Psoriasis Triggers: What Can Cause a Flare-Up?
The common triggers of psoriasis flare-ups, the medicines that can cause them and practical ways to calm a flare.
Part of our psoriasis guide.
Get urgent help first. Call 999 or go to A&E if your skin suddenly becomes red and inflamed over most of your body, or you have widespread pus-filled spots, especially with a fever, chills or feeling very unwell. These can be signs of erythrodermic or generalised pustular psoriasis, which are emergencies. See a GP soon if you have painful, swollen joints. Online treatment isn't suitable in these situations.
Key fact: common psoriasis triggers include throat infections, skin injury, stress, smoking, alcohol, cold weather and some medicines. Finding and avoiding your own triggers can reduce how often psoriasis flares.
Adults only online, and not in pregnancy or breastfeeding. Access Doctor's online psoriasis service is for adults aged 18 and over, and can't supply treatment if you're pregnant or breastfeeding: your GP or midwife can help. Children with psoriasis should see their GP.
What triggers psoriasis?
Psoriasis runs in families, but something usually sets off the first episode and later flare-ups. Triggers vary from person to person. Keeping a simple diary of flares, alongside what was happening at the time, can help you find yours.
Infections
Strep throat often triggers guttate psoriasis 2 to 3 weeks later. Other infections can trigger flares too.
Skin injury
Cuts, scratches, insect bites, tattoos, sunburn and friction can cause new plaques at the injured spot (the Koebner response).
Stress
One of the most common triggers reported. Psoriasis itself can also cause stress, creating a cycle.
Smoking
Linked with developing psoriasis, more severe psoriasis, and pustular psoriasis of the hands and feet.
Alcohol
Drinking heavily is linked with worse psoriasis and with treatment working less well.
Weather
Cold, dry weather often makes psoriasis worse; many people improve in summer.
Medicines that can trigger psoriasis
Some medicines can trigger or worsen psoriasis in some people. Don't stop a prescribed medicine yourself: talk to your doctor, who can weigh up the options.
- Lithium
- Some antimalarials, such as hydroxychloroquine and chloroquine
- Beta-blockers (for example for blood pressure or angina)
- Anti-inflammatory painkillers such as ibuprofen (in some people)
- ACE inhibitors (in some people)
- Stopping steroid tablets or a strong steroid cream suddenly, which can cause a flare or, rarely, pustular psoriasis
Stress and psoriasis
Many people notice flares after a stressful time, and living with psoriasis can be stressful in itself. Regular exercise, enough sleep, talking therapies and mindfulness can help. If psoriasis is affecting your mood, tell your GP: low mood and anxiety are common with psoriasis and can be treated.
Alcohol, smoking and weight
Cutting down on alcohol, stopping smoking and losing weight if you're overweight can all reduce how severe psoriasis is and how often it flares, and help treatments work better. Alcohol also matters if you take methotrexate, which affects the liver. Our guide to psoriasis and diet covers food, alcohol and weight in more detail.
Winter, sunlight and sunbeds
Cold, dry air and central heating dry the skin, so psoriasis often worsens in winter. Use emollients more often and keep the air in your home from getting too dry. Sunlight helps many people, but sunburn can trigger new plaques, so build up exposure gradually and use sunscreen. Sunbeds aren't recommended for psoriasis because they raise the risk of skin cancer; medical light therapy is carefully dosed and supervised instead (see light therapy).
Hormones
Psoriasis can change with hormones. Some people notice it around puberty or the menopause, and many find it improves in pregnancy, then flares after the birth. See psoriasis and pregnancy.
How to stop a psoriasis flare-up
1
Restart your treatment early
Start your usual treatment as soon as a flare begins, rather than waiting for it to spread.
2
Moisturise more
Use emollients several times a day and as a soap substitute.
3
Don't pick or scratch
Picking off scale or scratching can make new plaques form. Keep nails short.
4
Deal with the trigger
Treat a sore throat, manage stress, cut down alcohol, protect the skin from injury.
