Psoriasis: Top 10 Causes, Triggers and Treatments

Less Stress Is Best

A stressed woman featured with a photo of a rash.

Stress is a common trigger of psoriasis (a disease that produces silvery colored, scaly, dry and thickened skin with reddish patches) flares; however, psoriasis flares also cause stress. Stress increases inflammation in the body. Inflammatory compounds are damaging to body tissues. Women seem particularly vulnerable to experiencing psoriasis flares due to stress. People who have autoimmune conditions, such as psoriasis, seem to have immune systems that over respond and release an abundance of inflammatory compounds.

Stress Busters

Controlling stress is one way to minimize the risk of future psoriasis flares. There are many methods to combat stress.

  • Deep diaphragmatic breathing engages the so-called “rest and digest” parasympathetic nervous system. Breathe in through your nose, slowly and deeply from your diaphragm. Hold the breath and then breathe out slowly through your mouth.
  • Exercise boosts mood, improves energy levels, and releases endorphins, feel-good chemicals associated with decreased pain. Regular exercise decreases anxiety and improves sleep. Women who exercise vigorously and less likely to develop psoriasis than women who are less physically active.
  • Enlist the help of a therapist or enroll in a stress management program to learn how to handle stress more effectively. A therapist may use cognitive behavioral therapy (CBT) to help you change thoughts and behaviors to keep your stress levels down.

Get a Handle on Allergies

Both allergies and psoriasis are due to immune dysfunction but there is no scientific proof that psoriasis is an allergic reaction.

Allergies and Psoriasis

Although both allergies and psoriasis are due to immune dysfunction, there is no scientific proof that psoriasis is an allergic reaction. Some people who have both conditions report that allergy symptoms trigger psoriasis flares. Psoriatic skin lesions may be mistaken for allergic conditions, but the two disease processes are different.

Allergy Busters

If you have allergies and psoriasis, taking steps to control allergies may help reduce the risk of a psoriasis flare.

  • Avoiding known allergens is an effective strategy to reduce symptoms. For example, if you are allergic to dust mites, minimize upholstered furniture, replace carpet with hard flooring, and dust and vacuum frequently to reduce exposure.
  • Take allergy medications as prescribed by your doctor. Taking allergy medicines at the correct times and correct dosages will help minimize allergy symptoms.
  • Keep track of your symptoms in a diary. If new or troubling symptoms emerge, keeping track of what you eat, where you go, and what you're exposed to may help reveal patterns that can be used to adjust your treatment.

Be Mindful of Alcohol Consumption

Some studies show a link between heavy alcohol drinking and psoriasis flares.

Alcohol and Psoriasis

Some studies show a link between heavy drinking and psoriasis flares. It seems that men who drink heavily are more likely to suffer from psoriasis than men who do not drink alcohol. Alcohol consumption negatively impacts treatment and reduces the likelihood of remission. Alcohol may interact with certain psoriasis medications. Ask your doctor if it is safe for you to consume alcohol if you have psoriasis.

Tips to Stop Drinking

If you're trying to cut back or stop drinking all together, managing triggers can help you reach your goal. In general, avoid high-risk situations where you anticipate it will be difficult to avoid temptation. If you can't avoid a situation where you are concerned you might be triggered, have some strategies in place to help you stay on track and cope.

  • Distract yourself by calling or texting a friend or watching a funny video online. Go for a walk or take a few minutes to practice deep breathing or meditation.
  • Review your reasons for not wanting to drink. Write the reasons on a card that you keep in your purse or wallet to revisit when you need to.
  • Talk to a trusted friend when you're tempted to drink and discuss the reasons you're trying to abstain.

Guard Against Cold or Dry Weather

Cold weather air, dry temps, and diminished sunlight all contribute to psoriasis flares.

Winter Psoriasis

Cold air, dry temps, and diminished sunlight all contribute to psoriasis flares in the winter. Combat these conditions by using a humidifier indoors. Using heavy moisturizers helps fight dry skin and reduce the discomfort from winter psoriasis. Choose moisturizers and skin products that are fragrance-free, hypoallergenic, and formulated for sensitive skin.

