117: Can A Strep Infection Trigger Psoriasis?

If you’ve ever wondered if an infection you had in the past potentially triggered your psoriasis, keep reading.

Today I am going to share with you all the research I’ve been doing on the Strep Infection-Psoriasis Connection!

It’s actually very fascinating and well documented for at least the past 50 years.

Since hidden infections fall on my list of 16 potential root causes that underlie chronic skin rash conditions like psoriasis, I’m sure you’ll find this as interesting as I do.

Let’s dive in!

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In this episode:

• How I became interested in Strep as a trigger for Psoriasis
• Types of psoriasis most commonly triggered
• Two most common types of strep infections that appear to be triggers
• Strain of strep most often implicated
• What can you do if you have hidden strep?

Quotes:

In one study, people with psoriasis were 10x more likely to get a sore throat over other people living in the same exact house!

Group A beta-hemolytic streptococcus is the most commonly identified as a trigger for guttate psoriasis.

Can A Strep Infection Trigger Psoriasis? (FULL TRANSCRIPT)

Welcome back to episode #117 of the Healthy Skin Show!

In today's episode, I want to share some research that I've been doing on whether a previous (or current) strep infection could trigger or worsen your psoriasis.

Before I dive into the nitty-gritty research, let me share with you an experience from one of my clients.

Janine came to me complaining of really awful guttate psoriasis. Her doctor had told her that it was probably triggered by a strep infection.

She never really thought about it again until I asked her if she had any infections in her health history that were of significance.

Because a number of psoriasis clients shared a similar experience. They noted that their psoriasis started after a strep infection or that strep infections seemed to worsen or exacerbate the intensity of their rashes.

It turns out that this connection between psoriasis and strep has actually been pretty well documented for at least the past 50 years or so.

Most of the research points strongly towards an association between strep infection and guttate psoriasis.(1,2) But there may also be a connection between strep and plaque psoriasis too!

How Likely Is It That Strep Triggered Your Psoriasis?

One thing was interestingly clear — a strep infection could be the straw that broke the camel’s back (as they say). Combined with other factors (like genes), it could be the trigger causing your immune system to essentially go haywire.(3)

One paper that I looked at said that “as many as 80% of patients with guttate psoriasis have clinical or laboratory evidence of streptococcal infection.”(4)

I found a study funded by the National Psoriasis Foundation that looked at 275 psoriatic patients in Iceland.(1)

The researchers noted that “75% of patients who had been diagnosed with strep throat experienced worsening of their psoriasis along with the strep. This group included 72% of plaque psoriasis patients and 94% of patients with guttate psoriasis.”(1)

Other studies have also noted this interesting incidence of people who have this strep-psoriasis connection.

One paper that I looked at a whole bunch of different studies and reported that strep was found anywhere from 56% all the way up to 97% of those with guttate psoriasis.(5)

It was noted that “a relationship between streptococci and chronic plaque psoriasis was also proposed in a prospective 2003 study in which people with psoriasis reported a sore throat 10 times more than controls in the same household.”(5)

Types of Strep Infections To Watch Out For

There seem to be two very common types of strep infections that most literature points towards as a trigger:(2,6)

1. strep throat infection
2. perianal strep infection

It’s also possible to get a genitourinary strep infection.

The CDC notes on their website that this particular form of strep, which I'll discuss in a moment, can also cause illnesses such as Scarlet fever, Type II necrotizing fasciitis and acute rheumatic fever.(7)

I was looking at other studies again on this particular type of strep and it can cause pneumonia, and infections of the skin, soft tissue, and even the lymphatic system.(8)

My point here isn’t to scare you, but to help jog your memory.

At the end of the day, you know your medical history best as far as what you've been exposed to and what infections you've had.

I always encourage clients to dig through their history and think about previous infections (even dating back to being a young child).

Have you had strep? 

Have you had something in the past that you forgot about or wrote off?

This could be an important part of figuring out what's underlying or what triggered your rashes.

