6 Common Triggers of Psoriasis Flares

Identifying triggers is the first step to avoiding them

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Psoriasis is a chronic autoimmune disorder characterized by the spontaneous appearance or worsening of symptoms, known as flares, followed by periods of remission. The cause of flares is poorly understood but is believed to occur when a sudden rise in inflammation, either local or systemic, reactivates the autoimmune response.

When this happens, the immune system will release inflammatory compounds, called cytokines, as if an actual infection occurred. The ensuing inflammation is what causes the outbreak of symptoms (primarily skin lesions known as plaques).

As frustrating as psoriasis can be, identifying and avoiding common triggers can significantly reduce your risk of flares. Here are 6 you should know about:

Skin Trauma

An injury to the skin can sometimes cause the reactivation of psoriasis symptoms. Known as the Koebner response, the phenomenon occurs not only with psoriasis but other diseases like juvenile idiopathic arthritis, lichen planus, and vitiligo. Generally speaking, it can take anywhere from 10 days to two weeks for psoriasis symptoms to develop after the skin trauma.

Skin conditions that can trigger a psoriatic flare include:

  • Cuts and abrasions
  • Bruises
  • Friction from clothing
  • Vigorous scratching or shaving
  • Sunburn
  • Insect bites
  • Poison ivy or poison oak
  • Drug rash
  • Food allergies
  • Tattoos or piercings

To reduce your risk, treat any and all skin injuries immediately. Avoid scratching bites or rashes, using a topical ointment if needed to reduce itchiness. If outdoors, use an anti-bug spray or sunscreen.

Weather

Weather is a major factor in psoriasis flares. On the one hand, ultraviolet (UV) radiation from the sun can help ease symptoms as long as you avoid overexposure. On the other hand, overexposure and sunburn can trigger a flare. Even extreme humidity or hot baths can be problematic.

Extreme dry, cold temperatures are also a common trigger for psoriasis, making the disease all the more difficult to manage in winter months.

To avoid weather-induced flares:

  • Limit showers and baths to 10 minutes
  • Use warm rather than hot water when bathing
  • Use a moisturizer to avoid skin dryness
  • Stay warm and bundle up in cold weather
  • Remove wet clothing and shoes when coming in from the cold

Stress

Stress is known to be a known trigger for psoriatic flares. Scientists are not sure why this is but theorize that the release of cortisol during stress increases systemic (whole-body) inflammation as well as body temperature, both of which act as independent triggers.

Stress has both a cause-and-effect relationship to psoriasis. On the one hand, stress trigger psoriasis symptoms. On the other, the appearance of unsightly lesions can induce stress, perpetuating psoriasis symptoms.

According to a 2014 review of studies from Europe, no less than 50 percent of people with psoriasis report that stress is a major disease trigger.

Routine exercise is one of the more effective ways to control stress. Mind-body therapies, such as meditation, yoga, guided imagery, and progressive muscle relaxation (PMR), can also help. If unable to cope, considering seeing a therapist or psychiatrist who can provide you the tools to better control your emotions.

Infection

Infections caused by a bacteria or virus are common causes of psoriasis flares. Certainly, at the front of the list are bacterial infections like strep throat and impetigo. Common viral causes include colds, influenza, mumps, and chickenpox.

Infection-induced flares are more common in children than adults, leading to a form of the disease known as guttate psoriasis.

HIV is another trigger that can induce psoriasis symptoms. While HIV doesn't increase the frequency of psoriasis, it can significantly increase the severity of outbreaks.

The best way to avoid flares is to treat any infection immediately. If you have HIV, starting HIV therapy can reduce the inflammation that drives acute flares.

Smoking and Drinking

Both smoking and drinking place undue stress on the body. If struggling to manage your psoriasis symptoms, these are two modifiable risk factors you can readily address.

According to a 2016 report in the journal Psoriasis, smoking not only doubles your risk of getting psoriasis but increases the severity and frequency of flares if you have it.

Smoking instigates immediate inflammation while constricting blood vessels throughout the body. To make matters worse, the risk of flares increases with the number of cigarettes you smoke per day.

With alcohol, the type of beverage you drink can play a part. According to a 2010 study in the Archives of Dermatology non-light beer was more closely linked to psoriasis symptoms than either light beer, wine, or liquor. Heavy drinkers also appear to be a greater risk.

To avoid psoriatic flares, the best thing to do is quit. This is especially true with smoking. With respect to alcohol, switch from beer to a light beer or wine if struggling with symptoms and reduce your intake to no more than two or three drinks per day.

Medications

There are quite a few drugs known to induce or worsen psoriasis symptoms. Theoretically, any drug has the potential to induce flare, but there some more likely to do so. These include:

Corticosteroids sometimes used to treat psoriasis pose a serious risk if stopped abruptly. If this occurs, psoriasis symptoms can rebound, sometimes severely. To avoid this, corticosteroids may need to be tapered off gradually under the direction of a doctor if they are no longer needed.

The best way to avoid drug-induced flares is to let your rheumatologist know about any and all drugs you are taking, whether they are prescription, over-the-counter, nutritional, or recreational.

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