7 Psoriasis Triggers You Need to Know

Psoriasis is a chronic autoimmune skin disease that affects about 3% of people in the U.S. It affects each person differently, but there are common triggers that are more likely to worsen psoriasis. Knowing about these triggers — and those that may specifically affect you — can help you avoid them in the future. 

1. Medications

Some prescription and over-the-counter (OTC) medications can worsen psoriasis. Some can even cause you to develop psoriasis when you’ve never had it before. It’s not clear exactly why this happens.

Some medications that can do this include:

• Beta blockers treat conditions like high blood pressure and heart failure. Examples include metoprolol (Lopressor) and propranolol (Inderal). 

• Lithium (Eskalith) is used to treat bipolar disorder and depression.

• Antimalarials are also used to treat some autoimmune disorders like lupus and rheumatoid arthritis. Hydroxychloroquine (Plaquenil) is one example.

• Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to treat all sorts of different conditions, like headaches and menstrual cramps. Naproxen (Naprosyn) is one example.

Keep in mind that this is not the whole list. There may be other medications that trigger your psoriasis symptoms. And these can be different for different people. Talk with your provider if you think one of your medications could be worsening your psoriasis.

2. Foods

Specific foods can trigger symptoms for people with psoriasis. Keep in mind that each person is different, so not everyone will be affected by the same foods. Keeping track of your psoriasis symptoms and the different foods you eat can help you identify possible triggers. 

Here are some common food triggers for people with psoriasis:   

• Sugar

• Alcohol

• Tomatoes

• Gluten

• Dairy

• Meat

3. Smoking

There’s strong evidence that cigarette smoking worsens psoriasis. And smoking may also make your psoriasis treatment less effective. If you have psoriasis, quitting smoking can improve your skin and your overall health. You’ll experience fewer psoriasis flares and spend more time in remission, with little or no psoriasis.

Plus, stopping smoking will lower your risk of heart and autoimmune diseases.

4. Alcohol

For many people, drinking alcohol can be a big trigger for psoriasis symptoms. Again, it’s not clear exactly why this is. You don’t have to drink excessively either. Just drinking more than 2 drinks a day (for men) or more than 1 drink a day (for women) can cause psoriasis symptoms to flare. 

Limiting or cutting out alcohol has many benefits to your health, and even more if you have psoriasis. It can help avoid psoriasis flares and increase the time you spend with little or no psoriasis symptoms (remission).

Cutting out alcohol can also lower your risk of developing fatty liver disease and liver-related side effects from psoriasis medications. And for women, limiting alcohol can also lower the risk of developing psoriatic arthritis. 

5. Stress

Stress is a common psoriasis trigger — but it can be hard to avoid. When psoriasis flares, it can lead to more stress, which starts a cycle that’s hard to get out of. Finding ways to manage your stress can help. 

Beyond medication, here are some life strategies that are proven to help lower stress:

• Yoga

• Meditation

• Gratitude journaling

• Support groups

6. Infections

Certain infections can trigger or worsen psoriasis symptoms. 

Strep throat is a throat infection caused by Streptococcus bacteria. It’s a common trigger for guttate psoriasis, a less common type of psoriasis that usually starts suddenly in children and young adults. Treating the infection can help — but it usually isn’t enough to improve the psoriasis completely. Those affected often need additional psoriasis treatment. 

Some other infections can trigger guttate psoriasis and other types of psoriasis, too:

• Seasonal flu

• Sinus infections

• Upper respiratory infections

• Human immunodeficiency virus (HIV) 

7. Injuries to the skin

If you have psoriasis, injuring your healthy skin can trigger psoriasis in that area, even if you didn’t have it before. This is called the Koebner phenomenon. It’s not clear why it happens, but it affects about 1 in 4 people who have psoriasis.

Any skin injury can cause this, but some common ones include:

• Cuts or scrapes on skin

• Tattoos

• Sunburn

• Medical procedures (like shots, radiation, or surgery)

When this happens, psoriasis usually improves with usual treatments. But, it’s important to avoid future skin injuries as much as possible. 

How to avoid psoriasis triggers

The first step for avoiding triggers is to know what they are. This can be hard, especially since psoriasis affects each person differently. Keeping a daily journal of your psoriasis symptoms and how they relate to other parts of your day (like your medications or diet) can help you start to figure it out.

You likely can’t avoid every psoriasis trigger, but there are some tips and strategies to help you avoid some common culprits:

• Cut back or cut out alcohol.

• Stop smoking, if you smoke. 

• Avoid common dietary triggers (like added sugar).

• Get vaccinated, wear a mask, and wash your hands if you’re around people who are sick.

• Keep your skin hydrated and protected to lower your risk of injury. 

• Manage stress levels with meditation and other techniques. 

If you think a medication is triggering your psoriasis, talk with your provider before making any changes to your treatment for other conditions. 

How do you calm a psoriasis flare up?

The first step in calming a psoriasis flare is to cut out any known triggers. Sometimes, just doing this is enough to calm psoriasis symptoms. 

In other situations, you may need to treat the psoriasis flare to lessen your symptoms. This may include a short course of prescription medication, like topical steroids. If your flare is significant or isn’t clearing up, talk with your provider to see what your other options are. 

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Written by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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