How the Pagano Diet May Help Heal Psoriasis

Psoriasis affects over 8 million Americans, causing painful, itchy, scaly skin due to immune system dysfunction and chronic inflammation. While the go-to treatments often involve topical medications, phototherapy or immune-targeting injections, many people explore dietary changes to manage flare-ups. One such regimen gaining attention is the Pagano diet a plant-heavy meal plan aimed at reducing systemic inflammation and improving gut health.

But is it truly effective for healing psoriasis, or just another wellness trend? Here's what you should know before trying it.

What Is the Pagano Diet?

Created by chiropractor John Pagano, the diet is based on the premise that psoriasis stems from leaky gut syndrome, which supposedly allows “toxins” to pass through the intestinal wall into the bloodstream. Pagano believed the skin was simply the body’s way of eliminating these internal irritants.

Although the gut-skin connection is real the gut microbiome can influence immune responses experts say the notion of “toxins” causing psoriasis is oversimplified and unscientific. According to the National Psoriasis Foundation, psoriasis is best understood as an immune-mediated condition, not a reaction to dietary toxins.

Still, many patients turn to food as a complementary therapy. “Some people do report improvements in their symptoms with dietary changes, especially anti-inflammatory eating,” says Sharon Palmer, RDN, author of The Plant-Powered Diet.

What You Can and Can’t Eat on the Pagano Diet

Foods Emphasized

• Non-citrus fruits like apples, pears, and berries

• Vegetables (excluding nightshades)

• Wild-caught fish and lean poultry

• Brown or wild rice in moderation

• Eggs (no more than 4 per week)

• Plant oils such as olive, flaxseed, or sesame

• Herbal teas

Foods Avoided

• Red meat and shellfish

• Nightshade vegetables (e.g., tomatoes, peppers, eggplant, potatoes)

• Coffee and alcohol

• Gluten-containing grains

• Fried and highly processed foods

• Added sugars and artificial fats

The plan also encourages gut-friendly practices, such as consuming more fiber and avoiding known allergens. While the alkaline vs. acidic food categorization in the diet lacks scientific backing, the emphasis on whole, nutrient-rich ingredients is generally considered healthy.

The Science Behind the Diet

There’s currently no clinical research proving the Pagano diet cures or significantly improves psoriasis. But the general anti-inflammatory pattern mirrors other well-studied diets such as the Mediterranean and vegan diets which have shown promise in reducing psoriasis severity.

For example:

• A 2018 study in JAMA Dermatology found that those who adhered closely to a Mediterranean diet (rich in healthy fats, fruits, and vegetables) had milder psoriasis symptoms.

• People with psoriasis and a confirmed gluten sensitivity or celiac disease may experience relief from a gluten-free diet, per a 2020 meta-analysis in The Journal of the American Academy of Dermatology.

Still, dermatologists caution against assuming any diet including the Pagano diet will work for everyone. “There is no one-size-fits-all psoriasis diet,” says Marisa Garshick, MD, a board-certified dermatologist at MDCS Dermatology. “Individual factors like co-existing autoimmune conditions, food sensitivities, and overall inflammation matter.”

Pros of the Pagano Diet

1. It May Help Reduce Inflammation
The diet’s focus on antioxidant-rich produce and omega-3 fats from fish can support overall health and lower systemic inflammation, a key driver of psoriasis.

2. Supports Weight and Metabolic Health
People with psoriasis are at higher risk of cardiovascular disease, obesity, and metabolic syndrome, per the Cleveland Clinic. A nutrient-dense diet like Pagano’s may improve markers like blood sugar and cholesterol, which could indirectly ease symptoms.

3. May Help Those With Gluten Sensitivity
For the estimated 25% of psoriasis patients who also show antibodies to gluten, removing gluten may be beneficial especially for those diagnosed with celiac disease.

Cons of the Pagano Diet

1. There’s Little Scientific Evidence
While anecdotal reports are positive, no robust studies have validated the Pagano diet specifically for psoriasis relief.

2. It’s Highly Restrictive
Eliminating entire food groups (like nightshades, gluten, red meat and caffeine) may be unnecessary and difficult to maintain, especially without medical supervision. Over time, such restrictions can lead to nutrient deficiencies or disordered eating patterns.

3. May Not Address Underlying Causes
Psoriasis is driven by immune dysfunction and genetics not just diet. Relying on food alone could delay essential medical treatment.

Should You Try the Pagano Diet?

While the Pagano diet isn’t a magic bullet, it does encourage a mostly whole-food, plant-forward approach, which aligns with current dietary recommendations for reducing inflammation and supporting skin health.

If you're interested in experimenting with it, speak with a dermatologist or registered dietitian first, especially if you have other health conditions like diabetes or celiac disease. They can help you make adjustments without compromising nutrition or your long-term relationship with food.

The Bottom Line

There’s no cure-all for psoriasis, but healthy lifestyle habits including a nutrient-dense, anti-inflammatory diet may help ease symptoms and reduce flare-ups. The Pagano diet may be worth trying for some people, but it should be part of a broader, evidence-based treatment plan under medical supervision.

To stay informed about holistic health solutions and emerging wellness trends, subscribe to our newsletter.