Psoriasis

Causes and Triggers of Psoriasis

If you’re reading this, you or someone you love might be dealing with this condition. Psoriasis is more than just a skin issue; it’s an autoimmune disease. In simple terms, this means your immune system mistakenly attacks skin cells, leading to them rapidly building up into patches that are sometimes red, itchy, and uncomfortable.

We understand that dealing with psoriasis can feel overwhelming. That’s why this article aims to provide you with a comprehensive overview of the various factors that contribute to the onset and exacerbation of psoriasis. Whether you’re new to this journey or have been navigating it for a while, this guide aims to empower you with the knowledge you need to better understand and manage your condition.

Understanding the causes and triggers of psoriasis is a crucial step in effective management. When you know what triggers your symptoms, you can take proactive steps to avoid those triggers, thereby reducing flare-ups and improving your quality of life.

Role of Genetics and Heredity

Could Your Family History Be a Clue?

If you’re dealing with psoriasis, you might be wondering, “Why me?” It’s a valid question, and the answer often lies in a complex interplay of factors, including your genetic makeup. Yes, you read that right — your family history could be a significant clue in understanding why you have psoriasis. Psoriasis can run in families, making individual family members genetically predisposed to the condition. So, if you have parents or siblings with psoriasis, your chances of developing it are higher. (Source)

What Genes Are Linked to Psoriasis?

Now, let’s delve a bit deeper into the science behind it. Researchers have identified specific genes that are associated with psoriasis. These genes can influence how your immune system responds to various triggers, making you more susceptible to flare-ups.

Two such genes that have been closely studied are PSORS1 and PSORS2. These genes affect how your immune system interacts with environmental factors, thereby influencing the onset and severity of your symptoms. For example, the PSORS1 gene is strongly associated with plaque psoriasis, the most common form of the disease. (Source)

How Do These Genetic Factors Affect Your Immune Response?

How do these genes actually influence your body? In simple terms, these genes can affect how your immune system responds to triggers such as stress or skin injuries. When these genes are “activated,” so to speak, they can cause your immune system to react more aggressively, leading to the rapid buildup of skin cells that characterizes psoriasis. 

What Does This Mean for You?

Understanding your genetic predisposition can offer a more personalized approach to managing your psoriasis effectively. It can inform the types of treatments that work best for you and help you understand why certain triggers lead to flare-ups. While you can’t change your genes, knowing your genetic predisposition can empower you to take proactive steps in other areas of your life, such as lifestyle and environmental factors, to manage your symptoms better.

Environmental Factors

Navigating life with psoriasis can be a complex journey, and understanding the triggers is a crucial part of managing this condition effectively. While genetics plays a role, various environmental factors can also significantly affect your symptoms. Understanding the environmental triggers for psoriasis allows you to take control and make lifestyle adjustments that can significantly improve your quality of life.

Let’s explore these triggers to empower you with the knowledge you need.

Can Stress Really Make My Psoriasis Worse?

Yes, stress is a significant player when it comes to psoriasis. Picture stress as a switch, flipping on your body’s “fight-or-flight” mode. This isn't just about feeling anxious or upset; stress actually kick-starts a chemical reaction in your body, leading to inflammation and affecting your immune system.

Research showed that stress affects substances in your body called eicosanoids and endocannabinoids, which normally help keep skin inflammation in check. When you’re stressed, these substances can get out of balance, further increasing inflammation and worsening psoriasis. But there’s more; stress also affects the very structure of your cells, altering the fats (lipids) within them. These changes further worsens your psoriasis symptoms. (Source)

How Do Weather Conditions Affect My Psoriasis?

Extreme weather conditions can be particularly harsh on your skin. Cold, dry air can make your skin lose moisture, worsening psoriasis symptoms. On the other hand, excessive humidity can also lead to flare-ups. Adapting your skincare routine to the weather can make a world of difference. For instance, using a humidifier during dry months can help maintain skin moisture. (Source)

What’s the Link Between Skin Injuries and New Psoriatic Lesions?

Even a small injury to your skin can trigger psoriasis, a process known as the Koebner phenomenon. Imagine your skin’s normal barrier as a protective wall. When there’s a break or injury, like a cut or scrape, it’s like a breach in this wall. Your body is programmed to defend against these breaches, but in psoriasis, the defense system gets a bit too zealous.

Here’s what happens: An injury occurs, setting off a complex chain of events inside your skin. Cells called mast cells spring into action, releasing substances that cause inflammation and stimulate more cells to rush to the site. Think of these as the body’s alarm system, calling for backup.

