Stress
Stress is a proven trigger in some people. It can cause psoriasis to flare for the first time or aggravate existing psoriasis.
Relaxation and stress reduction may help people with psoriasis. For example, not only does relaxation help lower stress levels, but also it gives people a feeling of control. These techniques, however, seem to work best with traditional medical treatments, instead of using the techniques alone.
How can people cope with stress?
Cope with the stigma: A stigma - a characteristic that other people think of as negative - can erode a person's self-esteem. Low self-esteem can lead to stress, and possibly a worsening of psoriasis. One way to overcome the stigma, however, is to understand how and why it occurs.
Hypnosis: This relaxation technique may help people who are using other treatments. For example, one study found that people who listen to meditation-based relaxation tapes while they are using light therapy may clear faster than those who don't listen to the tapes.
Injury to skin
Sometimes psoriasis appears in areas of the skin that have been injured or traumatized. This is called the "Koebner phenomenon." Vaccinations, sunburns and scratches can all trigger a Koebner (KEB-ner) response. The Koebner response can be treated if it is caught early enough.
Medicine
Certain medications are associated with triggering psoriasis.
Lithium: Used to treat manic depression and other psychiatric disorders. Lithium aggravates psoriasis in about half of those with psoriasis who take it.
Antimalarials: Quinacrine, chloroquine and hydroxychloroquine may cause a flare of psoriasis, usually two to three weeks after the drug is taken. Hydroxychloroquine has the lowest incidence of side effects.
Inderal: This high blood pressure medication worsens psoriasis in about 25 percent to 30 percent of patients with psoriasis who take it. It is not known if all high blood pressure (beta blocker) medications worsen psoriasis, but they may have that potential. Sometimes other medications can be substituted.
Quinidine: This heart medication has been reported to worsen some cases of psoriasis.
Indomethacin: This drug is used to treat arthritis. It is a nonsteroidal anti-inflammatory drug. It has worsened some cases of psoriasis.
What are other triggers?
Weather: May make skin drier and more susceptible to a psoriasis outbreak.
Strep infection: May trigger guttate psoriasis.
Diet: Although unproven, changing the diet has helped some people improve their psoriasis or avoid flares.
Allergies: Although unproven, some people suspect that allergies trigger their psoriasis.
