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)
- strep throat infection
- 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:
- Get your tonsils removed if strep is found to be hiding in them (which I don't think anyone necessarily wants)
- 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
- https://www.psoriasis.org/advance/sore-throats-can-make-plaque-psoriasis-worse-npf-funded-study-finds
- https://www.contemporarypediatrics.com/pharmacy/streptococcal-infection-trigger-psoriasis
- https://jmg.bmj.com/content/39/10/767
- https://www.medscape.com/answers/1107850-103351/what-is-the-role-of-streptococcal-infection-in-the-etiology-of-guttate-psoriasis
- https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011571/full
- https://medlineplus.gov/ency/article/000822.htm
- https://www.cdc.gov/groupastrep/diseases-public/index.html
- https://www.ncbi.nlm.nih.gov/pubmed/9745311
- https://emedicine.medscape.com/article/1107850-overview#a5
- https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1346-8138.2005.tb00723.x
I had my tonsils out 25 years ago as the dr said it would improve my psoriasis, BUT you can still get strep without tonsils … so it didn’t help… maybe not as many sore throats
Do you still get strep infections now?
I had guttate psoriasis really bad a few years ago and it was all over. I went finally to a dermatologist and it was from strep. It eventually went away. So fast forward to Christmas of this year I got strep again and a few spots came back and I got psoriasis all over my hands and feet.
My husband who is 70 years old now
Has moderate to severe psoriasis since 1987, 2 weeks after untreated strep.
Since the fever, pus and pain in tonsils resolved, he was not treated for strep at that time since the provider did not realize the association.
Most dermatologists also did not believe the correlation.
He does not want the risk of tonsillectomy at this advanced age.
Any other recommendations to eradicate it?
There certainly maybe, but it’s best to discuss that with your practitioner so that the options are tailored to your husband’s specific issues. I’m certainly planning on doing a follow up with research on more natural options as well.
thank you for this podcast, jennifer! i have known about the connection between my psoriasis and strep for a long while now, and it’s good to hear it confirmed by research. i have a history of strep from when i was a kid, and a history of guttate psoriasis from when i was a kid, as well. although, as a child it was much more mild than as an adult. i learned of the connection after a particularly bad outbreak of psoriasis which coincided with a case of strep. oddly, the doctors presumed that the “rash” i had was in response to penicillin, and therefore have marked my medical records with an allergy to penicillin! when i go to the doctor now, i always have to say i question that particular note in my record. i don’t recall whether i read about the connection between psoriasis and strep (in a book called natural healing for psoriasis, which really helped me regain clear skin, and i highly recommend) or whether i learned about it from my dermatologist, who correctly diagnosed the post strep “rash”. but i am very careful to avoid people who may have strep, knowing the connection. i had just never thought about it from my whole history before. very interesting! thank you again for all you do, for all you share!
If you have strep, does that automatically mean you have SIBO or likely to?
Thanks
No, I’m not familiar with any connection between the two.
I have been suffering with psoriasis for 13 years after having an untreated strep infection. I have always considered the fact that the strep could have been what brought it out and this just confirms what I have always believed. I also had constant throat infections as a kid and had to have my tonsils out when I was 18 years old. I am constantly searching for natural ways of ridding myself of this horrible disease. May we all find the answers we need to obtain healthy skin again. Thank you for this podcast😊
Hi. Around 11 years old I got step multiple times in a year and also the pink liquid antibiotics to go with them. I got plaque psoriasis after. Never got strep again either. I have had it on my scalp and that’s it. I also got a swollen tonsil (not terrible but stayed a little bigger indefinitely) on my right side at about 21. I’m now 32. I am frightened of the tonsillectomy procedure but could be good if it helped. If that was a flare up of strep in my body. I have always wondered about this! Very interesting to read. Of course no Dr’s have made this connection at all.
Jennifer…please look into this further…..I have a strong anecdotal evidence that my 10 years if eczema symptoms were driven by staph aureus creating a biofilm. And the dermatologist administering antibiotics and steroids never really eliminated the symptom. I finally found a formula that has eradicated 95% of it….keep going….
Hi Cynthia, thanks for sharing… but in this case, we’re talking about Strep which is not the same as Staph.
My son had strep.. when he was about 5. The Dr. later said he got Psoriasis because of the combo of strep and antibiotics? He’s 28 now and still suffering from psoriasis….not sure what to do.
Have you checked out the other podcasts on psoriasis? Take a look here –> https://www.skinterrupt.com/?s=psoriasis
I’ve had two really bad bouts of guttate psoriasis from strep throat. The last one was two summers ago in 2017. It takes me about a year to clear up. The last time (2017), I took azithromycin (Z-pack) as my antibiotic to get rid of the strep. I was allergic to the antibiotic, so had a rash from head to toe – really bad. It all turned into psoriasis! Several things probably help in healing: I did a diet consisting of organic meats with lots of green veggies and nuts for a couple of weeks. Also take probiotics. Glutamine before meals building up to 10 grams 3x a day to total 30 grams a day. Do this for a month or so. This is all to help heal your gut. I also found a protocol that has been of benefit at: freedomfrompsoriasis.com. I hope this can help. It’s a rough time when you are going through it!
About 12 years ago my husband got strep throat. I caught the infection from him, but it migrated to my cheek and manifested as cellulitis. Half my face was swollen like the elephant man! I was treated for it, but several months later, got a strange red spot on my foot, then my knee. A dermatologist did a test and sent it to a lab, and told me it was definitely plaque psoriasis. The two plaques persisted for a few years, then magically disappeared. However, about 2 years ago, they reappeared again. Now wondering what to do. I definitely do not want to have my tonsils out.
Hi Lin, you don’t necessarily have to get your tonsils out. You might want to consider getting a stool test as it can pick up hidden strep (which I see quite a bit in Psoriasis cases) in the GI track. Hope that gives you more options!
Hi, I had plaque psoriasis on my left elbow for about 2 years, then in March 2020 within a few weeks my whole lower body was covered in psoriasis at the same time I had been unwell & yes stressed like everyone over the pandemic all I was told is it could be a number of factors But I was never tested for any possible underlying causes. They tried me on several types of topical creams which were unsuccessful then referred me to a dermatologist who diagnosed good heart psoriasis invert psoriasis and black psoriasis now on my scalp my face spots on my arms. I have been now attending light therapy three times a week and have had 20 treatments so far, it has made a difference the patches have reduced in scaling and the intense itching has now stopped. My concern is I had to stop treatment for two weeks due to getting burnt in the light therapy treatment and then my husband tested positive for Covid and by just missing two weeks I went back to even worse than I started you can only have 30 treatment on the NHS and if this doesn’t work they said I will have to start auto immune suppressant drugs! It has made me feel so low think when the light therapy stops I’m going to end up back where I was because they have not found the root cause 😌
Apologies gutate psoriasis, plaque psoriasis & invert psoriasis
Sadly, I had my tonsils removed at age 9 due to chronic throat infections. Then my allergies worsened, asthma started and finally psoriasis at age 18. I’ve never been diagnosed with strep. Any suggestions for plaque and guttate psoriasis that now covers my body? I’ve been doing AIP diet for the most part and I do all the supplements that are suggested such as vitamin D and probiotic.
Typically at that point, I’d suggest doing a comprehensive stool test to figure out what’s going on in the GI tract. Diet (and supplements) are really just 1 piece of the puzzle especially considering that Psorasis has the Inflammatory Bowel Disease connection.