UK psoriasis patients are putting their health at risk by seeking unverified dietary advice on social media, researchers warn

UK adults with psoriasis may be compromising their health and risking exacerbating their skin condition by seeking unverified dietary advice on social media, Herts researchers have warned.

An analysis of Instagram posts relating to psoriasis has shown a majority were promoting restrictive diets or detox approaches, none of which were backed by qualified nutrition professionals.

More than 99% of the posts providing dietary recommendations for psoriasis were rated as “low” quality by the researchers and the most common content creators were those with lived experience of psoriasis (29.7%).

Only 6.5% of the posts - rated as “moderate” quality by researchers - were created by healthcare professionals, mainly dermatologists.

The researchers said the findings, published in the Journal of Human Nutrition and Dietetics, raise concerns about the quality and credibility of dietary advice available to people living with psoriasis.

Dr Poppy Hawkins, Lecturer in Nutrition and Dietetics at the University of Hertfordshire’s School of Health, Medicine and Life Sciences, said: “Our findings show that people with psoriasis are frequently exposed to misleading dietary advice on social media.

“There is a clear need for larger and more robust studies on diet and psoriasis before specific dietary guidelines for this population can be made, but in the meantime, healthcare professionals need to be equipped to provide appropriate, reliable and evidence-based dietary advice and combat the common dietary misinformation promoted online.”

Psoriasis is a chronic immune-mediated condition affecting 1.1 million people in the UK and 60 million worldwide. It primarily affects the skin, causing patches of red, inflamed skin covered with silvery scales.

The condition is associated with other co-existing conditions, including cardiovascular disease and depression, and can significantly impact an individual's mental and physical wellbeing.

Psoriasis is typically managed with medical treatments, but many individuals adopt restrictive diets - such as dairy-free, gluten-free, or “cleansing” regimens - in hope of reducing symptoms, often based on conflicting, poor-quality information.

Dr Hawkins said: “There is a high demand for information on diet from both healthcare professionals and people living with psoriasis yet there aren’t any dietary guidelines to support those living with the condition and many are turning unverified online sources for guidance.”

To find out more, the researchers analysed 138 Instagram posts with psoriasis related hashtags providing dietary advice.

The most common type of dietary recommendation was ‘exclusion’, most frequently of alcohol and dairy.

Detox and ‘clean eating’ were also frequently mentioned, with some posts recommending a blanket elimination of multiple foods, such as dairy, gluten, red meat, and nightshades, all at once.

One Instagram post said: "Both internal and external cleansing and detoxification are the only lines of treatment for psoriasis... Strict food restriction has to be followed for a speedy & effective cure."

Dr Hawkins said some of these restrictive diets, if followed together, can lead to significant nutritional deficiencies.

She said: “In particular, individuals who avoid eggs, dairy and meat on a long-term basis, without substituting with appropriate plant-based alternatives, could be at risk of vitamin B12 deficiency. Dairy is also an important source of iodine and calcium while red meat can be an important source of iron. And following a gluten-free diet without the guidance of a healthcare professional can result in lower fibre intake.

“While dietary restrictions can be managed nutritionally, there was little information provided on the posts on key nutrients that individuals may be lacking when following such diets. Additionally, the evidence base for their effectiveness in managing psoriasis specifically is limited or non-existent, making clear guidance and information even more important.”

Dr Hawkins noted that although there is scientific evidence supporting weight loss in reducing psoriasis symptoms for individuals with obesity, most Instagram posts failed to clarify this, potentially encouraging harmful dieting among those at a healthy weight.

The findings are supported by a companion study led by Dr Hawkins and published in the journal BMJ Open, which revealed psoriasis patients living in the UK are relying on social media and online forums for dietary information.

The qualitative study, which involved in-depth interviews with nine patients, showed most of them believed diet played a role in managing symptoms. However, the researchers found those who had experimented with restrictive eating reported little improvement.

One participant shared their frustration with the overwhelming and conflicting information they encountered online, stating: “There are too many websites and too many pages with too many different conflicting things on and I get mind boggled [......] one will say, don’t eat that and then one will say, do eat that.”

The study also found that the lack of reliable dietary guidance from healthcare professionals left participants feeling unsupported and uncertain.

Dr Rosalind Fallaize, Associate Professor in Research, Registered Dietitian, and lead investigator of the study at the University of Hertfordshire’s School of Health, Medicine and Life Sciences, said: “Our study highlights a critical gap in the healthcare support available to people living with psoriasis.

“Many patients are turning to online sources for dietary advice, but without reliable, evidence-based guidance, they risk exacerbating their condition or compromising their health.

“It’s essential that healthcare professionals are equipped to provide fundamental dietary support tailored to the needs of psoriasis patients.”

As part of the next steps, the researchers aim to build on their work and develop tools to help people living with psoriasis navigate conflicting dietary misinformation online.

The University has recently launched its Clearing webpages, offering prospective students the chance to explore a wide range of courses, including dietetics, nutrition and public health.