The main triggers that worsen psoriasis

Psoriasis flares when your immune system becomes overactive, and certain things in your life and environment push that to happen. The most common triggers are stress, infections (especially strep throat), skin injuries, cold weather, and certain medications. Not everyone's psoriasis responds the same way—your triggers may be different from someone else's, and you may have multiple triggers that combine to set off a flare.

Stress is one of the strongest and most consistent triggers. When you experience emotional stress, your body releases hormones that can activate immune cells in your skin. This is why psoriasis often worsens during difficult periods—job loss, relationship problems, grief, or major life changes. The connection works both ways: stress triggers flares, and flares cause stress, which can trigger more flares.

Infections, particularly strep throat, can start a psoriasis flare within two to three weeks. Other bacterial and viral infections may also trigger or worsen plaques. This is why some people notice their psoriasis gets worse when they catch a cold or have another infection.

Key Takeaways

  • Stress, infections, skin injuries, cold weather, and certain medications are the most common things that make psoriasis worse.
  • Alcohol and smoking both worsen psoriasis and can make flares more severe and harder to treat.
  • Keeping your skin moisturized, managing stress, and avoiding your personal triggers can reduce how often flares happen.
  • Some medications used for other conditions—including certain blood pressure drugs and lithium—can trigger or worsen psoriasis.
  • Identifying your own triggers through tracking when flares happen helps you avoid them or prepare for them.

Skin injuries and physical trauma

A phenomenon called the Koebner response means that psoriasis can appear on skin that has been injured or irritated. This includes cuts, scrapes, burns, sunburns, tattoos, surgical scars, or even vigorous scratching. The new plaques usually show up one to two weeks after the injury.

This is why dermatologists recommend being gentle with psoriatic skin—avoiding scratching even when itchy, protecting skin from cuts and scrapes, and being cautious with procedures like tattoos or surgery. If you do get injured, keeping the area clean and moisturized may help reduce the chance of a flare at that spot.

Weather and seasonal patterns

Cold, dry weather worsens psoriasis for most people. Winter typically brings more flares because the air is drier, heating systems remove moisture from indoor air, and people spend less time in sunlight. The combination of cold temperatures and low humidity strips moisture from skin and can trigger immune activity.

Sunlight actually helps psoriasis for many people—this is why some flares improve in summer or after time at the beach. However, sunburn is a trigger, so sun exposure needs to be gradual and protected. A small amount of natural sunlight most days may help, but getting burned will likely make things worse.

Alcohol and smoking

Both alcohol and smoking worsen psoriasis and are among the few triggers you can directly control. Heavy alcohol use is linked to more severe psoriasis and flares that are harder to treat. Smoking increases the risk of developing psoriasis in the first place and makes existing psoriasis worse.

The effect is dose-dependent—the more you drink or smoke, the greater the impact on your skin. Cutting back or quitting can lead to improvement, though it may take weeks or months to see the full benefit. If you use either, talking with your doctor about reducing use is worth doing for your skin and your overall health.

Medications that can trigger flares

Certain medications used to treat other conditions can trigger or worsen psoriasis. The most common are beta-blockers (used for high blood pressure and heart conditions), lithium (used for bipolar disorder), and NSAIDs like ibuprofen and naproxen. Antimalarial drugs and ACE inhibitors can also trigger flares in some people.

If you take any of these and have psoriasis, do not stop taking them on your own—some are essential for your health. Instead, talk with the doctor who prescribed them about whether alternatives exist or whether the benefit of the medication outweighs the skin impact. Your dermatologist and primary care doctor can work together to find the best approach.

Diet and weight

Obesity is linked to more severe psoriasis and more frequent flares. Weight loss, even modest amounts, can improve psoriasis severity for some people. The connection appears to involve inflammation—excess weight increases inflammatory markers in the blood, which can activate the immune response that drives psoriasis.

Specific foods are not proven to trigger psoriasis in most people, though some individuals report that certain foods make their flares worse. Common suspects include alcohol, red meat, processed foods, and foods high in omega-6 fatty acids. Keeping a simple log of what you eat and when flares happen can help you spot your own patterns. Some evidence suggests that foods rich in omega-3 fatty acids (like fish and flaxseed) and a diet high in vegetables may help reduce inflammation.

Hormonal changes

Psoriasis often changes during hormonal shifts. Many women report that flares worsen before their period or during pregnancy, while others see improvement during pregnancy. Menopause can also trigger changes in psoriasis severity. These shifts happen because hormones influence immune function.

If you notice a pattern tied to your menstrual cycle or other hormonal events, tracking this information can help you anticipate flares and manage them. Your doctor can discuss whether hormonal treatments or timing adjustments might help, though this is individual and depends on your specific situation.

How to identify your personal triggers

Because triggers vary from person to person, the most useful thing you can do is track your own flares. When a flare happens, note what was going on in the days or weeks before—were you stressed? Did you have an infection? Was the weather particularly cold or dry? Did you start a new medication? Did you have a skin injury?

Over time, patterns usually emerge. You may find that stress is your main trigger, or that cold weather combined with dry skin is what sets things off. Once you know your triggers, you can take steps to avoid them when possible or prepare for flares when you cannot avoid them. Share this information with your dermatologist—it helps them understand your psoriasis and choose treatments that work for your situation.

Frequently Asked Questions

Can diet alone control my psoriasis?

Diet may help reduce inflammation and improve psoriasis for some people, but it is not a replacement for medical treatment. If you have moderate to severe psoriasis, you will likely need medications prescribed by a dermatologist. Diet changes work best as part of an overall approach that includes stress management, skin care, and medical treatment.

Does psoriasis get worse as you get older?

Psoriasis does not automatically worsen with age, but it can change. Some people have fewer flares as they age, while others experience more. Hormonal changes, medications for age-related conditions, and changes in immune function can all affect psoriasis over time. Your triggers and severity may shift, so what worked years ago might need adjustment.

If I avoid all my triggers, will my psoriasis go away?

Avoiding triggers reduces how often flares happen and how severe they are, but it does not cure psoriasis. Psoriasis is a chronic condition driven by your immune system, so even with perfect trigger avoidance, flares may still occur. The goal is to reduce flares and manage them when they happen, not to eliminate the condition entirely through lifestyle alone.

Is my psoriasis contagious?

No. Psoriasis is not contagious—you cannot catch it from someone else or pass it to someone else through contact, even during a flare. It is an autoimmune condition, not an infection. You can be around others without any risk of spreading it.

Can exercise make psoriasis worse?

Exercise itself does not trigger psoriasis, and regular physical activity may actually help by reducing stress and supporting overall health. However, sweating combined with friction from tight clothing can irritate skin and potentially trigger a flare in some people. Wearing loose, breathable clothing and showering after exercise can help prevent this.