DR PHILIPPA KAYE: I’ve treated psoriasis patients for more than 20 years and here’s why I am increasingly convinced that weight loss can banish the itchy red skin patches

I don’t need to tell you that weight-loss injections have changed everything. 

These drugs, such as Wegovy and Mounjaro, have given people living with overweight and obesity hope for the first time – allowing many of them to lose as much as a fifth of their body weight.

And the benefits don’t end there. I’ve seen countless patients – the majority of whom are paying for the jabs privately, as NHS access remains poor – enjoy other remarkable improvements in their health.

These drugs can reduce blood pressure and cholesterol, both of which contribute to deadly heart disease. They can reverse type 2 diabetes. They can even ease joint pain and heartburn.

But there is another benefit I’ve started to notice – and it has the potential to be game-changing. Some of my patients say that taking weight-loss jabs has markedly improved their psoriasis.

Psoriasis is an uncomfortable red, flaky skin condition that affects more than one million Britons. 

In recent years, psoriasis has gained greater attention worldwide after the mega-celebrity and reality TV star Kim Kardashian revealed she struggles with the condition.

At its worst, it can make life miserable for patients, who are left constantly itchy and self-conscious about their skin.

And while it can be managed with medication, there is currently no cure.

What my patients have reported may be only the tip of the iceberg. Growing research suggests that weight-loss – whether or not it is triggered by the jabs – could be one of the most effective ways to ease psoriasis.

In fact, some of Britain’s top experts are now calling for weight-loss to be considered part of routine treatment. This raises the possibility that psoriasis could be eased without extra drugs, something many patients would welcome.

But weight-loss is not the only lifestyle change that can help with this unpleasant skin condition. And it isn’t right for everyone.

So why does losing weight combat psoriasis? And is it something you should try?

First, it’s important to explain what psoriasis is.

It is a skin condition linked to the immune system. The body mistakenly begins to make skin cells faster than normal, leading to a build-up that forms scaly plaques, often on the elbows, knees, scalp, lower back and hands.

It can start at any age, though it most often appears in adults under 35, and affects men and women equally.

Treatment usually starts with emollients (medical-grade moisturisers), followed by prescription creams such as steroids, which can ease the inflammation.

More severe cases might be treated with UV light therapy or immune-suppressing injections called biologics.

But a growing body of research suggests weight should be part of the conversation too.

It is estimated that around four in five people with psoriasis are overweight or obese, and carrying extra weight is linked to more severe disease.

The evidence is strong enough that last year University of Oxford researchers, who reviewed 13 trials involving more than 1,100 patients, concluded that weight-loss should be considered part of routine treatment – though, of course, losing weight is often not easy.

The research isn’t perfect. For one, the average improvement seen in the patients included in the Oxford review was modest.

Even so, this link is something that GPs, psoriasis specialists and, of course, patients all need to take seriously.

So why might shedding pounds help the skin?

 One theory is that fat, particularly that found around the tummy (known as visceral fat), can interfere with hormones and the immune system, driving psoriasis.

Extra weight can also mean more skin folds, with more sweating and friction. Any injured skin can trigger new patches of psoriasis – something known as the Koebner response.

Obesity also seems to be linked to a poorer response to treatment, so losing weight may help the medications used for psoriasis work better.

However, it’s important to stress that weight-loss won’t help everyone with psoriasis. Most obviously, patients who are already a healthy weight won’t benefit – and shouldn’t try to lose weight to treat their skin.

Even if you do have obesity and lose weight, psoriasis doesn’t necessarily clear completely, and you will most likely still need treatment of some sort.

There are also other lifestyle factors that can worsen psoriasis. The worst culprits are smoking and alcohol. I’ve seen plenty of psoriasis patients who have given up these unhealthy habits and seen impressive improvements in their symptoms.

And while there is no specific psoriasis diet, there is some evidence that a Mediterranean diet – rich in fruit, vegetables, wholegrains, nuts, seeds, olive oil and fish – may help.

It’s also important that patients stick with their existing treatment plan.

For most, this means applying their emollients every day. These soothe the skin, reduce soreness, itching and scaling, and help repair the skin barrier.

Many people stop using them when their psoriasis patches get better, but this can cause the symptoms to return.

But it’s possible that, in the future, psoriasis patients will be told to lose weight – with or without jabs – alongside using their emollients. Watch this space.