What Causes Psoriasis Flare-Ups?

Psoriasis goes through cycles of improving and worsening symptoms. Sometimes psoriasis is well-controlled, but then suddenly becomes worse, leading to inflammation or new and painful lesions. These episodes are known as psoriasis flare-ups, or flares. They can make living with the disease particularly frustrating and unpredictable.

While it may not be possible to eliminate psoriasis flares completely, you can take steps to prevent them or reduce their impact by knowing your triggers. In this article, learn more about what causes psoriasis flare-ups.

What Is a Psoriasis Flare-Up?

A psoriasis flare-up is an acute episode of worsened psoriasis symptoms. For example, one day, a person may have minimal or no skin lesions and the next day wakes up with painful new lesions, plaques, or inflamed patches.

It is common to have a psoriasis flare-up, and the fluctuating nature of symptoms is one of the hallmarks of the disease. Knowing your triggers can help prevent or ease future flare-ups.

Symptoms

There are multiple different types of psoriasis and symptoms can vary between the different kinds. The most common type is plaque psoriasis, which accounts for around 80%–90% of cases.

Symptoms can include:

• Raised, scaly patches
• Itching
• Pain
• Cracking
• Dryness

These skin plaques can appear on any body part.

Other types of psoriasis include nail symptoms, such as crumbling, flaking, pitting, and separating. Some people with psoriasis also develop eye issues or psoriatic arthritis.

What Triggers a Psoriasis Flare-Up?

Stress

Stress is one of the main causes of a psoriasis flare-up. When you are stressed, your body is triggered to release chemicals that start the inflammatory psoriasis process.

There are many different kinds of stress, including financial, professional, emotional, and physical.

You might be stressed due to a busy work or school schedule, approaching deadlines, or worrying about paying the bills. A relationship breakup, grief, or simply being overwhelmed by the demands of daily life can all cause emotional stress. Injury or illness can create physical stress.

It's impossible to eliminate stress in life, but you can try to reduce your stress and learn techniques to cope with it when it undoubtedly happens. Tools for managing stress include:

• Join a psoriasis support group.
• Practice yoga and meditation.
• Try deep breathing.
• List things you are grateful for.
• Write in a journal.
• Stay engaged in meaningful hobbies.

Smoking

Smoking, or even being around people who smoke, is another common psoriasis trigger. A wide body of research has found that smoking not only makes you more likely to develop psoriasis but can also make psoriasis more severe.

If you smoke and have psoriasis, talk to your healthcare provider about options for quitting. Be sure to consult them before using nicotine patches or other topical treatments that could affect your skin.

Drinking Alcohol

Research has not confirmed that drinking alcohol can cause psoriasis. However, research does show that people with psoriasis drink more alcohol than the general public. Alcohol can also interact with certain psoriasis medications and make them less effective.

If you have psoriasis and drink alcohol, be honest with your healthcare provider about how often and how much you drink. They will review your medications and advise on any interactions. You may also want to consider quitting alcohol or reducing the amount you drink.

Skin Injury

Injury to the skin, like a cut, sunburn, piercing, or bug bite, can alert the immune system and start an inflammatory process that may lead to a psoriasis flare. This is such a common psoriasis trigger that it has its own name: the Koebner phenomenon.

Medication

Certain medications can also cause a psoriasis flare-up. It's important for you and your healthcare provider to be aware of this when treating any co-occurring conditions.

Medications that can be potential psoriasis triggers include:

• Beta-blockers
• Lithium
• Antimalarials (including chloroquine, interferons, imiquimod, and terbinafine)
• Angiotensin-converting enzyme (ACE) inhibitors
• Tumor necrosis factor (TNF) alpha antagonists
• Monoclonal antibodies
• Potent topical corticosteroids (rebound effect)
• Rapid treatment or withdrawal from oral corticosteroids

Weather

Weather patterns can lead to psoriasis flare-ups in different ways, so it's important to be aware and prepared.

Hot weather can cause psoriasis flares. This is not necessarily because of the temperature itself but rather due to factors such as an increased risk of getting a sunburn or having to spend additional time in air-conditioning, which can dry out your skin.

Very dry or cold weather can also lead to psoriasis flares. Be sure to keep your skin moisturized, follow your treatment plan, and consider using a humidifier.

Allergies

There is no scientific evidence to suggest that seasonal allergies or an allergic reaction can trigger psoriasis flares. However, there is anecdotal evidence of people with psoriasis who report allergies as a trigger.

Both psoriasis and allergies are mediated by the immune system, so it's plausible that the two are linked in some way. Know your allergies and do your best to avoid allergy triggers.

How to Manage Psoriasis Flares

If you feel like your psoriasis is flaring out of nowhere, it might be helpful to keep a journal to track symptoms and possible triggers. Consider the common psoriasis triggers mentioned in this article. Something as simple as a stressful day at work or a shaving cut could lead to a psoriasis flare. Some people also choose to track factors like their sleep, diet, and hormonal changes.

Knowing your psoriasis triggers can help you avoid them and thereby manage your psoriasis flares. Be consistent with your prescribed treatment, even if your psoriasis is in remission.

When to See Your Healthcare Provider

Talk to your healthcare provider if you are having trouble managing your psoriasis flares, or feel like your flares are unpredictable and impacting your life. Your healthcare provider can adjust your treatment, as well as help identify any possible triggers.

Summary

Psoriasis is an autoimmune skin disease characterized by inflamed, flaky skin patches. Psoriasis can flare up, meaning symptoms become worse as a result of certain triggers.

Common triggers of psoriasis flares include stress, skin injury, smoking, hot or dry weather, certain medications, and alcohol. Knowing your triggers and doing your best to avoid them can help you manage psoriasis flares.

A Word From Verywell

Psoriasis can flare up unexpectedly. For many people, this is the most frustrating part of the disease. Nobody should have to live in a state of constant uncertainty. Unfortunately, life can sometimes feel that way with psoriasis. Identifying your personal psoriasis triggers is an important step in managing your symptoms and preventing future flares.