What Triggers Psoriasis Flare
While the underlying cause of psoriasis stems from your body’s immune system, certain triggers can make symptoms worse or cause flare-ups. These psoriasis triggers include:
- Cold and dry weather. Such weather can dry out your skin, which makes the chances of having a flare-up worse. In contrast, hot, sunny weather appears to help control the symptoms of psoriasis in most people.
- Stress. Having psoriasis can itself cause stress, and patients often report that outbreaks of symptoms come during particularly stressful times.
- Some medications. Certain drugs, such as lithium , drugs for malaria, and some beta-blockers , can cause flare-ups of psoriasis symptoms.
- Infections. Certain infections, such as strep throat or tonsillitis, can result in guttate or other types of psoriasis two to three weeks after the infection. Psoriasis symptoms may worsen in people who have HIV.
- Trauma to the skin. In some people with psoriasis, trauma to the skin — including cuts, bruises, burns, bumps, vaccinations, tattoos, and other skin conditions — can cause a flare-up of psoriasis symptoms at the site of the injury. This condition is called “Koebner phenomenon.”
- Alcohol. Using alcohol may increase the chances of psoriasis flare-ups.
- Smoking. Some experts think that smoking can worsen psoriasis symptoms.
National Institute of Arthritis and Musculoskeletal and Skin Diseases.
American Academy of Dermatology.
Injuries Or Damage To Your Skin
Though a minor cut or scrape may not seem like a big deal, it can potentially lead to a flare-up according to Dr. Feinberg, who says that skin lesions are a common source of local flares.
“Almost anything that causes damage to an area of skin can cause psoriasis to come out when we’re dealing with an overall flare-up of the disease,” he explains. “It can be any type a small cut or injury.”
Getting a sunburn can also be the cause of flares. As AAD points out, “even a mild sunburn can worsen existing psoriasis and cause new psoriasis to form.”
Should I Avoid Any Foods Or Drinks If I Have Scalp Psoriasis
Certain foods or drinks may contribute to scalp psoriasis flare-ups. If you have scalp psoriasis, its a good idea to keep track of what you eat and drink in a food journal. Keeping track of what you eat and drink can help you and your healthcare provider determine any causes of your flare-ups.
An anti-inflammatory diet may limit your scalp psoriasis flare-ups. Foods that have anti-inflammatory properties include:
- Oily fish, such as mackerel, salmon or sardines.
- Leafy greens, such as spinach and kale.
- Olive oil.
Foods and drinks that may cause flare-ups include:
- Nightshade vegetables, including peppers, potatoes and tomatoes.
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Research And Statistics: Who Has Psoriasis
According to the National Psoriasis Foundation, about 7.5 million people in the United States have psoriasis. Most are white, but the skin disease also affects Black, Latino, and Asian Americans as well as Native Americans and Pacific Islanders.
The disease occurs about equally among men and women. According to the National Institutes of Health , it is more common in adults, and you are at a greater risk if someone in your family has it. A study published in September 2016 in the journal PLoS One concluded that interactions between particular genes as well as genetic and environmental factors play an important role in the diseases development.
People with psoriasis generally see their first symptoms between ages 15 and 30, although developing the disease between 50 and 60 years of age is also common.
The biggest factor for determining prognosis is the amount of disease someone has, says Michael P. Heffernan, MD, a dermatologist at the San Luis Dermatology and Laser Clinic in San Luis Obispo, California.
What Does Scalp Psoriasis Look Like
With scalp psoriasis, too much skin cell growth can typically lead to chronic inflammation across the whole scalp. The excess cells can form psoriatic plaques, which often have a reddish-silver appearance that can flake, itch, crack and even bleed. Not fun at all! Sometimes the patches are sore and irritating, and sometimes, theyre not. Mild scalp psoriasis can, at times, go almost unnoticed. However, severe scalp psoriasis can last for a long time and be very noticeable.
During a psoriasis flare-up, the swollen edges of the thick plaques are usually well defined. And if the white, silvery scale gets knocked off, thats when bleeding can occur. To protect the sensitive, thickened skin, its crucial you take care when brushing or combing the hair. Its also essential you use a shampoo and conditioner that are appropriate for your scalps condition.
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Clinical Trials For Psoriasis
Before a new treatment can be registered in Australia it must undergo extensive testing. Clinical trials are used to determine the safety and effectiveness of new treatments for psoriasis. The regulations governing clinical trials in Australia make the process as safe as possible for clinical trial participants. People with psoriasis may consider volunteering to participate in a clinical trial. Participation provides volunteers with access to cutting edge treatments that are not otherwise available. General information about being part of a clinical trial can be found here. Internationally, ClinicalTrials.gov provides patients, their family members, and the public with easy and free access to information on clinical studies for a wide range of diseases and conditions. If you are interested in participating in a clinical trial, talk to your doctor.
