What Our Gut Tells Us About Our Skin:
The Psoriasis-Candida Connection

It’s funny how something that looks just fine on the outside can look quite different on the inside. As I seek out answers to my health concerns, doctors and other health care providers often view me as just a regular, healthy, 20-something year old.

I’ve suffered from plaque psoriasis for several years now. It’s hard to recall exactly when it first showed up, but increasingly over the past 10+ years I’ve been dealing with flaky, dry, painful inflamed skin patches across mainly my face, elbows, and feet. The patches sometimes change shape, getting bigger or smaller, and pop up in new places while disappearing in others.

Looking back, I can trace my worst psoriasis flare-ups ever to my most recent antibiotic prescriptions. I took a round of antibiotics in the spring of 2012, and that following winter I was suffering not only from psoriasis, but also a whole host of odd symptoms. My bones hurt. I couldn’t eat that much. I was losing weight. I was sleeping poorly. I had recurrent urinary tract infections. I constantly craved sweets and was quick to get “hangry”. My body felt like it was falling apart. Thankfully, as a shot in the dark, I tried a gluten-free diet. Immediately, I began to see a reversal of these symptoms when I cut out wheat and began following basically a gluten-free diet. Incredibly, my psoriasis disappeared. This was the first hint that my skin problem was related to my intestinal microbiome – which is the wide variety of normally healthy or benign bacteria, fungi, and other microscopic organisms that live inside your large intestine. In hindsight, I believe these seemingly unconnected symptoms had one root cause: the overgrowth of a particularly virulent fungus, called Candida albicans, in my intestinal microbiome.

Over a year later, in spring 2014, I was put on another round of antibiotics for a kidney infection – and although I’m terribly thankfully to have fully functioning kidneys nowadays – my psoriasis returned with a vengeance worse than I had yet experienced. This was the second hint that my skin problem was related to my intestinal microbiome. I developed stubborn patches on my elbows and ankles that refused to budge seemingly no matter what I did. Not only were they unsightly, but worse than that – plaque psoriasis is often painful, as your skin hardens into flakes that rip off exposing skin that seems too fresh to be on the outside, similar to when you cut your fingernails too short. Your psoriatic skin cracks and bleeds with a constant dull ache of pain.

Western medicine tells us that they don’t fully understand the etiology of psoriasis, and don’t know how to treat it without medications. In fact, that’s exactly what the dermatologist told me this past spring after she officially diagnosed what I’ve known to be psoriasis for years. She offered a topical steroid cream, and was shocked when I refused it. She asked why wouldn’t I use the medication. I told her that no steroid cream will fix the root problem of what’s actually causing my psoriasis – it will just mask the symptoms. She reminded me that there’s “no cure”.

Another Western “solution” to psoriasis is immune-suppressing drugs. I regularly see TV ads for these drugs, promising to help with “moderate to severe plaque psoriasis” as the ad always seems to say. These drugs increase your risk for cancer and catching nasty bugs like Tuberculosis. Hmm, thanks but no thanks – I’ll take my chances with psoriasis.  

And so, I had no choice but to do my own research. I began reading about Candida albicans (colloquially known as just “Candida”). In my research, I learned that Candida is a fungus that normally exists in our intestinal microbiome. However, taking antibiotics can cause large disruptions in your microbiome, as they indiscriminately kill off both disease-causing transient bugs but also healthy bugs that have been with you for a lifetime (and may even go generations back). This disruption in your microbiome ultimately leaves you vulnerable to whole host of new acute or chronic health problems. I’ve taken numerous courses of antibiotics in my American life – likely taking a huge toll the little health-giving microorganisms that I depend on in my large intestine. My best guess is that the last round of antibiotics I took to save my kidneys did a big number on my microbiome, allowing the naturally occurring Candida in my intestines to grow totally out of control. (Although, totally love my kidneys – no arguments there.) 

Candida is a fungal yeast that produces several toxins, which are difficult for your body to remove. One of the toxins Candida makes is acetaldehyde, which is a highly toxic carcinogen that is hard on your liver. Another such toxin Candida produces is called candidalysin. Candidlysin directly damages the epithelium – which is the outer protective layer of tissue on body surfaces, including the lining your intestines – and makes it more permeable. In the intestines, this contributes to intestinal permeability, also known as leaky gut. Yet another toxin generated is called gliotoxin, which has been shown to suppress the immune system, preventing your body from being able to fight off the Candida and protect itself. 

It appears that the link between Candida and psoriasis is finally beginning to be researched – recent research is finding higher rates of Candida on the skin and in the mouths and also in the stools and saliva of psoriasis sufferers. How to best handle this imbalance of the microbiome, however, is an even greater challenge than proving the psoriasis-Candida connection.

My next step is to meet with a gastroenterologist and request a stool sample be taken for a fungal culture to be performed, to hopefully determine once and for all if the levels of Candida albicans in my microbiome are higher than usual. I had asked the dermatologist during my recent visit if she would order a stool sample to test for Candida – she said she couldn’t do that. Why are we taught in Western medicine that the body isn’t connected to itself? But I digress. Wish me luck, and stay tuned for updates on my GI visit! 

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