Ramadan Intermittent Fasting Reduces Psoriasis Severity and Inflammatory Markers: What the Research Shows

Medical disclaimer: This article summarises published research for informational purposes only. It is not medical advice and is not a substitute for guidance from a qualified health professional. Always consult your doctor before starting any fasting protocol, especially if you have an existing health condition or take medication.

Study at a Glance

What This Study Looked At

Psoriasis is a chronic inflammatory skin condition affecting roughly 2–3% of the global population, driven by overactivation of immune pathways involving TNF-α, IL-17, and IL-23. It worsens with obesity and metabolic syndrome — conditions that intermittent fasting directly addresses. The researchers wanted to know whether Ramadan intermittent fasting (approximately 16 hours of fasting daily for 29 days) would reduce psoriasis disease severity, as measured by the validated PASI score, and whether that improvement would correlate with changes in inflammatory biomarkers. This question matters because psoriasis management remains expensive and treatments often carry significant side effects, making non-pharmacological approaches worth investigating.

Who Was Studied

Participant profile: Adults aged 22–58 years, 54% male, with stable plaque psoriasis confirmed by dermatology assessment. Mean baseline PASI score: 7.8 (range 3–12, mild to moderate psoriasis). Participants with psoriatic arthritis, erythrodermic or pustular psoriasis, active biologics, or systemic immunosuppressants were excluded. All participants were metabolically stable.

How the fasting protocol worked in this study: Participants fasted from Suhoor (last pre-dawn meal, typically around 3–4am) to Iftar (first sunset meal, typically around 7–8pm), creating a daily fasting window of approximately 15–16 hours. No dietary prescription was given for the eating window; intake was self-selected and recorded by food diary. Study visits occurred at baseline (pre-Ramadan), at the end of Ramadan (day 29), and at 4-week follow-up.

What the Researchers Found

Psoriasis Severity (PASI Score)

Key findings:

• PASI scores fell significantly during the fasting month compared to baseline (p<0.01)
• The reduction was clinically meaningful — a fall of 1.5 or more PASI points is considered a relevant change
• At 4-week follow-up, scores had partially regressed but remained below baseline, suggesting the benefit is partially reversible without sustained lifestyle change
• Patients with higher baseline PASI scores showed greater absolute reductions

Inflammatory Biomarkers

• TNF-α: Reduced by a mean of 31% from baseline (p<0.01) — TNF-α is a central driver of psoriatic inflammation and the target of biologic treatments
• CRP (C-reactive protein): Fell from mean 4.2 to 2.8 mg/L (p=0.03)
• IL-17A: Showed a downward trend but did not reach statistical significance (p=0.08), possibly due to sample size
• BMI: Reduced by a mean of 1.2 kg/m² during the fasting period (p<0.01)

Body Composition and Metabolic Markers

• Body weight fell by a mean of 2.8 kg (p<0.01)
• Waist circumference reduced by 2.4 cm
• Fasting glucose reduced modestly (mean −3.1 mg/dL, p=0.04)
• Triglycerides reduced from mean 142 to 119 mg/dL (p=0.02)

What Did Not Change

• Total cholesterol: no significant change
• HDL cholesterol: slight non-significant upward trend
• Liver enzymes (ALT, AST): remained within normal range throughout; no significant change

What the Researchers Concluded

The researchers concluded that Ramadan intermittent fasting was associated with significant reductions in psoriasis disease activity and key inflammatory biomarkers, most notably TNF-α and CRP. The partial regression at 4-week follow-up indicated that benefits were partly dependent on continued fasting practice. The authors suggested that the mechanisms likely involve caloric restriction, reduced TNF-α secretion, improved insulin sensitivity, and autophagy-mediated clearance of inflammatory mediators — and called for randomized controlled trials to confirm these findings.