But in psoriasis, this process is like an alarm that doesn't turn off, leading to continued inflammation and rapid skin cell growth. The result? New psoriatic lesions where the skin was injured. It’s a delicate balance, and even the nerve growth factor, which normally helps heal wounds, can contribute to inflammation in psoriasis. (Source)

Can Infections Trigger My Psoriasis?

Yes, infections can be a significant trigger, particularly streptococcal infections. Additionally, psoriasis is closely linked with fungal pathogens like Candida and Malassezia, as well as viruses such as HIV, hepatitis C, and human papillomavirus. When your body fights off these infections, the immune response can sometimes cause your psoriasis to flare up. (Source)

Lifestyle Choices

Understanding that each person’s journey with psoriasis is unique, it’s crucial to recognize how certain lifestyle choices can influence the severity and frequency of flare-ups. While these factors don’t cause psoriasis, they can worsen symptoms and affect your overall quality of life. Let’s delve into how your daily choices can play a significant role in managing this condition.

What’s the Connection Between Diet and Psoriasis?

Diet plays a pivotal role in managing autoimmune conditions like psoriasis. Certain foods can promote inflammation, a key player in psoriasis, while others can help reduce it. For instance, foods high in omega-3 fatty acids, such as fatty fish and flaxseeds, have anti-inflammatory properties, while processed foods and those high in saturated fats may worsen inflammation. (Source)

Additionally, maintaining a balanced diet ensures your body gets the essential nutrients it needs to function optimally, potentially easing psoriasis symptoms.

Do Alcohol and Smoking Influence Psoriasis?

You might seek comfort in alcohol or feel the urge to smoke, especially during stressful times. However, alcohol and tobacco are known to be psoriasis triggers.

Excessive consumption of alcohol can make your body more prone to infections and can cause certain cells in your body to multiply faster than usual, which can worsen psoriasis. Alcohol also triggers your body to produce substances called proinflammatory cytokines, which basically means it creates a kind of internal environment that can ignite inflammation, leading to a psoriasis flare-up. So, cutting back on alcohol consumption can be a big help in keeping your psoriasis in check. (Source)

Smoking, too, can increase the risk of psoriasis and also make the symptoms more severe. Smoking creates a chaotic environment in your body, producing harmful substances that cause oxidative stress (think of it as rusting, but inside your body). This interferes with important pathways in your cells, leading to the production of harmful proteins and inflammation, which are big players in psoriasis.

Also, smoking’s effects aren’t limited to your skin. It’s linked to several other health issues, some of which are also common in people with psoriasis, such as heart disease and certain types of cancer. (Source, Source)

Can Regular Exercise Trigger Psoriasis?

While regular physical activity is a cornerstone of healthy living, some individuals with psoriasis might experience flare-ups triggered by certain types of exercise, especially those that cause friction or sweating. However, this doesn’t mean you should avoid exercise. It’s important to find the right balance and type of physical activity that suits your body. Activities such as yoga and walking can be excellent options. (Swimming is another good exercise, but chemicals in public pools may worsen psoriasis, so care must be taken to protect skin.) It’s always advisable to consult with your health care provider before starting any new exercise regimen. (Source)

Other Triggers

It’s essential to recognize that psoriasis doesn’t operate in isolation. It’s a complex condition influenced by various internal and external factors. Understanding these triggers can empower you to manage your symptoms more effectively.

Can Other Medications Worsen My Psoriasis?

Certain medications, though meant to heal, can sometimes trigger psoriasis, a bit like an unexpected guest showing up at your door. This is particularly seen with the following medications;

  • lithium: Used for treating mood disorders, lithium can be a bit of a double-edged sword. It helps stabilize your mood but can also cause psoriasis in some people. The tricky part is that it doesn’t happen immediately — it might take several weeks or even months before you notice any skin changes, and these changes can sometimes be resistant to typical psoriasis treatments.
  • beta blockers: These medications are used for managing high blood pressure and a wide range of other medical conditions, and they’re known to contribute to psoriasis. 
  • antimalarial drugs: If you’re traveling and you take drugs like chloroquine to prevent malaria, they might exacerbate your psoriasis. These drugs are more likely to cause flare-ups of existing psoriasis than to cause new cases.
  • corticosteroids: Unlike other medications, corticosteroids (anti-inflammatory medications) can cause problems when you stop taking them. If you’ve been using corticosteroids and suddenly stop, your psoriasis can come back with a vengeance, as your body rebounds and overreacts.
  • Other medications: Some blood pressure medications (such as ACE inhibitors and sartans), pain relievers (NSAIDs), and certain antibiotics and antifungals can also be culprits. They might trigger psoriasis or make existing cases worse.

