Psoriasis triggers: What you need to know

Symptoms of psoriasis can be uncomfortable, causing itchiness, pain, and plaques on the skin.

The World Health Organization (WHO) reports that nearly half of people who have psoriasis experience their symptoms as flare-ups. These are episodes of more severe symptoms that include thick, scaly, itchy plaques on the skin.

The triggers of a flare-up vary between individuals. By finding your psoriasis triggers, you may be able to manage your symptoms and predict possible flares.

Finding your triggers may take some effort. The following common psoriasis triggers may show you what could be a trigger for you:

• diet
• stress
• medications
• skin injuries, such as shaving or sunburn
• infection
• weather conditions
• smoking

Causes of psoriasis

Doctors are still unclear on why psoriasis develops in some people. However, there are two key factors they know are involved in causing psoriasis: genetics and a person’s immune system.

Genetics

Some people inherit genes that make them more predisposed to developing psoriasis. According to the National Psoriasis Foundation, if a parent has psoriasis, their child has around a 28% chance of developing the condition.

The genes that scientists think increase your risk of psoriasis cause changes to the function of the immune system.

The immune system

Psoriasis is an autoimmune condition that causes the body’s immune system to attack itself. With psoriasis, the white blood cells that attack and destroy invading bacteria to prevent disease mistakenly attack your skin cells.

This causes skin cells to rapidly overproduce. As a result, these skin cells pile up on the skin surface, causing the formation of the plaques people associate with psoriasis.

Triggers of psoriasis

While everyone’s triggers can be different, examples of common psoriasis triggers include the following:

Diet

While there’s no specific diet to help manage psoriasis, avoiding certain things may help you manage flare-ups.

A 2019 review notes that people with psoriasis are more likely to consume excessive amounts of alcohol than people without the condition. The review reports that from a sample of 95 people with psoriasis, almost one-third had elevated alcohol intake.

The same review concluded alcohol can increase inflammation levels, leading to the worsening of psoriasis symptoms and causing more frequent and severe flare-ups.

Food items that people report can worsen symptoms of psoriasis include:

• tomatoes
• eggplant
• potatoes
• white bread and pasta
• dairy products
• red meat
• high sugar foods
• fatty foods

Stress

Stress is a common psoriasis flare trigger. While stress is not enough on its own to cause psoriasis, it can induce a flare-up in people genetically more likely to develop the condition.

There are ways to manage stress and reduce the risk of bringing on a flare-up. Whenever you feel stressed, you might consider some of the following activities:

• yoga
• exercise
• meditation
• journaling
• slow, deep breathing

Medications

Certain medications may cause a psoriasis flare-up. Typically, a flare-up will happen 2–3 weeks after you start taking the medication.

Medications that people claim worsen their symptoms include:

• lithium
• antimalarial medications
• some blood pressure medications

If you think a psoriasis flare is the result of your medication, do not stop taking it. It is important to talk with the prescribing doctor about your symptoms. You and your doctor can work together to find a suitable alternative treatment.

Skin injury

If you have an injury to the skin’s surface, such as a cut, insect bite, or sunburn, it can often trigger a psoriasis flare around that area.

This can also happen after shaving, which can cause minor injury to the skin.

Ways to reduce the risk of a flare-up from a skin injury include:

• moisturizing the injury site to help it heal
• reducing the irritation if it starts to itch
• avoiding scratching
• wearing sunscreen to prevent sunburn
• using insect repellent to prevent insect bites

Weather conditions

Dry air, cold weather, or high humidity can often trigger psoriasis symptoms. If you notice your symptoms worsen at certain times of the year, these may be a trigger for you.

Ways to help manage seasonal psoriasis include:

• showering in warm — not hot — water
• using moisturizer
• removing wet clothes as soon as possible
• wearing warm clothes to protect your skin from the cold
• using a humidifier if the air feels dry in your home

Infections

When the body is fighting an infection, natural inflammation levels increase. This is how the immune system works. However, in people with psoriasis, this can trigger a flare-up. This is more common in children.

Treating the infection is the best way to manage this type of flare-up.

Smoking

Smoking can cause psoriasis flares. According to a 2020 review, smoking may also prevent your psoriasis treatment from working, particularly if you’re taking biologic medications.

If you smoke and you’re taking medication for psoriasis, your doctor may suggest stopping smoking during treatment.

Treatments

Most psoriasis treatments aim to do the following:

• soften and remove plaques
• slow the growth of skin cells
• reduce inflammation

There is no cure for psoriasis, but various treatments can help manage symptoms.

There are three main ways of treating psoriasis.

• Topical treatments: High strength ointments and creams can help reduce mild psoriasis symptoms. Some are available over the counter. They include:
  • corticosteroids like flurandrenolide
  • salicylic acid
  • coal tar
  • anthralin
  • retinoids
  • nonsteroidal treatments like calcipotriene (Calcitrene) and tazarotene (Tazorac)

• Systemic medications: When topical treatments are not enough, medications can help to treat severe psoriasis. Oral or injectable medications can help reduce inflammation or slow skin cell turnover. These include:
  • cyclosporine
  • apremilast (Otezla)
  • ibuprofen
  • oral retinoids
  • methotrexate
  • acitretin (Soriatane)
• Biologic medications: These can affect the entire immune system. They include:
  • etanercept (Enbrel)
  • golimumab (Simponi)
  • adalimumab (Humira)

• Light therapy: Phototherapy, or light therapy, uses ultraviolet light to slow the growth of skin cells.

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Summary

Psoriasis is a chronic skin condition with no cure. Certain triggers can make your symptoms worse. Healthcare professionals usually describe this as a flare-up. Triggers of flare-ups can include stress, certain medications, and infections.

Learning to recognize your triggers can help you manage symptoms and help prevent flare-ups. Various treatments are available to help you manage your symptoms when they worsen.

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