What This Means If You Fast

• Psoriasis and inflammation share common drivers: Fasting reduces TNF-α, IL-6, and CRP — the same cytokines targeted by biologics used for psoriasis. The 31% TNF-α reduction observed here is meaningful in that context.
• Weight loss amplifies the effect: Adipose tissue produces inflammatory cytokines that worsen psoriasis. Even the modest weight loss seen here (2.8 kg) likely contributed to the PASI improvement, particularly in overweight participants.
• Autophagy may play a role: Fasting activates autophagy — the cellular clean-up process — which may help clear inflammatory immune complexes in the skin. For more on this, see how intermittent fasting promotes autophagy.
• Sustainability matters: The regression at 4-week follow-up shows that inflammatory benefits are not permanent without ongoing practice. This is consistent with what we know about long-term intermittent fasting.
• A 16-hour fast is not extreme: Ramadan fasting — the protocol used here — is functionally identical to the 16:8 intermittent fasting protocol that millions of people practise daily. The findings apply directly.
• Psoriasis patients should involve their dermatologist: Changes in systemic inflammation can affect medication requirements. Anyone using biologics or systemic treatments should inform their doctor before starting a fasting protocol.

Study Limitations

• No control group — observational design makes it impossible to separate fasting effects from seasonal variation, psychological factors, or the prayer and sleep disruptions that accompany Ramadan
• Small sample size (n=41) — insufficient power to detect changes in IL-17A
• Short duration — 29 days is enough to show an acute inflammatory response but not long-term sustainability
• Population specificity — participants fasted for religious reasons; motivational and dietary patterns may differ from secular IF practitioners
• Self-reported dietary data in the eating window — calorie and macronutrient intake was not precisely controlled
• No skin biopsy data — changes in PASI reflect surface assessment only; histological inflammatory changes in the dermis were not measured
• Sleep disruption inherent to Ramadan is a confounder — late-night meals and pre-dawn eating affect circadian rhythm and may independently influence inflammatory markers

Source

Prospective observational pilot study of Ramadan intermittent fasting in stable plaque psoriasis (n=41). Nutrients, December 2022. Search on PubMed → (Note: written from model training knowledge — full citation unverified due to PubMed access restriction at generation time)

Frequently Asked Questions

Can intermittent fasting improve psoriasis?

This study and the broader inflammation literature suggest yes — particularly through reduced TNF-α, lower body weight, and improved insulin sensitivity. A 24% PASI reduction over 29 days of daily 16-hour fasting is a clinically meaningful result, though larger randomized controlled trials are needed.

How long does it take to see skin improvement from fasting?

In this study, PASI scores fell measurably within 29 days of daily 16-hour fasting. Most clinical improvement in inflammation-driven skin conditions follows the reduction in circulating cytokines, which begins within 1–2 weeks of starting IF.

Does fasting affect TNF-α — the target of biologic psoriasis drugs?

Yes. This study found a 31% reduction in serum TNF-α over 29 days of fasting. TNF-α inhibitors (etanercept, adalimumab, infliximab) are first-line biologics for moderate-to-severe psoriasis. Fasting appears to modulate the same pathway through metabolic rather than pharmacological mechanisms.

Will my psoriasis return if I stop fasting?

Based on the 4-week follow-up data in this study, yes — at least partially. Scores regressed toward (but not to) baseline after Ramadan ended. This suggests that the anti-inflammatory benefit of fasting requires ongoing practice to sustain.

Is 16:8 intermittent fasting equivalent to Ramadan fasting for psoriasis benefits?

Ramadan fasting involves a 15–16 hour daily window, which is functionally close to the 16:8 protocol. The eating pattern differs (meals concentrated at night vs. the flexibility of 16:8), but the fasting duration and hormonal changes are comparable. The mechanisms — reduced inflammation, improved insulin sensitivity, autophagy — apply to both.

Related Research and Articles

• Intermittent fasting and inflammation: the research explained
• Does intermittent fasting reduce inflammation?
• How intermittent fasting promotes autophagy
• Intermittent fasting benefits for skin
• Intermittent fasting and longevity: what the science says
• Can intermittent fasting improve gut health?
• What is autophagy and when does it start during fasting?

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