. (Source, Source)

How Do Hormonal Changes Affect Psoriasis?

Your body’s hormonal balance plays a crucial role in the development and severity of psoriasis. Let’s break it down.

  • stress hormones: When you’re stressed, your body releases hormones such as cortisol and epinephrine. These hormones can affect your immune system. For instance, epinephrine can both promote and regulate immune responses. Stress can lead to the activation of immune cells, which produce substances called cytokines. These cytokines cause inflammation, which can trigger psoriasis. 
  • prolactin: Prolactin is a hormone related to lactation and reproduction. Your skin cells have receptors for prolactin, and this hormone can make them grow faster. Prolactin also has effects on the immune system, such as inhibiting certain immune cells, that can promote the development of psoriasis. 
  • thyroid hormones: Your skin also has receptors for thyroid hormones, which can stimulate skin cell growth. There’s evidence to suggest that excessive production of thyroid hormones can intensify psoriasis. Some people with psoriasis have higher levels of certain thyroid hormones. Interestingly, some drugs used to treat thyroid conditions can also help with psoriasis.
  • sex hormones: Estrogens, a type of sex hormone, can both help and potentially worsen your psoriasis. On the positive side, they have anti-inflammatory effects by calming keratinocytes, the cells forming the outermost layer of your skin. However, estrogens can also stimulate skin cell growth, potentially worsening psoriasis. Your hormone levels change dramatically during specific times in your life, such as puberty or pregnancy. For some, psoriasis symptoms improve around the 30th week of pregnancy due to increases in hormones such as estrogen. But after giving birth or during menopause, when hormone levels drop, psoriasis might flare up again. Androgens, another type of sex hormone, also affect psoriasis. They play a role in maintaining your skin’s health and controlling inflammation. However, therapies based on androgens can sometimes make psoriasis worse.
  • other hormones and factors: Leptin, ghrelin, and insulin are other hormones that have been linked to psoriasis. For instance, obesity and diabetes, conditions related to these hormones, are strongly associated with psoriasis. Leptin, a hormone produced by fat cells, might have a connection with psoriasis, especially in overweight or obese individuals. Similarly, there’s a link between insulin resistance and psoriasis.

(Source, Source, Source, Source)

Are Coexisting Autoimmune Conditions Common With Psoriasis?

Yes, individuals with psoriasis are at a higher risk of developing other autoimmune diseases due to shared inflammatory pathways and genetic predispositions. For instance, individuals with Crohn’s disease, a type of inflammatory bowel disease, have a higher likelihood of developing psoriasis. Similarly, conditions such as thyroid disorders, psychological stress, and metabolic syndrome can exacerbate psoriasis. These conditions contribute to a systemic inflammatory state, heightening the autoimmune response and potentially worsening psoriasis symptoms.

Additionally, patients with psoriasis may experience more severe manifestations of non-alcoholic fatty liver disease and a slightly increased risk of lymphomas (cancers of the lymph system), underscoring the intricate interplay between psoriasis and various bodily systems. (Source)

The Bottom Line: Understanding Psoriasis to Empower Your Health Journey

Psoriasis, an autoimmune condition that manifests in various ways from person to person, isn’t just skin-deep. It involves a complex interplay of genetic factors, immune system responses, and environmental triggers. Recognizing these aspects is crucial because knowledge is power — power that enables you to take charge of your health and well-being.

Understanding the intricacies of what causes psoriasis and what can trigger a flare is foundational in managing the condition effectively. Remember, psoriasis is not a one-size-fits-all condition. What may trigger a flare in one person might not affect another. This individual variability is why personalized care plans are paramount in your journey to wellness.

How WellTheory Can Guide Your Path to Wellness

At WellTheory, we’re committed to providing personalized, evidence-based care plans that align with your individual needs and lifestyle. Our approach is holistic, encompassing not just medical treatments but also nutrition, stress management, and other lifestyle factors that can improve your psoriasis symptoms. We’re here to guide you every step of the way, offering daily support and a care team that understands firsthand the challenges of living with autoimmune conditions like psoriasis.

