Symptoms of psoriasis, such as itchy patches of skin and thickened nails, can come and go. However, there are common triggers that people with psoriasis may want to avoid just in case.
It’s not always possible to avoid every trigger, but a little planning can go a long way.
The first step is to identify any change in your symptoms and reflect on the circumstances surrounding it, like what you had to eat or whether you spent time in a new environment.
It may be helpful to track this information in a journal or a note on your phone. Over time, patterns or themes may begin to emerge.
You can use these findings to adopt certain precautions or limit exposure. This can help prevent or lessen the severity of future outbreaks. Your healthcare professional might also be able to make additional recommendations.
Here are some of the most common triggers to be aware of.
There’s no definitive diet for psoriasis, and food triggers can vary from person to person. It may take a fair amount of trial and error to determine what foods, if any, impact your symptoms.
The following are often reported to trigger flare-ups:
- red meat, especially beef
- dairy, including milk, cheese, and other animal products
- gluten, which is found in many grains and condiments
- processed foods, which are usually high in added sugars, salt, and fat
- nightshades, such as tomatoes, eggplant, and white potatoes
According to the results of a 2017 national survey, people with psoriasis saw their symptoms improve or go away completely after they cut back on or eliminated these items.
People saw the most improvement after cutting back on or eliminating nightshade plants and gluten.
The amino acid taurine and the nutrient choline may trigger psoriasis. Psoriatic lesions also contain elevated amounts of both nutrients, according to 2016 research.
Your body naturally makes taurine, but it’s also found in meat, fish, and energy drinks such as Red Bull.
Your body can make choline, too, but it’s largely found in liver, eggs, and other animal products. Other food sources of choline include soybeans, wheat germ, and potatoes.
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The researchers hypothesized that starch in the beer may have contributed to the development of psoriasis.
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Lastly, alcohol misuse affects almost one-third of people with psoriasis, according to a
For people with psoriasis, too much sun can spell a major outbreak. While a moderate amount of sun can relieve symptoms in some, sunburns can almost certainly cause a flare-up.
If you find a small amount of sun actually helps your symptoms, remember to keep it to a minimum. Carry a hat and sunscreen with you at all times.
Try to minimize time spent in the elements during the coldest months. You might also consider getting a portable humidifier or investing in a more sizable machine for your home.
Stress and psoriasis often go hand in hand. The condition itself can be a source of stress, and stress is a big trigger for psoriasis outbreaks.
It’s important to attempt to reduce stress in your life as much as possible. Yoga and meditation practices have shown great success in relieving stress associated with many types of underlying conditions.
Obesity can increase the risk of psoriasis as well as make the symptoms worse.
Do what you can to cut back or quit, and take care to reduce your exposure to secondhand smoke or vapor. Tobacco can make your symptoms more severe. Nicotine can interact with your psoriasis medication, too.
According to a 2006 study, smoking and tobacco use may also increase your risk of developing palmoplantar pustular psoriasis, a rare psoriasis type that affects the hands and feet.
Smoking can also worsen other psoriasis comorbidities, such as:
- heart disease
Some medications interfere with your body’s autoimmune response and can cause a severe psoriasis attack. These include:
- beta-blockers and angiotensin-converting enzyme (ACE) inhibitors, which are used to treat high blood pressure
- interferon-alpha, which is used to treat hepatitis C
- lithium, which is used to treat certain mental health conditions
Steroidal medications are often given to people with psoriasis and can be very helpful during flare-ups. However, rapid withdrawal of steroidal medications can have adverse effects.
Always remind your healthcare professional that you have psoriasis if you’re being prescribed any of these medications. They may be able to prescribe an alternative medication or make other recommendations.
Many infections can trigger psoriasis outbreaks. Common examples include:
- ear infection
- sinus infections
- strep throat (Streptococcal pharyngitis)
- thrush (Candida albicans)
- respiratory infection
HIV and other chronic infections can also impact psoriasis.
Prompt diagnosis and treatment can help reduce the risk of complications, so be sure to consult with a healthcare professional.
If you have a bug bite, cut, or scrape, or you’ve experienced any skin injury, you may notice new psoriasis lesions near the affected area.
These types of injuries can even occur during everyday activities, such as shaving or tending to a garden.
When performing any activity that may cause skin injury, be sure to take extra precautions such as wearing long sleeves, wearing gloves, and using bug spray.
Keeping your skin moisturized can also help. Dry skin is more prone to skin injury.
Low estrogen levels can trigger psoriasis in people with female reproductive systems, according to research in a 2015 review.
This may be why many people with psoriasis experience more severe symptoms during puberty and menopause and improved symptoms during pregnancy.
Q: What psoriasis symptoms or triggers signal an emergency?
A: There are two types of emergencies when it comes to psoriasis.
The first is erythrodermic psoriasis, an inflammatory condition that can cause high fevers, high-output cardiac failure, and desquamation (peeling) of the skin.
The second is pustular psoriasis, which can develop suddenly due to infection or a traumatic event. It has also been linked to systemic steroid pulse.
A systemic steroid pulse is a corticosteroid injection (such as cortisone) or a tapering dose of prednisone (starting with a high dose and then tapering to a lower dose in a week or 2). It can also occur if you abruptly stop taking steroid drugs after an extended period of use.
Pustular psoriasis can also lead to cardiac failure, inability to control body temperature, and desquamation of the skin.
Both of these conditions are considered medical emergencies and should be dealt with immediately.
Doctors continue to study the treatment and triggers for psoriasis. Some of the areas they’re pursuing for future potential treatment are:
- gene therapy
- new treatments that help skin not react to the immune system
- how other conditions, such as obesity, high blood pressure, and diabetes may contribute to psoriasis
Although there’s no existing cure for psoriasis, treatment can help. Understanding your triggers can also help you avoid flare-ups and manage your symptoms.
Talk with your doctor about treatment options that are best for you.