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Most people who have psoriasis find that they have times when their skin is clear, followed by sudden relapses of red, scaly, itchy eruptions. Usually there is a trigger. Here are ten of the most common psoriasis triggers and how to avoid them.

Psoriasis is an all-too-common skin condition that tends to relapse, making the skin break out in fresh, itchy, scaly plaques, and then to remit, clearing up, often on its own, with no discernible reason. The causes of psoriasis are only slowly being worked out by medical science, but the triggers, the events that set off a flare-up of the disease, are both identifiable and controllable. Here are nearly-universal triggers of psoriasis and what to do about them.

1. Psychological stress.

Psoriasis is a condition that presents itself in toddlers and young children, and also in adults 60 and older. Psychological stress triggers the very first attack of psoriasis, one group of researchers found, in 44% of people who have the disease. 

Mental stress triggers recurring attacks in 88% of people who have psoriasis. The reason that stress sets off psoriasis is that the skin is the body's first line of defense against the outside world.

Anything that triggers a fight-or-flight response in the brain, whether it is a change in the weather for the worse, a charging Doberman Pinscher or a bad day at work, activates the hypothalamus and pituitary glands in the brain to send signals to the adrenal glands to release stress hormones. These hormones in turn amplify a similar effect in the skin itself to cause inflammation and rapid growth of protective skin tissue, which make the characteristic scaly, itchy, dry plaques of psoriasis. Avoid the stress, and you will like avoid aggravations of psoriasis.

What if you simply can't avoid the stresses in your life? Part of the mechanism of stress-induced psoriasis is decreased production of lubricating, fatty lipids in the skin. Replacing these lipids with light skin creams will not stop psoriasis, but it will reduce itching.

2. Bacterial infections anywhere in the body.

Bacterial infections are another common trigger for psoriasis. Infections do not have to occur in the skin to cause a visible skin outbreak or even a round of psoriatic arthritis.

The body fights infection with the help of a group of white blood cells known as T-cells. A specialized kind of T-cell known as the helper-T cell regulates more aggressive white blood cells to keep the immune system from destroying healthy tissue. In psoriasis, one of the chemical processes regulated by these helper-T cells goes wrong and skin tissue is injured, only to be replaced by rapidly growing skin plaques.

Pharmaceutical intervention for an overactive immune system usually has the undesirable side effect of reducing the effectiveness of the immune system. Fortunately, there is another approach.

Most people who have psoriasis also have high levels of the yeast Candida in the nose, mouth, throat, and digestive tract. Reducing Candida also reduces the frequency of psoriasis flare-ups. How do you eliminate Candida? Reducing sugar consumption helps. It also helps to avoid "drying out" sensitive mucous membranes with douches, washes, and alcohol-based gargles.

3. Undetected injury to the skin.

Many people who have psoriasis notice that psoriasis flares up after a cut or a scrape. Even invisible damage to the skin, however, can cause an outbreak of psoriasis.

The genes that trigger the release of inflammatory hormones such as interleukin-1 and interleukin-8 occurs at a cellular level. Even a single injured cell activates its genes for the production of the chemicals that send a distress signal to its neighbors. In psoriasis, the skin overreacts and produces more new skin cells than are needed to keep the skin intact.

What kinds of things cause invisible injury to the skin? Rubbing alcohol and alcohol in perfumes and skin care products can trigger outbreaks of psoriasis. So can the use of abrasive soaps, such as Lava, or the application of allergenic essential oils--nearly everyone has a mild allergic reaction to the essential oils of citrus. Extremely gentle skin care is necessary for keeping psoriasis under control.

4. Obesity.

People who are obese tend to suffer systemic inflammation, which aggravates skin conditions. The medical literature presents many studies that confirm that losing excess weight helps make psoriasis drugs more effective. Just losing weight, however, usually is not the whole answer to keeping plaque psoriasis under control. It is necessary to lower levels of inflammation at the same time.

This means that any reducing diet needs not just to involve reduced calories, but reduced sugar intake. It is especially important to avoid consuming sugars and fats at the same time.

This also means that weight control for psoriasis relief cannot be accomplished through exercise alone. Working out may make you feel better, but calorie counting is necessary for psoriasis relief.

5. Excessive consumption of alcohol.

Heavy drinking (more than 2 drinks of alcohol per day) is a significant risk factor for psoriasis, especially for men. Eliminating alcohol, however, needs to be coupled with comprehensive detoxification programs that reduce stress on the liver.

Continue reading after recommendations

  • Hall JM, Cruser D, Podawiltz A, Mummert DI, Jones H, Mummert ME. Psychological Stress and the Cutaneous Immune Response: Roles of the HPA Axis and the Sympathetic Nervous System in Atopic Dermatitis and Psoriasis. Dermatol Res Pract. 2012. 2012:403908. doi: 10.1155/2012/403908. Epub 2012 Aug 30
  • Wilson FC, Icen M, Crowson CS, McEvoy MT, Gabriel SE, Kremers HM. Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: a population-based study. Arthritis Rheum. Feb 15 2009. 61(2):233-9.
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