What Causes Psoriasis to Flare?

Most psoriasis sufferers know that the condition can flare and improve, sometimes seemingly for no reason. The unexpected nature of the flares can be particularly frustrating, you can be doing well one minute and then poorly the next. Certainly, not all flares can be predicted. Controlling the known triggers of psoriasis in your life, however, can help prevent some of them.

Woman scratching her elbow
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Stress

Stress is a common trigger of psoriasis. Emotional stress can come in many forms, including issues at your job, challenges at home like divorce or raising children, and anxiety about current events. Sometimes emotional stress is not just one thing but a collection of hectic issues that prevent you from relaxing.

Although not all stress can be prevented, taking some time every day to help control stress can help prevent flares of psoriasis. Exercise, including walking and dancing, healthy eating habits and meditation are all ways to reduce stress.

Physical stress on the body is also a common trigger. A major illness, surgery, or childbirth are all common causes of a psoriasis flare. Infections are particularly common sources of a flare-up, especially streptococcal infections like strep throat. See your healthcare provider for new symptoms to try to prevent a minor illness from becoming major and wreaking havoc with your psoriasis.

Medications

Medications for other health problems can cause unexpected flares of psoriasis. Whenever you are being prescribed a new medication, let your prescribing healthcare provider and pharmacist know that you have psoriasis. Never stop a medication without first consulting with the healthcare provider who prescribed it, since some medications can be dangerous if stopped suddenly.

  • Beta-blockers. These medications are commonly used to treat high blood pressure and certain heart problems. Their generic names usually end in the letters -lol, like atenolol, metoprolol, or propranolol.
  • Lithium. It is used for bipolar disorder and some other psychiatric problems.
  • Anti-malarials. Some older medications to treat malaria, like hydroxychloroquine (Plaquenil) cause psoriasis flares. These medications are not commonly used for malaria anymore but are sometimes used for lupus and related conditions.
  • Indomethacin. It is a non-steroidal pain medication that is sometimes used for sore joints, which may be a sign of psoriatic arthritis.
  • Oral steroids. Medications like prednisone and prednisolone can temporarily make psoriasis better but then cause flare-ups, sometimes severe, when they are finished.

Weather

Dry winter weather or travel to dry climates can cause psoriasis to flare up as the skin dries out and splits. Using a gentle soap to bathe (like Aveeno or Cerave Cleanser) can help. Be sure to moisturize the skin with a fragrance-free cream daily. Avoid the soaps in hotels which usually are very drying and have a heavy fragrance.

The sun typically makes psoriasis better, so traveling to darker and colder climates can also cause a flare. Too much sun can be a problem too, though, as sunburn can cause psoriasis to arise in the sites of the burn. Make sure to wear a hat and sunscreen with an SPF of 30 or higher when traveling to sunny climates.

Injury to the Skin

It has long been known that cutting or injuring the skin can cause a flare of psoriasis in the same spot. Dermatologists call this effect the “Koebner Phenomenon.” Psoriasis can often arise along the incision line after surgery or on the arms after a burn or bite wound. Protect yourself with long-sleeves and thick clothing when working in the yard or other places where minor injuries are common. When a minor injury does occur, clean the area with soap and water and then apply an antibiotic ointment and cover with a bandage until it heals. See your dermatologist for any wounds that are slow to heal or for signs of infection like unusual pain, heat, or redness around the wound.

Although these triggers are all common reasons for psoriasis to flare, others have been suggested by scientific evidence like smoking cigarettes, being overweight, and drinking too much alcohol. It is important to keep track of how your skin is doing so you can develop a list of your own psoriasis triggers. If you suspect something is triggering your psoriasis, be sure to discuss it with your healthcare provider to see if there are ways to control the trigger, or calm the flare-up.

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15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Academy of Dermatology Association. Are Triggers Causing Your Psoraiss Flare-Ups?

  2. National Psorasis Foundation. Causes & Triggers.

  3. Harvard School of Public Health. Stress and Health.

  4. National Psoriasis Foundation. Pregnancy and Breastfeeding.

  5. Cochrane. Does Treating Streptococcal throat infection help improve psoriasis?

  6. Awad VM, Sakhamuru S, Kambampati S, Wasim S, Malik BH. Mechanisms of beta-blocker induced psoriasis, and psoriasis de novo at the cellular level. Cureus. 2020;12(7). doi. 10.7759%2Fcureus.8964

  7. HMP Global Learning Network. An Unexpected Effect of Lithium in Causing, Sustaining, and Ameliorating Psoriasis.

  8. Gravani A, Gaitanis G, Zioga A, Bassukas ID. Synthetic antimalarial drugs and the triggering of psoriasis - do we need disease-specific guidelines for the management of patients with psoriasis at risk of malaria? Int J Dermatol. 2014;53(3):327-330. doi. 10.1111/ijd.12231

  9. DermNet NZ. Drug-induced psoriasis.

  10. Schwarz CW, Loft N, Andersen V, Juul L, Zachariae C, Skov L. Are systemic corticosteroids causing psoriasis flare-ups? Questionnaire for danish dermatologists, gastroenterologists and rheumatologists. Dermatology. 2021;237(4):588-594. doi. 10.1159/000510712

  11. National Psorasis Foundation. Psoriasis: Causes & Triggers.

  12. National Psoriasis Foundation. Must-have Lotions.

  13. National Psoriasis Foundation. Taking Care of Your Skin in Summer.

  14. DermNet NZ. Koebner phenomenon.

  15. Seattle Children's. Skin Injury.