6 Things That Can Cause a Psoriasis Flare-Up


Psoriasis is an autoimmune disorder thought to happen when your white blood cells produce too much of certain chemicals, in turn triggering inflammation. This causes skin cells to form and die much quicker than normal; that leads to a thick buildup of cells on your skin. The buildup takes the form of the silvery-red plaques that are characteristic of psoriasis.

Although the most visible symptoms show up on your skin, psoriasis can have other complications, including increasing your risk of heart disease, diabetes, and Crohn’s disease.

Once you have psoriasis, you’re never going to completely get rid of it, but your symptoms can come and go. Flares or flare-ups of the condition can be triggered by a number of things; avoiding your triggers can help you keep your symptoms under control for longer. Not everyone with psoriasis has the same triggers, but here are some common ones to look out for.

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You're getting over an infection

Particularly an infection with strep bacteria. Some people have a psoriasis flare after a bout with strep throat, earache, bronchitis, tonsillitis, or a respiratory infection. This makes sense because infections go to the heart of what causes psoriasis: the immune system. Some people have a flare even without obvious symptoms of an infection, but a strep test may reveal an infection with the bug.

You got a cut

Skin injuries like a scratch or a cut–or even a sunburn, insect bite, or new tattoo–can cause something called the Koebner response or Koebner phenomenon. Here, a psoriatic lesion shows up in an area of the body where psoriasis typically doesn’t occur. (Psoriasis lesions most commonly appear on the scalp, knees, elbows, and lower back.)

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You're stressed

Both infections and trauma to the skin can be seen as physical stressors, but psychological stress can also trigger psoriasis flare-ups. In fact, stress is one of the most common triggers of psoriasis. For some people, it marks the first episode of the disease. A particular manifestation of stress–not sleeping well–is a prime offender, says Emily Newsom, MD, clinical assistant professor of dermatology at UCLA David Geffen School of Medicine.

Stress-easing complementary and alternative therapies like meditation and acupuncture can help reduce flares in people with psoriasis, according to a recent review published in JAMA Dermatology.

More drastic measures may produce even more drastic results. “I’ve seen people who’ve moved [to] a less stressful environment, and they tell me that they’re thriving,” says Michele S. Green, MD, a dermatologist with Lenox Hill Hospital in New York City.

You drink or smoke

Reducing stress isn’t always easy when you’re living with psoriasis, however. Some of the methods people use to cope may actually exacerbate the skin condition. Alcohol, for example, has been shown to make the disease worse, especially in men. Drinking may make certain treatments for psoriasis less effective, too.

Smoking doubles your risk of developing psoriasis and can make the condition worse if you do get it. In one study, nonsmokers with psoriasis were more likely to experience remission than smokers with psoriasis.

“Anything in excess puts stress on your body,” says Dr. Newsom. “Stopping smoking can really improve psoriasis.”

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You just gave birth

In women, hormonal changes can exacerbate psoriasis. In general, higher hormone levels seem to protect against psoriasis flares, while falling levels can make them worse. That’s why psoriasis may flare during puberty, menopause, and after having a baby.

For the same reason, psoriasis tends to clear up in pregnant women. “Some pregnant women with psoriasis will get better because pregnancy is a natural immunosuppressed state,” explains Dr. Newsom. The same thing sometimes happens with other autoimmune conditions, such as lupus.

You started a new medication

Certain medications can also trigger psoriasis flare-ups. These include lithium, which is used to treat bipolar disorder and other psychiatric conditions; some medications used to treat malaria; nonsteroidal anti-inflammatory medications (NSAIDs) like ibuprofen; and some high blood pressure medications like beta-blockers.

“Sometimes changing around blood pressure medications can help,” says Dr. Newsom.

If you think a medication is behind a psoriasis flare, don’t stop taking it without asking your doctor first.

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