What causes a psoriasis flare-up?

Most people with psoriasis know that the condition flares up and improves, sometimes for no apparent reason. The unexpected nature of flares can be especially frustrating, where you might be doing well one minute and not doing well the next. Of course, not all flares are predictable. However, controlling your known psoriasis triggers in your life can help prevent some of them.


Stress is a common trigger for psoriasis. Emotional stress can take many forms, including work problems, family challenges (such as divorce or raising children), and anxiety about current events. Sometimes emotional stress isn’t just one thing, it’s a series of busy issues that keep you from relaxing.

While not all stress is preventable, taking some time each day to help manage stress can help prevent psoriasis flare-ups. Exercise, including walking and dancing, healthy eating habits, and meditation are all ways to reduce stress.

Physical stress on the body is also a common trigger. Major illness, surgery, or childbirth are all common causes of psoriasis flare-ups. Infections are a particularly common source of outbreaks, especially strep infections such as strep throat. Talk to your healthcare provider about new symptoms to try and prevent a small illness from turning into a big one and wreaking havoc with your psoriasis.

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Medicines that treat other health problems can cause unexpected flare-ups of psoriasis. Whenever you are prescribed a new medicine, let your prescribing healthcare provider and pharmacist know that you have psoriasis. Never stop taking the medicine without first consulting the healthcare provider who prescribes it, as some medicines can be dangerous if stopped suddenly.

  • beta-blockers. These drugs are commonly used to treat high blood pressure and certain heart problems. Their common names usually end in the letters -lol, such as atenolol, metoprolol, or propranolol.
  • lithium. It is used for bipolar disorder and some other mental problems.
  • Antimalarial. Some older drugs for malaria, such as hydroxychloroquine (Plaquenil), can cause flare-ups of psoriasis. These drugs are no longer commonly used to treat malaria, but are sometimes used to treat lupus and related diseases.
  • Indomethacin. It is a nonsteroidal pain reliever sometimes used to treat joint pain, which can be a sign of psoriatic arthritis.
  • Oral steroids. Medications such as prednisone and prednisolone can temporarily make psoriasis better, but can cause flare-ups, sometimes severe, when they’re done.
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Dry winter weather or travel to a dry climate can cause psoriasis to flare up when the skin is dry and cracked. Bathing with a mild soap (such as Aveeno or Cerave Cleanser) can help. Be sure to moisturize your skin every day with a fragrance-free cream. Avoid soaps that are often very dry and strongly scented in hotels.

The sun usually makes psoriasis better, so traveling to darker and cooler climates can also cause flares. However, too much sun can also be a problem, as sunburn can lead to psoriasis on the burned area. When traveling in sunny climates, be sure to wear a hat and sunscreen with an SPF of 30 or higher.

skin damage

Cutting or injuring the skin is known to cause flare-ups of psoriasis in the same area. Dermatologists refer to this effect as the “Koebner phenomenon.” Psoriasis usually develops along incision lines after surgery, or on the arms after burns or bites. When working in the yard or other areas prone to minor injuries, protect yourself by wearing long sleeves and thick clothing. When a minor injury does occur, clean the area with soap and water, then apply antibiotic ointment and cover with a bandage until it heals. Consult your dermatologist if the wound heals slowly or if there are signs of infection, such as unusual pain, warmth, or redness around the wound.

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While these triggers are all common causes of psoriasis flare-ups, scientific evidence suggests other causes, such as smoking, being overweight, and drinking too much alcohol. It’s important to keep track of your skin condition so you can develop your own list of psoriasis triggers. If you suspect that something is triggering your psoriasis, be sure to discuss it with your healthcare provider to see if there is a way to control the trigger or quell a flare-up.