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Are triggers causing your psoriasis flare-ups?

If your psoriasis seems to flare for no reason, one or more triggers could be to blame. Everyday things like stress, a bug bite, and cold can trigger psoriasis.  Triggers vary from person to person. By finding your triggers and learning how to manage them, you can gain better control of your psoriasis and have fewer flares. To find yours, you’ll have to do a bit of detective work. A good place to start is by looking at this chart of the common triggers, which also gives you signs that that it could be a trigger for you.

TriggerSigns this triggers your psoriasisWhat you can do
StressYour psoriasis flares after a stressful event.Find a way to manage your stress and practice it—even when you’re feeling okay. Common stress busters include yoga, meditation, and support groups. 

Before going to sleep, write down three things that you’re grateful for. Do this daily.

When you start to feel stressed, take a deep breathe, hold it, and exhale slowly.
Cuts, scrapes, and bug bitesPsoriasis flares about 10 to 14 days after you injure your skin. A cut, scrape, sunburn, scratch, outbreak of poison ivy or poison oak, bruise, or bug bite can cause psoriasis to flare near (or in the same spot as) the injury or bite.
  • If you injure your skin, treat it quickly.
  • If your skin itches, calm the itch.
  • Avoid scratching, which can trigger a flare.
  • Try to avoid getting bug bites by using insect repellant and staying indoors when bugs are most active—during dusk and dawn.
DrinkingYour psoriasis treatment has little or no effect and you often drink 2 or more drinks a day or you binge drink.Quit drinking—or limit your drinks to one drink per day for women and two drinks per day for men. 

Be sure to tell your dermatologist if you drink alcohol. Drinking can make it risky to take some psoriasis medications like methotrexate. 
SmokingYour psoriasis flares unexpectedly and you smoke or spend time with people who are smoking.Stop smoking. Because this can be difficult, ask your dermatologist or primary care doctor for help.

Before trying a nicotine patch, ask your dermatologist whether using it could trigger your psoriasis.

Avoid being around people who are smoking.

Dry, cold weather Your psoriasis worsens when the humidity and temperature drop, such as in the winter, fall, or both. 
  • Treat your psoriasis.
  • Limit showers and baths to 10 minutes and use warm rather than hot water.
  • Immediately after bathing, slather on moisturizer, using a fragrance-free ointment or cream rather than a lotion.
  • Use a gentle, moisturizing cleanser instead of soap.
  • Apply moisturizer throughout the day when your skin feels dry. 
  • Plug in a humidifier when the air in your home feels dry.
  • Stay warm and protect your skin from extreme weather when outside by wearing a hat, gloves, waterproof boots, and a winter jacket.
  • Sit far enough away from a fireplace, radiator, or other heat source so that you cannot feel the heat on your skin.
  • Remove wet clothes and footwear when you come in from the cold.
  • If your psoriasis continues to flare, see your dermatologist. Ask if phototherapy may be a treatment option for you in the winter.
Sunshine, warm weatherYour psoriasis flares after you get a sunburn or when you spend time in air conditioning.You can avoid a sunburn by always applying sunscreen to all bare skin without psoriasis. Check the bottle to make sure your sunscreen offers:

  • Broad spectrum protection
  • SPF 30 or higher
  • Water resistance

If your skin is dry from spending a lot of time in air conditioning, apply moisturizer throughout the day.​​ 
InfectionYou flare 2 to 6 weeks after strep throat, an earache, bronchitis, or another infection. This is especially common in kids. Treating the infection can lessen or clear the psoriasis.

Tell your dermatologist if you have an HIV (human immunodeficiency virus) infection, which can make some psoriasis treatments risky. 
Some medicinesYou flare 2 to 3 weeks after beginning a medicine.If you think a medication is causing your psoriasis to flare, DON’T stop taking it. Ask the doctor who prescribed it whether the medicine could be causing your psoriasis to flare. If it could, ask if you could take another medication.

Before taking a medicine for the first time, ask the doctor prescribing it if the medicine could cause psoriasis to flare. Medicines that commonly trigger psoriasis include:

  • Lithium
  • Drugs taken to prevent malaria
  • Strong corticosteroids like prednisone (if you quit taking it rapidly instead of stepping down)
  • Medicine that treats high blood pressure, chest pain, and problems with your heartbeat 
  • Some arthritis medicines 
Make a list of all your medications (not just the ones for psoriasis), vitamin and mineral supplements, and herbal remedies. Show this list to your dermatologist and ask if anything could be triggering your psoriasis.  
Tattoos, piercings, and other types of body artPsoriasis can develop on skin that was tattooed or pieced because these injure your skin. It’s best to avoid tattoos and other types of body art if you have psoriasis. 
ShavingYou cut yourself while shaving and then notice new psoriasis about 10 to 14 days later where you cut.Take care to avoid cutting yourself while shaving.

To prevent cuts and nicks, try applying moisturizer and then shaving gel before you shave.

Bergstrom, KG, Kimball AB. (2011) 100 questions & answers about psoriasis. Sudbury, Mass: Jones and Bartlett. 

Marks, B. “More than skin deep: Triggers, treatments, and you.” An educational session hosted by the National Psoriasis Foundation. Chicago: Presented June 20, 2015.

Murzaku EC, Bronsnick T, et al. “Diet in dermatology Part II. Melanoma, chronic urticaria, and psoriasis.” J Am Acad Dermatol. 2015 Aug;73(2):353.

All content solely developed by the American Academy of Dermatology.

Supported in part by Novartis.

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