Sometimes, psoriasis flares seem to come from nowhere. “I’m dealing with an awful flare-up. It’s never been this bad. I’m trying to figure out the trigger,” one MyPsoriasisTeam member wrote.

Psoriasis flares can happen when genetic or environmental factors trigger inflammation in the skin. During a psoriasis flare, symptoms can get worse. The skin may become discolored, scaly, itchy, cracked, and painful.

You may not always know what caused a flare, and some triggers can be hard to avoid. But learning your possible triggers may help you better manage your psoriasis.

Psoriasis Flare-Up Triggers

Triggers can affect people with psoriasis in different ways. What causes a flare-up in one person might not affect someone else at all. Learning what leads to flares can help you take steps to avoid them.

Stress

Stress is one of the most common triggers of psoriasis flares. “Stress is my worst trigger. Now that I’m retired, my psoriasis is lots better,” one member shared.

Stress can cause changes in the brain and hormone levels that affect the skin. These changes can trigger inflammatory immune responses, which are immune system reactions that lead to inflammation.

People with psoriasis have higher rates of depression, stress, and sleep problems compared to those without psoriasis. Feeling self-conscious about skin symptoms, avoiding social situations, and needing to carve out time for treatments can all contribute to stress.

Research suggests that inflammation may also play a role in increasing depression and anxiety in people with autoimmune conditions like psoriasis. Some studies are exploring whether treating inflammation could also help ease stress.

“I’m dealing with an awful flare-up. It's never been this bad. I’m trying to figure out the trigger."

— A MyPsoriasisTeam member

Smoking

Smoking and secondhand smoke are both linked to psoriasis flare-ups. Even nicotine patches have been linked with psoriasis flares. Nicotine can trigger inflammation, which can irritate the skin and lead to flare-ups.

Smoking tobacco is harmful to overall health and can weaken the immune system. Research shows that smoking may trigger psoriasis, make the disease more severe, and reduce how well treatments work. People with psoriasis who smoke also tend to have fewer periods of remission​​ (when psoriasis symptoms are under control).

Alcohol

Although research on alcohol and psoriasis is limited, some evidence suggests that drinking alcohol can make inflammation worse and raise the risk of flares. Alcohol can weaken the skin’s protective barrier, making psoriasis symptoms worse.

Medications

Certain medications are known to trigger psoriasis flare-ups or even cause psoriasis to develop. If you have psoriasis and are being treated for other conditions, talk with your dermatologist about potential risks.

Medications known to increase the risk of flares include:

• Beta-blockers, which treat high blood pressure
• Lithium, prescribed for mood disorders such as bipolar disorder
• Antimalarial drugs, which are taken to prevent and treat malaria and some autoimmune/inflammatory conditions
• Imiquimod, a topical cream used to treat precancerous skin lesions

Diet

Certain foods may trigger psoriasis flares or make symptoms worse. Much of what’s known about diet and psoriasis flares comes from people with psoriasis sharing their experiences.

Although exactly how and why some foods cause flares isn’t fully understood, processed foods and refined sugars have been linked to inflammation.

Food triggers will vary from person to person. “Keeping a food journal through the years has helped me identify problem foods and replace them with things that don’t cause issues,” one member recommended.

People with psoriasis have reported various food-related triggers, such as:

• Nightshades — Vegetables like tomatoes, potatoes, eggplant, and peppers that contain a compound called solanine
• Sugar
• Processed snack foods
• Fried foods, such as french fries
• Gluten — A protein in wheat, rye, and barley that causes inflammation in people with celiac disease

Saturated fats may also raise the risk of psoriasis flares. Saturated fat is found in foods like butter, fatty meats, cured meats such as bacon and sausage, and cheese. High-fat diets can contribute to weight gain, another risk factor for psoriasis flares.

Talk to your doctor before making major changes to your diet.

Injury to Skin

People with psoriasis have very sensitive skin, and even small injuries can trigger flare-ups. This reaction is called the Koebner phenomenon, in which previously healthy skin develops new psoriasis lesions.

Injuries such as bugbites, scratches, cuts, burns, or bruises can cause flare-ups and new lesions at the injury site.

Researchers don’t fully understand what causes the Koebner phenomenon. People with psoriasis who have this reaction usually develop a flare 10 to 20 days after the injury. Minor skin injuries like sunburn or getting a vaccine can sometimes cause new psoriasis plaques to form.

“Stress is my worst trigger. Now that I’m retired, my psoriasis is lots better."

— A MyPsoriasisTeam member

Changes in Weather

“The cold, wet weather seems to trigger a flare-up,” one MyPsoriasisTeam member wrote.

Cold, dry weather and low humidity, which cause dry, irritated skin, are associated with psoriasis flares. Heat sources like fireplaces and radiators can further dry out the skin, increasing the risk of flare-ups.

During warmer weather, air-conditioning can lower humidity and dry out the air, also affecting the skin. Some people find that sweating can also trigger flares.

Sun exposure is another factor. Although sunburn can trigger flare-ups, getting some sunlight may help improve symptoms by increasing vitamin D levels.

Hormonal Changes

Hormonal changes can lead to psoriasis flare-ups, especially during puberty, after pregnancy, and during menopause. These hormone shifts may make psoriasis symptoms worse. “My psoriasis peaked while I was going through menopause,” one member reported.

Androgens are hormones that help control sex-related traits and skin changes. Testosterone is one type of androgen. Changes in androgen levels may affect psoriasis symptoms.

Infection

Bacterial and viral infections can trigger sudden flares. Strep throat bacteria have been linked to psoriasis flares, especially guttate psoriasis flares.

Viral infections such as the flu or common cold can also cause severe flares in people with psoriasis. Upper respiratory infections, including influenza B, are among the common triggers​​​.

One member reported, “I keep getting throat infections, which trigger bad flare-ups.”

Preventing and Treating Flares

You can lower your risk of psoriasis flare-ups by following your skin care and treatment plans, managing stress, and making healthy lifestyle choices.

Ask your healthcare provider about ways to reduce stress, eat a balanced diet, quit smoking, and limit alcohol. You may want to consult a dietitian or mental health counselor for additional help. Always talk to your doctor or dermatologist before making any changes to your treatment.

Try to avoid situations that could injure your skin, such as cuts, scrapes, or sunburns. To prepare for weather changes, use a humidifier indoors and dress for outdoor conditions.

Some people with psoriasis find it helpful to keep a record of what triggers their flare-ups so they can better manage the condition.

Managing psoriasis flares can take time, and triggers aren’t always easy to spot. Tracking your symptoms, following your treatment plan, and talking with your healthcare provider can help you better understand what affects your skin.

Join the Conversation

On MyPsoriasisTeam, people share their experiences with psoriasis and psoriatic arthritis, get advice, and find support from others who understand.

Have you identified any triggers for your psoriasis flares? Let others know in the comments below.