Are triggers causing your psoriasis flare-ups?
If your psoriasis seems to flare for no reason, one or more triggers could be to blame. Everyday things like stress, a bug bite, and cold temperatures can trigger psoriasis.
Triggers vary from person to person. By finding your triggers and learning how to manage them, you can gain better control of your psoriasis and have fewer flares.
To find yours, you’ll have to do a bit of detective work. A good place to start is by looking at this chart of the common triggers, which also gives you signs that that it could be a trigger for you.
Common psoriasis triggers that can cause psoriasis flare-ups
Stress
Do you get flare-ups when you're feeling overwhelmed or stressed? Stress is a common trigger.
Reduce risk of flare-ups from stress
Find a way to manage your stress and practice it — even when you’re feeling okay. Common stress busters include yoga, meditation, and support groups.
Before going to sleep, write down 3 things that you’re grateful for. Do this daily.
When you start to feel stressed, take a deep breath, hold it, and exhale slowly.
Check out what board-certified dermatologist Alexa Boer Kimball, MD, MPH, FAAD, tells her patients to help them cope with stress.
Stress is a common trigger
Do you get flare-ups when you're feeling overwhelmed or stressed? Stress is a common trigger of a psoriasis flare-up.
Skin injury
If this triggers your psoriasis, you’ll get a flare-up near (or in the same spot as) the injury or bite. This happens about 10 to 14 days after you injure your skin.
Flare-ups happen after getting a cut, scrape, sunburn, scratch, outbreak of poison ivy, bruise, or bug bite.
Reduce the risk of flare-ups from a skin injury
If you injure your skin, treat it quickly.
If your skin itches, calm the itch.
Avoid scratching, which can trigger a flare.
Try to avoid getting bug bites by using insect repellent and staying indoors when bugs are most active. Bugs are most active at dusk and dawn.
Skin injury
Flare-ups happen after getting a cut, scrape, sunburn, scratch, outbreak of poison ivy, bruise, or bug bite.
Drinking frequently or in excess
If you drink daily or have more than 2 drinks in a day frequently, your treatment for psoriasis may have little or no effect. Even treatment that could be effective for you may not work and you’ll continue to have flare-ups.
Reduce the risk of flare-ups from drinking
Quit drinking.
If you continue to drink, limit how much you drink in a day. Women should stop after 1 drink. Men should limit themselves to 2 drinks per day.
Be sure to tell your dermatologist if you drink alcohol. Drinking can make it risky to take some psoriasis medications like methotrexate.
Drinking frequently or in excess
If you drink daily or have more than 2 drinks in a day frequently, your treatment for psoriasis may have little or no effect.
Smoking
Does your psoriasis flare unexpectedly? If you smoke or spend time with people who smoke, this could be the cause.
Reduce the risk of flare-ups from drinking
Stop smoking. Because this can be difficult, ask your dermatologist or primary care doctor for help.
Before trying a nicotine patch, ask your dermatologist whether using it could trigger your psoriasis.
Avoid being around people who are smoking.
Smoking
Does your psoriasis flare unexpectedly? If you smoke or spend time with people who smoke, this could be the cause.
Dry, cold weather
If your psoriasis worsens when the humidity or temperature drops, such as in the winter or fall, this is likely a trigger for you.
Reduce the risk of flare-ups from dry, cold weather
Treat your psoriasis.
Limit showers and baths to 10 minutes and use warm rather than hot water.
Immediately after bathing, slather on moisturizer, using a fragrance-free ointment or cream rather than a lotion.
Use a gentle, moisturizing cleanser instead of soap.
Apply moisturizer throughout the day when your skin feels dry.
Plug in a humidifier when the air in your home feels dry.
Stay warm and protect your skin from extreme weather when outside by wearing a hat, gloves, waterproof boots, and a winter jacket.
Sit far enough away from a fireplace, radiator, or other heat source so that you cannot feel the heat on your skin.
Remove wet clothes and footwear when you come in from the cold.
If your psoriasis continues to flare, see your dermatologist. Ask if phototherapy may be a treatment option for you in the winter.
Dry, cold weather
If your psoriasis worsens when the humidity or temperature drops, such as in the winter or fall, this is likely a trigger for you.
Sunshine, warm weather
During warm weather, psoriasis can flare if you:
Sunburn
Spend time in air conditioning
Reduce the risk of flare-ups during warm weather
If you spend time in air conditioning, apply moisturizer immediately after showering or getting out of a bath.
If your skin still feels dry from spending time in air conditioning, apply moisturizer throughout the day.
Avoid sunburn by wearing sunscreen. You want to apply sunscreen to skin that clothing doesn’t cover and is free of psoriasis. To get the protection you need, use sunscreen that offers broad-spectrum protection, SPF 30 or higher, and water resistance.
Sunshine, warm weather
During warm weather, psoriasis can flare if you get a sunburn or spend time in the air conditioning.
Infection
Psoriasis can flare 2 to 6 weeks after strep throat, an earache, bronchitis, or another infection. This is especially common in kids.
Reduce the risk of flare-ups due to infection
Treat the infection. This can lessen or clear the psoriasis.
Tell your dermatologist if you have an HIV (human immunodeficiency virus) infection, which can make some psoriasis treatments risky.
Infection
Psoriasis can flare 2 to 6 weeks after strep throat, an earache, bronchitis, or another infection. This is especially common in kids.
Medication
Some medications can cause a flare-up. If a medication is a trigger for you, you’ll flare 2 to 3 weeks after beginning a medication.
Reduce the risk of flare-ups from medication
If you think a medication is causing your psoriasis to flare, DON’T stop taking it. Ask the doctor who prescribed it whether the medicine could be causing your psoriasis to flare. If it could, ask if you could take another medication.
Before taking a medicine for the first time, ask the doctor prescribing it if the medicine could cause psoriasis to flare. Medicines that commonly trigger psoriasis include lithium, drugs taken to prevent malaria, strong corticosteroids like prednisone (if you quit taking it rapidly instead of stepping down), medicine that treats high blood pressure and problems with your heartbeat, some arthritis medications.
Medication
Some medications can cause a flare-up. If a medication is a trigger for you, you’ll flare 2 to 3 weeks after beginning a medication.
Tattoos and piercings
When you get a tattoo or piercing, you injure your skin. Any time you injure your skin, psoriasis can flare.
Reduce the risk of flare-ups from tattoos and piercings
Avoid tattoos and other types of body art if you have psoriasis.
If you want to get any type of body art, talk with your dermatologist first. Your dermatologist may be able to offer some tips that can reduce flare-ups.
Tattoos and piercings
When you get a tattoo or piercing, you injure your skin. Any time you injure your skin, psoriasis can flare.
Shaving
If you cut yourself while shaving, you may notice new psoriasis about 10 to 14 days later where you cut yourself.
Reduce your risk of flare-ups from shaving
Take care to avoid cutting yourself while shaving.
Dermatologists’ tip: To reduce cuts and nicks, try applying moisturizer and then shaving gel before you shave.
Shaving
If you cut yourself while shaving, you may notice new psoriasis about 10 to 14 days later where you cut yourself.
Images
References
Bergstrom, KG, Kimball AB. (2011) 100 questions & answers about psoriasis. Sudbury, Mass: Jones and Bartlett.
Marks, B. “More than skin deep: Triggers, treatments, and you.” An educational session hosted by the National Psoriasis Foundation. Chicago: Presented June 20, 2015.
Murzaku EC, Bronsnick T, et al. “Diet in dermatology Part II. Melanoma, chronic urticaria, and psoriasis.” J Am Acad Dermatol. 2015 Aug;73(2):353.