks for psoriasis and gives personalized diet, lifestyle, and supplement recommendations to help you optimize your skin health.
You can learn whether or not gluten is a potential trigger for psoriasis symptoms or if something like indigo oil may provide extra relief for the plaques and itching. SelfDecode offers over 30 DNA wellness reports to help you optimize all aspects of your health, including acne, eczema, stress, and allergies.
Concluding Remarks About Psoriasis And Genetics
Psoriasis is a complicated, frustrating, and still not fully understood disease. Anything involving your immune system tends to be complex and interconnected in ways that can often be a mystery. Technology is allowing us to unravel that mystery to some extent, revealing more with every passing year and every genetic study. A whole host of new medications exist now thanks to that research.
It can be hard to identify triggers of psoriasis. Genetics may play a role, so knowing your genes may help you get ahead of the problem and find which strategies are more likely to work for you.
Be proactive and start today by investigating your DNA to discover more about psoriasis and genetics. For gene-based health recommendations to help you optimize your skin health, you should check out SelfDecode.
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