5
Get help if it's spreading
See a GP if the flare is widespread, very sore or you feel unwell. Red skin all over your body or widespread pus spots needs urgent care.
Psoriasis flaring on your body?
Our GPhC-registered pharmacist independent prescribers can assess your psoriasis online and, if suitable, prescribe treatment to calm the flare. Adults 18 and over. Dispensed from our UK pharmacy. Approved before 3pm, Monday to Friday? Dispatched the same day, by Royal Mail Tracked 48, Tracked 24 or Special Delivery guaranteed by 1pm next working day: you choose.
Start Psoriasis Consultation →How our online service supplies psoriasis treatment: adults 18 and over, not for the face, genitals or skin folds. Enstilar, Dovobet and other psoriasis-only treatments need psoriasis already diagnosed by a GP or dermatologist. Enstilar and Dovobet: one pack per order, supplied as a course of up to 4 weeks, on no more than 30% of the body. Betnovate and Elocon: up to 3 × 30g or 1 × 100g, for a 4-week course followed by a 4-week break. Dermovate only if you have been prescribed it before. Widespread psoriasis, joint pain or psoriasis that hasn't responded to treatment is referred to your GP.
UK safety and reporting side effects
Prescription psoriasis treatments are only supplied after a GPhC-registered pharmacist independent prescriber reviews your consultation, including where your psoriasis is, how much skin it covers and what you have used before. Always read the patient information leaflet. Since 2024, UK steroid packs show their strength on the front (mild, moderate, strong or very strong). The MHRA advises using topical steroids for the shortest time needed, and to tell a healthcare professional if your skin flares badly after you stop a steroid you have used for a long time, which can be a topical steroid withdrawal reaction.
If you think you've had a side effect, tell your pharmacist or doctor. You can also report it to the MHRA through the Yellow Card scheme.
Psoriasis treatments from Access Doctor
See our psoriasis treatment options guide for how flares are treated, or our psoriasis treatment page for the treatments we supply.
Vitamin D + potent steroid · Rx
Enstilar Foam
Calcipotriol with betamethasone in a spray foam, once a day for up to 4 weeks. For diagnosed plaque psoriasis.
View product →Potent steroid · Rx
Betnovate Ointment
The greasier form, better for thick, dry or scaly plaques.
View product →Frequently Asked Questions
What is the biggest trigger for psoriasis?
It varies from person to person, but stress, infections such as strep throat, skin injury, smoking and alcohol are among the most common. Keeping a flare diary can help you find your own triggers.
How do I stop a psoriasis flare-up?
Restart your usual treatment early, use emollients more often, avoid picking or scratching, and deal with any trigger such as an infection or stress. See a GP if the flare is spreading quickly or you feel unwell.
Can stress cause psoriasis?
Stress doesn't cause psoriasis on its own, but it's one of the most common triggers for flares in people who already have it. Managing stress can help reduce flares.
Can smoking make psoriasis worse?
Yes. Smoking is linked with developing psoriasis, with more severe psoriasis and especially with pustular psoriasis of the hands and feet. Stopping smoking can help psoriasis settle and treatments work better.
Why is my psoriasis worse in winter?
Cold, dry air and indoor heating dry out the skin, and there's less sunlight, which helps many people's psoriasis. Using emollients more often in winter can help.
Can sunbeds help psoriasis?
Sunbeds aren't recommended. They raise the risk of skin cancer and aren't controlled like medical light therapy, which a dermatologist can offer if your psoriasis is widespread.
References
- NHS. Psoriasis. nhs.uk
- NICE Clinical Knowledge Summaries. Psoriasis. cks.nice.org.uk
- British Association of Dermatologists. Psoriasis: an overview (patient information leaflet), August 2023. skinhealthinfo.org.uk
- NICE. Psoriasis: assessment and management (CG153). nice.org.uk
Medical disclaimer: This article is for information only and isn’t medical advice. Prescription psoriasis treatments need a clinical consultation before they can be supplied. If your skin is red all over, you have widespread pus spots, a fever or you feel unwell, seek medical advice the same day. In a medical emergency, call 999.