References

Balak, D. M., & Hajdarbegovic, E. (2017). Drug-induced psoriasis: Clinical perspectives. Psoriasis, 7, 87–94. https://doi.org/10.2147/PTT.S126727

Capon, F. (2017). The genetic basis of psoriasis. International Journal of Molecular Sciences, 18(12), 2526. https://doi.org/10.3390/ijms18122526

Ceovic, R., Mance, M., Bukvic Mokos, Z., Svetec, M., Kostovic, K., & Stulhofer Buzina, D. (2013). Psoriasis: Female skin changes in various hormonal stages throughout life—Puberty, pregnancy, and menopause. BioMed Research International, 2013, 571912. https://doi.org/10.1155/2013/571912

Ji, Y. Z., & Liu, S. R. (2019). Koebner phenomenon leading to the formation of new psoriatic lesions: Evidences and mechanisms. Bioscience Reports, 39(12), BSR20193266. https://doi.org/10.1042/BSR20193266

Keen, M. A., & Hassan, I. (2014). Serum prolactin levels in psoriasis and its association with disease activity: A case-control study. Indian Journal of Dermatology, 59(6), 562–566. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4248491/

Naldi, L. (2016). Psoriasis and smoking: Links and risks. Psoriasis, 6, 65–71. https://doi.org/10.2147/PTT.S85189

Naldi, L., & Mercuri, S. R. (2009). Smoking and psoriasis: From epidemiology to pathomechanisms. Journal of Investigative Dermatology, 129(12), 2741–2743. https://doi.org/10.1038/jid.2009.315

Naldi, L., Péli, L., Parazzini, F., & Carrel, C. (2001). Family history of psoriasis, stressful life events, and recent infectious disease are risk factors for a first episode of acute guttate psoriasis: Results of a case-control study. Journal of the American Academy of Dermatology, 44(3), 433–438. https://doi.org/10.1067/mjd.2001.110876

Oliveira, M. F., Rocha, B. O., & Duarte, G. V. (2015). Psoriasis: Classical and emerging comorbidities. Anais Brasileiros de Dermatologia, 90(1), 9–20. https://doi.org/10.1590/abd1806-4841.20153038

Phan, C., Touvier, M., Kesse-Guyot, E., Adjibade, M., Hercberg, S., Wolkenstein, P., Chosidow, O., Ezzedine, K., & Sbidian, E. (2018). Association between Mediterranean anti-inflammatory dietary profile and severity of psoriasis: Results from the NutriNet-Santé cohort. JAMA Dermatology, 154(9), 1017–1024. https://doi.org/10.1001/jamadermatol.2018.2127

Roman, I. I., Constantin, A. M., Marina, M. E., & Orasan, R. I. (2016). The role of hormones in the pathogenesis of psoriasis vulgaris. Medicine and Pharmacy Reports, 89(1), 11–18. https://doi.org/10.15386/cjmed-505

Rongioletti, F., Fiorucci, C., & Parodi, A. (2009). Psoriasis induced or aggravated by drugs. Journal of Rheumatology Supplement, 83, 59–61. https://doi.org/10.3899/jrheum.090227

Svanström, C., Lonne-Rahm, S. B., & Nordlind, K. (2019). Psoriasis and alcohol. Psoriasis, 9, 75–79. https://doi.org/10.2147/PTT.S164104

Teng, Y., Xie, W., Tao, X., Liu, N., Yu, Y., Huang, Y., Xu, D., & Fan, Y. (2021). Infection-provoked psoriasis: Induced or aggravated (review). Experimental and Therapeutic Medicine, 21(6), 567. https://doi.org/10.3892/etm.2021.9999

Wang, T., Xia, Y., Zhang, X., Qiao, N., Ke, S., Fang, Q., Ye, D., & Fan, Y. (2022). Short-term effects of air pollutants on outpatients with psoriasis in a Chinese city with a subtropical monsoon climate. Frontiers in Public Health, 10, 1071263. https://doi.org/10.3389/fpubh.2022.1071263

Wójcik, P., Biernacki, M., Wroński, A., Łuczaj, W., Waeg, G., Žarković, N., & Skrzydlewska, E. (2019). Altered lipid metabolism in blood mononuclear cells of psoriatic patients indicates differential changes in psoriasis vulgaris and psoriatic arthritis. International Journal of Molecular Sciences, 20(17), 4249. https://doi.org/10.3390/ijms20174249

Yumnam, D., Kansal, N. K., & Kant, R. (2022). Association of psoriasis with thyroid disorders: A hospital-based, cross-sectional study. Cureus, 14(3), e22987. https://doi.org/10.7759/cureus.22987

Zheng, Q., Sun, X. Y., Miao, X., Xu, R., Ma, T., Zhang, Y. N., Li, H. J., Li, B., & Li, X. (2018). Association between physical activity and risk of prevalent psoriasis: A MOOSE-compliant meta-analysis. Medicine, 97(27), e11394. https://doi.org/10.1097/MD.0000000000011394