Winter Skin Care Tips

Skin needs extra care and attention in the winter, whether you have psoriasis or not. Use this winter skin care tips to keep your skin healthy when it's cold and dry outside.

  • Clean and exfoliate skin: Use gentle, soap-free cleansers that won't strip moisture from the skin. Slough off dead skin cells gently with a soft wash cloth or mild exfoliate scrub to reveal fresh, healthy skin underneath.
  • Skip the hot baths and showers: Although it's tempting to warm up in hot bath or shower on a cold winter day, hot water actually strips moisture from the skin. Bathe or shower in warm water instead.
  • Step up the moisturizer: You may need to switch to a heavier, oil-based moisturizer in the winter to quench dry skin.
  • Dress in layers and remove wet clothing promptly: Sitting around in wet clothes may irritate your skin and lead to breaks and sores. Remove any wet clothing promptly. And dress in layers so you can remove clothing if you get too warm and avoid excess sweating.
  • Rely on your humidifier: Dry weather dries out skin and may lead to cracks and itching. Use a humidifier to make your living space less arid. Humidity helps keep skin healthy and moistens mucus membranes in the nasal cavity, which may help reduce the risk of sinusitis.

Rethink the Ink: Tattoos

Tattoos are associated with skin trauma that may trigger psoriasis.

Tattoos and Psoriasis

You may like the look of tattoos, but they may not be a good idea if you have psoriasis. Piercing the skin and injecting dye underneath the skin is associated with skin trauma that may trigger psoriasis. Some people who have psoriasis develop new psoriatic lesions 10 to 14 days after getting a tattoo. Tattooed skin may also become infected. Skin infections are also potential psoriasis triggers.

Skin Trauma and Psoriasis

Other types of skin trauma besides acupuncture may trigger psoriasis flares. These include

  • cuts and scrapes,
  • severe sunburns,
  • bug bites, and
  • skin piercings.

Assess Your Medications

Medications may trigger psoriasis flares or make it worse.

Can Medications Trigger Psoriasis?

Some medications may trigger psoriasis flares or make psoriasis worse. Some medications to control high blood pressure, heart disease, arthritis, or mood disorders may affect psoriasis. Do not stop taking a medication or adjust the dose of a medication without speaking with your doctor. If you have concerns that a medication has a negative impact on your psoriasis, discuss the situation with your doctor.

Medication That Trigger Psoriasis

There are several classes of medications that may trigger psoriasis flares. Speak with your doctor if you're concerned any of the following medications may be exacerbating your psoriasis.

  • Quinidine is a heart medication that may trigger psoriasis.
  • Inderal is a blood pressure medication that may worsen psoriasis in approximately 30% of people who take it and have both conditions.
  • Antimalarial medications including chloroquine, hydroxychloroquine, and quinacrine may be associated with a psoriasis flare approximately 2 to 3 weeks after taking these medications.
  • Indomethacin is an anti-inflammatory medication that is prescribed to treat arthritis. It may worsen psoriasis in some people.
  • Lithium is a medication prescribed to treat manic depression and other types of mood disorders. It may worsen psoriasis in approximately 50% of people who take it.

Diagnose and Treat Infections

Infections activate the immune system and may trigger a flare up of psoriasis.

Psoriasis and Strep

When the immune system is busy fighting an infection, psoriasis may flare up. Streptococcus infection, or strep throat as it is more commonly known, is an infection that is particularly linked to flare ups of psoriasis. Strep is linked to a type of psoriasis called guttate psoriasis (type of skin lesion where fine scales appear on top of reddish drop-like lesions). Strep infection in children may be the trigger for the onset of guttate psoriasis. If you have psoriasis and experience a flare up, it's a good idea to ask your doctor to evaluate you for strep throat as well.

Psoriasis and Infections

Infections activate the immune system and may trigger a flare up of psoriasis. Infections linked to psoriasis flares include

  • tonsillitis,
  • respiratory infection,
  • earache, and
  • bronchitis.

Psoriasis flare ups tend to calm down when a concomitant infection is treated effectively.

