People living with psoriasis know that there is no cure that will completely eliminate the condition. But there are many treatment options available to help manage symptoms and lessen the discomfort. Understanding the things that can trigger a psoriasis flare-up gives patients a measure of control to prevent outbreaks. While not all triggers affect all psoriasis patients, below is a list of several common triggers that do affect many.
Injury to the Skin
In the 19th century, Dr. Koebner had a psoriasis patient who developed new lesions after being bitten by a horse. Many psoriasis patients have the same reaction when their skin is broken, and this response is now known as the Koebner phenomenon. About half of psoriasis patients will develop a new lesion when the skin is injured, although only 10 percent develop new lesions every time. Injury to the skin can include minor scrapes, bites, chemical irritations, vaccinations, sunburn, tattoos, and even shaving.
There is a nearly universal agreement that winter is the hardest season for psoriasis sufferers. The air is dry, which can trigger lesions. Indoor heat further dries out skin. Although hot, sunny climates may lessen flare-ups, air conditioning can dry the skin out just as much as winter heating. In either case, keeping skin well-moisturized is often helpful in reducing flare-ups.
There are several medications that have been known to induce psoriasis outbreaks. These include:
- beta-blockers for high blood pressure,
- heart medications,
- anti-malarial drugs,
- overuse or sudden withdrawal of corticosteroids,
- lithium for treating psychiatric conditions, and
- indomethacin, for treating inflammation and arthritis.
If you know you have psoriasis or if you have any family history of psoriasis outbreaks, let your doctor know when he prescribes medication. Often, it is possible to substitute a different medicine that is less likely to cause a flare-up.
Many people find that illness or specific infections precede new psoriasis lesions. Strep throat is a common trigger for outbreaks. Other infections that are known to increase the possibility of psoriasis flare-ups are thrush, HIV, upper respiratory illness, and boils caused by the Staphylococcal virus. Treating the infection is usually helpful in reducing the flare-up.
An allergic reaction is your body over-reacting to benign substances. Sensitivities to chemicals, pet dander, and seasonal allergies are all common. For psoriasis patients, these allergies may not manifest themselves as sneezing or itchy eyes, but rather as an outbreak of new lesions. Once you identify your environmental allergies, avoiding them will help prevent flare-ups.
Some psoriasis patients can pinpoint their first outbreak to a specific stressful situation. Several studies confirm that stress can induce flare-ups and increase itching. Anxiety can also cause flare-ups. It is not clear exactly why stress and anxiety trigger psoriasis outbreaks, but learning to manage stress can help control the frequency and intensity of flare-ups.
Doctors and scientists do not know all of the causes of psoriasis outbreaks. It appears that hormones may influence psoriasis, although not for everyone. Smoking and heavy drinking also seem to affect psoriasis in some people, and quitting may improve lesions.
Although you may not be able to identify all of the triggers than can cause your psoriasis to flare up, identifying even one or two causes can help you manage your symptoms. When you identify something that causes new lesions, talk to your doctor about ways to avoid that trigger. The more triggers you can identify and avoid, the better you will be able to reduce your number of outbreaks.