What Kind Of Strep Can Trigger Psoriasis?

When I talk about strep in this particular instance, what the research is looking at specifically is streptococcus pyogenes, which is a gram-positive bacteria.

So if we drill down even deeper, this particular form of strep, group A beta-hemolytic streptococcus, is the most commonly identified as a trigger.(9)

There are other types of beta-hemolytic strep that have been identified as triggers including groups C and G.(2,4,9)

Here’s a really simplified explanation of what happens…

You get a strep infection.

To defend itself, your body mounts a response and builds anti-streptococcal antibodies.(9)

These antibodies have been found in people who have guttate psoriasis along with elevated anti-streptococcal M6 protein.(10)

This is a natural response intended to protect you from strep, but in some people, this whole process goes sideways.

In no way am I implying nor even saying that every strep infection will automatically trigger psoriasis in everyone.

That’s clearly NOT the case.

But for those who have the right combo of factors (genes are also likely a piece of the puzzle), a strep infection could end up being the final straw that leads to psoriasis.

Obviously more research needs to be done, but nonetheless, this is all really fascinating!

Options To Deal With Strep + Psoriasis

So what's the best solution here?

At the end of the day, that's really what this is all about, right?

Step number one would be to review your own health history.

Find out if you've had any strep infections. Perhaps you had something as a kid that correlated with the onset of your psoriasis.

Or maybe you struggled with a lot of strep infections over the course of your life or since you've gotten psoriasis.

Heck… ask your mom if she remembers if you ever got strep as a young child.

Step number two, I would recommend that you speak with your doctor or practitioner.

This way you can get the appropriate testing!

I’ve had some clients test positive for beta-hemolytic strep in their urine and get diagnosed with a UTI by their doctor — some with and others without symptoms.

All of the research that I looked at seemed to indicate that if you address some of the strep problem, you might see an improvement in your psoriasis.

I'm not saying full resolution because I didn't see that anywhere in any of the literature that I read.

But some of the research papers indicated the potential for improvement and that could really be helpful depending on how bad things are for you, where you are right now.

The two options in published research were:

1. Get your tonsils removed if strep is found to be hiding in them (which I don't think anyone necessarily wants)
2. Antibiotics to address the infection

The study funded by the National Psoriasis Association that I shared earlier noted that “48 percent of patients who had their tonsils out after getting psoriasis reported that their psoriasis got better.”(1)

That’s why you need to discuss the options with your doctor so that you can find out what’s going on and determine the best way forward based on your own health values.

I have to admit that I felt like a kid in a candy store digging through all of this information. There were so many studies to look at!

I did my best to pull the ones together that would help show you where I really found interesting information, but there is a heck of a lot more out there. (Remember that the references are listed below and notated within this post.)

If you have any questions or experiences with Strep infections, comment below! 

I would love to know if you were told that your psoriasis was triggered by strep or if you've had some experience with strep infections in the past, but never really connected the two before.

Before you head off. I would really appreciate it if you would share this with someone you know who is seeking information to better understand their psoriasis.

By sharing information, we educate our fellow skin rash warriors so that together we can ask better questions and hopefully get better results.

Thank you so much for tuning in and I look forward to seeing you in the next episode!

REFERENCES

1. https://www.psoriasis.org/advance/sore-throats-can-make-plaque-psoriasis-worse-npf-funded-study-finds
2. https://www.contemporarypediatrics.com/pharmacy/streptococcal-infection-trigger-psoriasis
3. https://jmg.bmj.com/content/39/10/767
4. https://www.medscape.com/answers/1107850-103351/what-is-the-role-of-streptococcal-infection-in-the-etiology-of-guttate-psoriasis
5. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011571/full
6. https://medlineplus.gov/ency/article/000822.htm
7. https://www.cdc.gov/groupastrep/diseases-public/index.html
8. https://www.ncbi.nlm.nih.gov/pubmed/9745311
9. https://emedicine.medscape.com/article/1107850-overview#a5
10. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1346-8138.2005.tb00723.x