Avoid Skin Trauma: Cuts and Bruises

Guarding and protecting skin against injuries such as cuts and bruises can help minimize the risk of psoriasis flare ups.

Koebner’s Phenomenon

People who suffer from psoriasis may develop psoriatic lesions at the site of a skin injury. This is called Koebner's phenomenon. Very often, people develop psoriatic lesions on injured skin areas where they don't normally experience flare ups. Taking extra care to protect your skin against avoidable trauma and injury may help you reduce the risk of psoriasis flare ups.

Protect Your Skin

Guarding your skin against injuries can help minimize the risk of psoriasis flare ups. There are simple things you can do to protect your skin.

  • Wear sunscreen and stay out of the sun during peak hours to avoid sunburn.
  • Use bug repellant and wear long-sleeved tops and long pants to deter bugs from biting.
  • Trim toenails straight across and avoid trimming nails too short.
  • Take care while shaving or better yet, use an electric razor to minimize nicks and bumps that could trigger psoriasis.

The Dangers of Smoking

Smoking greatly increases the risk of psoriasis and makes the condition much worse.

Smoking and Psoriasis

Smoking greatly increases the risk of psoriasis and makes the disease much worse. Studies have documented that approximately 20% of cases of psoriasis are related to smoking. Compounds in cigarette smoke negatively impact the immune system and the growth of skin cells to promote psoriasis. The more cigarettes a person smokes per day, the greater his or her risk of developing psoriasis.

Smoking and Psoriasis Statistics

Smoking increases the risk of developing of psoriasis and it increases the severity of the disease. Here are the statistics regarding psoriasis and smoking.

  • People who smoke have double the risk of developing psoriasis compared to nonsmokers.
  • Female smokers are more likely to develop psoriasis than male smokers.
  • Smoking increases the risk of a type of psoriasis called palmoplantar pustulosis (psoriasis on the hands and feet).
  • Women who smoke 20 cigarettes per day have 2.5 times the risk of developing psoriasis compared to women who are nonsmokers.
  • Men who smoke 20 cigarettes per day have 1.7 times the risk of developing psoriasis compared to men who are nonsmokers.
  • About 78% of people who experience remission from psoriasis are nonsmokers. Only 22% of people who experience psoriasis remission are smokers.

Smoking isn't good for anyone but it's especially important to quit if you have psoriasis.

Balance Hormones

Hormones changes usually precede psoriasis and can influence the severity.

Hormones and Psoriasis

Anyone of any age can get psoriasis but the condition most commonly occurs in people between the ages of 20 and 30 and in those over the age of 50. It is believed that hormone changes at those times precede the onset of psoriasis. Hormones influence the severity of the condition. Hormone changes in pregnancy result in decreased psoriasis symptoms in more than 50% of women at 30 weeks of gestation and a worsening of symptoms in more than 20% of women.

Which Hormones Affect Psoriasis?

Sex hormones and prolactin have long been known to affect the development and severity of psoriasis, but many more hormones have been implicated in the process. Hormones that have an effect on psoriasis include

  • estrogen,
  • progesterone,
  • cortisol,
  • epinephrine,
  • prolactin,
  • thyroid hormones,
  • leptin,
  • ghrelin, and
  • insulin.

If you suspect out-of-whack hormones are contributing to your psoriasis symptoms, see your doctor or an endocrinologist to discuss your concerns.

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REFERENCES:

  • American Osteopathic Association: "Radiant in the Winter – Skin Care Tips"
  • Asthma and Allergy Foundation of America: 'Preventing Allergic Reactions and Controlling Allergies'
  • Clujul Medical, vol 89, 2016: "The Role of Hormones in the Pathogenesis of Psoriasis Vulgaris"
  • Journal of Medicine and Life: "Tattoo-Induced Psoriasis"
  • National Psoriasis Foundation: "Causes and Triggers."
  • National Psoriasis Foundation: "Frequently Asked Questions: Psoriasis in Spring, Summer, Fall and Winter"
  • National Psoriasis Foundation: "How Cigarettes and Alcohol Affect Psoriasis"
  • National Psoriasis Foundation: "Stress and Psoriatic Disease."
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