Identifying and Reducing Psoriasis Triggers

It goes without saying that the less psoriasis the better. I doubt I’m alone in wanting to prevent more psoriasis from breaking out like a wildfire. Of course, I can’t always avoid psoriasis flares, but I can try to avoid as many of my psoriasis triggers as possible.

I’m still learning more about my psoriasis triggers after forty years of living with severe psoriasis. At a psoriasis educational event earlier this year, I asked a prominent dermatologist how long it takes for psoriasis to worsen after a triggering event.

He told me succinctly that it depends on the trigger and briefly mentioned the differences between infection and damage to the skin.

Paying attention to psoriasis triggers

Going into the conversation I figured the answer could not be as easy as a predetermined time such as a day or two weeks. But his brief answer led me to pay more attention to my psoriasis triggers.

I especially want to get a better handle on which ones affect me most and how long before they start to affect my skin.

My personal psoriasis triggers

If you are motivated to do the same, the National Psoriasis Foundation’s webpage “Psoriasis Causes and Triggers” is a helpful place to start. The NPF notes there that “Psoriasis triggers are not universal. What may cause one person's psoriasis to become active, may not affect another.”

Here I will list four of my psoriasis triggers and briefly comment on ways they impact my life and how I approach them.

Infection, flares, and medications

Infections are a clear trigger for my psoriasis. One of my first major flares after being diagnosed with psoriasis as a child came during a strep throat infection.

Whenever I experience fever my skin tends to flare. A few years ago, I fought an influenza virus for over a week, then worked on calming my skin for the next few weeks.

Some psoriasis medications increase susceptibility to infections as a side effect. For years I took systemic medications for psoriasis that suppressed my immune system to where I would frequently get infections.

After stopping those, I haven’t caught colds, flu, or bacterial infections as easily. I don’t seem to get the same level of infections with biologic injectables either.

I also learned the importance of washing hands frequently and avoiding people who are ill. Sometimes it felt awkward to keep a distance from others or not shake their hands during flu season. With the coronavirus pandemic, everyone is more aware of the measures to prevent spreading germs so it’s less of a concern.

Why I avoid drinking alcohol

As a minister, some people think I avoid drinking alcohol for religious reasons. That is not the case at all. I enjoy a glass of wine at dinner or champagne at a festive occasion.

During the toasts at a wedding, I am tempted to grab a glass of champagne to join in the celebration. At last year’s New Year’s Eve gathering, I felt sad that I couldn’t drink with my friends to usher in the new year.

It’s disappointing to not be able to drink socially, but alcohol is one of those psoriasis triggers I’ve learned to respect.

It can feel awkward to explain to others why I need to refrain from drinking. I might even need to explain psoriasis to them in doing so. But I’d rather suffer that social discomfort than have my psoriasis flare.

The importance of moisturizing and avoiding dry skin

I’m a big advocate for regular skin moisturizing. My skin feels better overall when moisturized with reduced itch and irritation. I didn’t always understand the importance of moisturizing, however.

The dermatologist during the time I lived in the Bay Area pointed out my dry skin each visit. He first asked me to reduce showering frequency and duration. He also asked me to lightly scratch my skin to illustrate when I needed to moisturize.

It wasn’t until I moved to the drier Southern California climate that I took his advice more seriously. I noticed that days with very low relative humidity left my skin irritated.

I started using humidifiers in my office and home during those times. I also developed a layered moisturizer approach that I still apply throughout the day.

Lack of sleep and psoriasis flares

I’ve struggled with insomnia for as long as I can remember. However, it took some years to identify the connection between the lack of quality sleep and psoriasis flares. It was during a particularly stressful time of my life that I only slept a few hours each night. Sure enough, my psoriasis worsened not soon after.

Insomnia is a tough issue to address for me. It tends to be a symptom of an underlying source. That source could be work stress, irritated skin, relational conflict, or financial worry. As I work on mitigating the source of my insomnia, I’ve found it helpful to talk to my doctor about my sleep patterns.

My current dermatologist agrees that insomnia triggers my psoriasis. During regular check-ups, she asks about my sleep and has prescribed medications to help with both itch and sleep. I don’t always need them, but when insomnia worsens, I use them for a time to avoid triggering my psoriasis.

What psoriasis triggers have you identified? Does avoiding them bring about challenges in other areas of your life? Feel free to share in the comments how you are doing managing your psoriasis, especially your triggers.