You’re Getting Over An Infection
Particularly an infection with strep bacteria. Some people have a psoriasis flare after a bout with strep throat, earache, bronchitis, tonsillitis, or a respiratory infection. This makes sense because infections go to the heart of what causes psoriasis: the immune system. Some people have a flare even without obvious symptoms of an infection, but a strep test may reveal an infection with the bug.
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How Can You Prevent Hair Loss
If youre living with scalp psoriasis there are a few things you can do to prevent unnecessary hair loss:
Treat Your Psoriasis
One of the best things you can do to prevent hair loss is to get rid of the source of it, which means learning how to manage your psoriasis. Hair loss is most likely to occur during a severe outbreak, so you should try to avoid stimuli that can trigger any flare-ups. If you find yourself in the middle of a symptom outbreak, then try to reduce the severity of your plaques through topical treatments or other medicines that were prescribed to you by your doctor.
Switch Up Your Wash Routine
Another way you can protect your tresses is by updating your wash routine. You should use a shampoo that is specially formulated to treat scalp psoriasis. Ingredients like salicylic acid and coal tar can reduce the severity of your scales and make them easier to remove. If you find these shampoos to be overly drying, then you may need to alternate your washes with your medicated shampoo and a gentle, non-medicated one.
Youll want to make sure that youre being very gentle while you wash your hair. Try to keep your nails smooth and free of any ridges or sharp edges. These can snag onto your hair strands and pull them out. Youll also want to avoid scrubbing your head too harshly or using your nails as this can cause further damage to your scalp.
Limit your amount of hot tools
Keep your hair moisturized
Talk to your dermatologist
What Causes Psoriasis To Flare Up And Worsen
Sometimes, psoriasis flare-ups can be completely random. But they can also occur in response to specific triggers.
The severity of a flare-up varies from person to person. Thats why its helpful to find out whether youre doing anything that may cause your psoriasis to worsen. Here are nine triggers that have been linked to flares:
- Stress. An increase in stress levels or living with ongoing, chronic stress can cause your psoriasis to flare up. Psoriasis itself can also be a source of stress.
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Clinical Features Of Psoriatic Alopecia
Since the first report of psoriatic alopecia was published in 1972, other authors have expanded the original clinical and histological descriptions. Shuster described hair loss affecting both the scalp and psoriatic plaques on the trunk and limbs, noting three types of scalp alopecia: alopecia confined to lesional skin, generalized telogen effluvium and rarely scarring alopecia.,
Lesional skin contains a higher proportion of telogen and catagen hairs compared with uninvolved patient skin or normal control skin, which provides further evidence for a localized telogen effluvium confined to the psoriatic plaque. Another study of hair root pattern found that patients with scalp psoriasis had a lower percentage of anagen hairs, a higher percentage of telogen hairs and a higher number of vellus-like hairs, compared with healthy controls . Trichograms in 29 patients revealed an increased telogen rate of up to 63% in patients with acute hair loss and 36% in those with chronic hair loss.
Patients with psoriasis have more dystrophic hairs in both affected and unaffected skin, compared with HCs. Hair shaft diameter is narrower in psoriatic plaques compared with unaffected skin in patients and HCs, but there is no difference between the skin of unaffected patients and that of HCs.
Sneaky Trigger: Getting Sick
Sometimes getting sick can be a double whammy: In addition to your actual illness, you could get a psoriasis outbreak, too. Anything that puts stress on the body can flare psoriasis, but infections in particular can exacerbate it, says Adam Friedman, M.D., professor and interim chair of dermatology at George Washington School of Medicine and Health Sciences. The same inflammation that jumps into high gear to fight the infection can worsen a psoriasis outbreak. Vitamin C, anyone?
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Avoid Scrapes Cuts Bumps And Infections
Its extra important for people with psoriasis to avoid bumps and cuts. Trauma to the skin can cause a flare, a condition called Koebners phenomenon. Infections can also cause problems. Be especially careful when shaving. Avoid acupuncture, tattoos, and do your best to prevent insect bites and chafing. Get more information on Koebners phenomenon and psoriasis.
How Is Guttate Psoriasis Diagnosed
Your doctor can identify signs of guttate psoriasis during a physical examination. Your doctor will likely refer you to a dermatologist for a proper diagnosis.
The dermatologist will examine your skin and make note of the affected areas. This mapping will help them track treatments after diagnosis.
Theyll also take a complete medical history to rule out other conditions, like an allergic reaction. People often have allergic reactions to the antibiotics used to treat the infection that precedes the guttate psoriasis outbreak.
Your dermatologist can usually diagnose guttate psoriasis by examining your skin. But the following conditions may occasionally be mistaken for guttate psoriasis:
- scarlet fever rash, which can occur after strep throat
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Covid19 Infection In Known Psoriasis Patients With Specific Changes In Psoriatic Symptoms
Gananandan et al. reported a 38yearold male with chronic active psoriatic plaques that 6 days after the onset of fever caused by COVID19 developed multiple erythematous legions on his lower limbs.47
In Ghalamkarpour’s paper, a 45yearold male with a 20year history of psoriasis had erythrodermic flareup following COVID19 infection. Moreover, the patient had discontinued his psoriasis medications before being infected with COVID19.48
Signs And Symptoms Of Psoriasis
Psoriasis plaques can range from a few spots of dandruff-like scaling to major eruptions that cover large areas. The diseases symptoms and appearance vary according to the type and severity of psoriasis.
