While psoriasis has a definite genetic component, environmental factors also play a key role in the onset and severity of disease. Patients with psoriasis might note that they experience a worsening or flare-up of their disease in response to external or internal factors. There are many such factors that can indirectly trigger the onset of psoriasis or aggravate it in someone who is already affected. These include:
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Climate
Many patients will experience changes in their condition in different seasons, and typically report that cold weather can worsen their psoriasis, while sunlight is usually beneficial.
Infection
Certain infections, such as streptococcal throat infections, are believed to trigger a flare of psoriasis.
Medications
Certain medications have been related to aggravating psoriasis, including antimalarials, beta-blockers, lithium, and interferons. Sudden discontinuation of treatment with cyclosporine, systemic corticosteroids, is known to cause psoriasis flare-ups in some patients. Medications that may induce or worsen psoriasis include:
Antimalarials (used to treat malaria initially and now other conditions such as lupus)
- chloroquine
- hydroxychloroquine
- quinacrine
Beta-blockers (used to treat high blood pressure)
- acebutolol
- atenolol
- metoprolol
- propranolol
- sotalol HCL
Interferons (used to treat hepatitis C, multiple sclerosis cancer)
- interferon <alpha>
- interferon <gamma>
Lithium carbonate (used to treat manic-depressive disorder)
Skin Injury (Koebner phenomenon)
Psoriasis can occur after injury to the skin. This is known as the Koebner phenomenon. Any picking, scratching, or injuries from cuts, burns, or bruises can trigger the development of new psoriatic lesions at the exact site of injury. This could partly explain why psoriasis can be present over the elbows and knees, where friction and trauma are frequent, or after surgery at the site of a surgical scar.
Stress
Excessive stress can play a role in making psoriasis worse. Stress is a constant feature of modem life, but major events that cause significant stress can cause a flare-up in a patient's psoriasis. For example, sickness, job pressures, the death of a loved one, or relationship breakups are all events that may cause a flare-up in psoriasis.
Stress is not the root cause of psoriasis, but it can aggravate an existing condition or lead to the development of psoriasis in predisposed people. Stress can also delay the healing process. In a study at the University of Manchester (U.K.), it was found that psoriasis patients who worry excessively might experience slower responses to phototherapy than those who do not worry a great deal. The findings revealed that those patients classified as "high-level" worriers took about twice as long to improve than those who were "low-level" worriers.
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Other
Other factors that may contribute to psoriasis onset or worsening include smoking (with pustular psoriasis) and alcohol. To find out more, you can check out Psoriasis Research Studies.