“Psoriasis triggers don’t cause the disease, but they can activate it,” says Danielle M. Miller, MD, a dermatologist in Concord, Massachusetts. Understanding common psoriasis triggers also helps you and your doctor form strategies to treat and manage the condition. Here are some common psoriasis triggers — and what you can do to manage them to help prevent flares.
Skin injuries
An injury to the skin, such as a cut, bruise, or bump, can cause a psoriasis flare. “People with psoriasis will often develop symptoms at the site of skin trauma,” Dr. Miller says. “This could be in an area where they have had surgery, or where they have had an infection. This may also explain why psoriasis tends to form on elbows and knees, as these are areas of the body that are exposed to more hard use.” Other types of skin injuries that may trigger psoriasis symptoms include vaccinations, sunburns, and even insect bites. To help prevent a psoriasis flare, take steps to reduce your risk of skin injuries, such as wearing bug spray and avoiding scratching your skin, and treat any injuries quickly. Keeping your skin moisturized and practicing good skin care is also an important part of managing psoriasis. “That means moisturizing well every day,” says Miller. It’s best to use an oil-based ointment or cream instead of a water-based lotion. Apply moisturizer immediately after a bath or shower, and keep moisturizing during the day. Moisturizing an affected skin area and keeping it covered with a plastic wrap overnight can also help.
Cold weather
Cold winter weather seems to be a psoriasis trigger for some people. “Psoriasis does seem to get worse in the winter and better in the summer, but it’s hard to know how much of this is due to dryness in the winter and how much is due to lack of sunlight,” says Miller. Increased humidity in the summer may be a positive factor, but studies also show that some sun exposure is good for psoriasis. “Using a humidifier at home or at work in the winter may help a little, but what may be even better is getting some exposure to ultraviolet light B (UVB),” says Miller. UVB is a type of light that is present in natural sunlight, and has been shown to be an effective psoriasis treatment. “Narrow band UVB can help 80 percent of people with psoriasis, and when it’s used in a controlled setting, it is much safer than a tanning booth,” says Miller. Ask your dermatologist about a UVB light box for psoriasis treatment. The American Academy of Dermatology also recommends limiting showers and baths to 10 minutes, applying moisturizer after bathing and throughout the day, and protecting your skin from the cold by wearing warm clothing during the winter.
The stress factor
“We don’t know the exact reason, but stress is a psoriasis trigger for some people. Stress increases the body’s inflammatory response, and it can also make other skin conditions worse,” says Miller. “A stressful trigger could be in the form of a move, a breakup, or the loss of a job. And, of course, psoriasis itself is stressful.” As a result, stress and psoriasis symptoms can fuel each other: Psoriasis is a chronic disease that causes stress, and stress makes psoriasis worse. You can help reduce stress by learning stress management techniques, such as meditation or yoga, and getting regular exercise. You can also get help from a strong support system of friends and family members. In addition, many people benefit from psoriasis support groups. “People with psoriasis often hide their condition from others. Joining a support group helps them understand that their disease is not that uncommon and that they are not alone,” says Miller.
Smoking and drinking
“Both alcohol and smoking are common triggers for psoriasis symptoms and can make psoriasis treatment harder,” notes Miller. An occasional glass of wine probably won’t hurt you, but heavy use of any alcohol has been shown to trigger the body’s inflammatory response. And research published in May 2016 in Psoriasis found that smoking increases your risk of psoriasis, impacts the severity of the disease, and can contribute to other health conditions, such as cardiovascular disease. If you drink, you should do so in moderation. That means up to one drink per day for women and up to two drinks per day for men, according to the Dietary Guidelines for Americans. And if you smoke, quit. If you need help quitting, talk to your doctor about smoking cessation methods. In addition, taking other steps to live a healthy lifestyle can help you manage psoriasis, as well as improve your overall health. Getting plenty of rest and regular exercise are both important as they help you maintain a healthy immune system and avoid flare-ups, especially those triggered by illness. A review published in September 2014 in JAMA Dermatology that examined the results of 15 trials on the benefits of omega-3 fatty acids in fish oil for treating psoriasis indicated mix results. The researchers found some outcomes showed that fish oil given to participants in both large and small amounts gave them the most benefit, improving erythema (redness), induration (thickness), and scaling in both plaque and guttate psoriasis. But other results did not mark improvement. Overall the researchers cited moderate benefit for the use of fish oil supplements in psoriasis.
Effects of medication
Certain medications are common psoriasis triggers. Treatments that can trigger psoriasis symptoms include beta-blockers that may be used for heart disease, lithium to treat some psychiatric disorders, and several drugs for malaria. “Steroid medications like cortisone work well as psoriasis treatments topically. But systemic cortisone — a steroid taken by mouth — can trigger a flare of psoriasis symptoms when the medication is stopped,” says Miller. Talk to the prescribing doctor if you think a medication is triggering your flares. Never change or discontinue medication without first checking with your doctor. Identifying and avoiding your triggers, keeping your immune system healthy by reducing stress, avoiding illness, and maintaining a healthy lifestyle are the best ways to keep psoriasis under control. Learn as much as you can about the disease, work closely with your doctor, and stick to your psoriasis treatment plan.