Some common signs and symptoms include:
- Discolored patches or raised plaques of skin that are covered with scales
- Burning, itching, or soreness near the affected areas
- Pitted or thickened fingernails or toenails
Maintain A Healthy Weight
When it comes to managing your psoriasis, Warycha says maintaining a healthy weight can help lower the levels of inflammation in the body. In addition to diet, engaging in physical activity can also help you manage your weight.
If youre finding it challenging to lose weight or maintain a healthy weight, talk to your doctor.
Most Importantly Be Patient With Yourself
Dont worry if you still havent found your flare-up silver bulletpsoriasis symptoms and triggers can vary immensely from person to person, so different treatments will work better for different people.
That said, if you find that your flares are becoming more frequent or increasingly difficult to treat, Dr. Newsom says its probably time to check in with your dermatologist for guidance around how best to treat your condition.
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How To Manage Scalp Psoriasis
Scalp psoriasis may result in the urge to scratch your scalp. Dont do this. Picking or scratching at your scalp can actually cause your psoriasis to flare up, bleed and result in hair loss.
- When removing scales, do this with care. Part of treating scalp psoriasis means the scales will have to be removed.
- Dont stress. Stress can result in a flare up of your psoriasis. We understand this treatment can be frustrating, but try to reduce stress as much as possible.
- Pay attention to your hair care. When brushing your hair, be gentle. Limit the use of hot tools on your hair or wearing a tight hairstyle. Pulling on your hair can cause hair loss. Coloring and styling your hair may also cause your psoriasis to flare.
Sneaky Trigger: Falling Temps
Baby, its cold outsideand that cold weather isnt doing good things for your skin. The lack of sunlight can cause patients to flare during the winter months, says Omar Noor, M.D., board-certified dermatologist at Rao Dermatology in New York City. You can try phototherapy, a treatment that uses a specific wavelength of UVB sunlight to improve psoriasis. Insider tip: moisturize, moisturize, moisturize! Slathering on lots of lotion and using a humidifier in your home can be a big help to prevent flares.
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Sneaky Trigger: Prescription Meds
While your medication may fix one problem, it could be causing another. Dr. Friedman advises those with psoriasis to steer clear of beta blockers, anti-malarials and lithium. Oral steroids are also a big no-no, he adds, as they can cause a severe flare when going off of them. It is important to speak with your physician before starting or stopping any medications.
Causes And Risk Factors Of Psoriasis
Psoriasis, in general, is a genetic condition passed down through families. “It’s likely that multiple genes need to be affected to allow psoriasis to occur and that it’s frequently triggered by an external event, such as an infection,” says James W. Swan, MD, professor of dermatology at the Loyola University Stritch School of Medicine in Maywood, Illinois.
Certain risk factors, such as a family history or being obese, may increase your odds of developing psoriasis.
According to the National Psoriasis Foundation , at least 10 percent of people inherit genes that could lead to psoriasis, but only 3 percent or less actually develop the disease. For this reason, it is believed that the disease is caused by a combination of genetics and external factors or triggers.
A psoriasis outbreak may be provoked by:
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Light Treatment For Plaque Psoriasis
Light therapy is a common treatment for plaque psoriasis. Because light therapy is nonpharmaceutical, its a popular choice prior to systemic medications.
Some people are able to achieve healing through regular limited sessions of sun exposure, while others fare better using a special light machine.
Check with your dermatologist before treating your psoriasis through exposure to sunlight. Too much sun exposure can burn your skin and make plaque psoriasis worse.
What Psoriasis Medications Can I Take
Biologics for Psoriasis
The following drugs are categorized under the term biologic because they are all proteins produced in the laboratory by industrial cell culture techniques and must be given either subcutaneously or intravenously. The frequency of treatment depends on the specific drug. All of these medications are very precise in that they block only one or two parts of the inflammatory reaction and are moderately immunosuppresive.
Biologics are expensive and do not cure psoriasis but as a group are quite effective and reasonably safe. If it is decided to start a patient on a biologic drug, the choice will depend on the particular physicians expertise, as well as insurance coverage and payment issues.
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Beware Of Insect Bites
Psoriasis sufferers are vulnerable to suffering from the Koebner phenomenon, where symptoms get worse after the skin is damaged.
An insect bite will break the skin and could set this reaction off, so its well worth taking care during the warmer months.
If youre worried, its a good idea to cover up with long-sleeved tops and long trousers to prevent insects from getting close to your skin.
You should also invest in an effective insect repellent. However, bear in mind that one of the key ingredients in these products, DEET , can react badly with your psoriasis and cause plaques to get worse.
Choose a product with low levels of DEET and never spray insect repellent directly on patches of irritated skin or open sores.
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