A psoriasis flare-up can happen unexpectedly — your symptoms worsen seemingly out of nowhere and more patches and scaly plaques start popping up on previously healthy skin. As you wonder how you’ll get your skin to calm down this time, your stress level skyrockets — making the flare-up even worse.

During a flare-up, you may be questioning what triggered your psoriasis. And another question that may have crossed your mind is: How does psoriasis spread? It might sometimes seem as if your psoriasis is spreading, but because psoriasis is an immune-mediated skin disease it doesn’t “spread” like an infectious skin disease. Your immune system is causing your symptoms, not a virus or bacteria that spreads by contact or from person to person. (Source)

A flare-up can be a lot to handle when you’re already working every day to manage your skin health as best you can. That’s why we have 5 valuable tips that will help you control flare-ups, keeping your skin as happy and healthy as possible by incorporating simple changes into your self-care routine. Read on to discover more about the truth behind psoriasis spreading, and the many actions you can take to control a flare. 

How Does Psoriasis Spread? The Truth Is, It Doesn’t

First things first: Psoriasis is not contagious or infectious. It isn’t a skin disease that spreads by contact — you can’t get it from someone else, and you also won’t spread it by touching an area of your own affected skin and then touching a different area of healthy skin.

Instead, psoriasis is rooted in an overactive immune system response, which could be in part because of genetics, family history, or an external trigger. The weather, infections, stress, damaged or dry skin, and medications are some examples of external triggers that all have the potential to cause the inflammation, flaky skin, and scaly patches that characterize psoriasis. (Source, Source)

A condition called “Koebner phenomenon” can make it seem as if your psoriasis is spreading. Within 10 to 20 days following an injury to healthy skin, new skin lesions may show up that resemble your psoriatic skin. The new affected areas are usually linear and show up in the same area where you injured your skin. You can lessen your chance of experiencing Koebner phenomenon by keeping your skin as injury-free as possible. (Source, Source)

Understanding that your psoriasis isn’t spreading — your immune system is (over)reacting to new stimuli — can help reduce the stress and worry when new skin lesions start to appear.

5 Tips for Controlling Flare-Ups

Now that we’ve established that psoriasis isn’t contagious, infectious, or spreading by contact, let’s dig into 5 helpful tips for controlling flare-ups so you can live more of your life in a state of remission and healing. Regardless of the type of psoriasis you have — whether it's plaque psoriasis (the most common type), inverse psoriasis, or another form of the condition — these suggestions can help keep your chronic skin condition under control.

1. Make Stress Management Non-Negotiable

Stress is a common trigger for psoriasis flare-ups. Several studies have found a link between stress and chronic inflammatory diseases such as psoriasis. If you notice that your psoriasis tends to worsen during times of high stress, then stress could be a trigger for you. (Source, Source)

Psoriasis is a lifelong condition, but suffering from chronic stress doesn’t have to be. You can reduce your risk of flare-ups from stress in many ways — you just have to find what works for you, and what practices motivate you the most. 

Does your body shed stress via movement? Yoga, dancing, gardening, or walking in nature are all positive ways to move toward managing stress. When you need a moment of stillness, deep breathing exercises or micro-meditation sessions can give you the mental space to check in with yourself. And cultivating joy and a sense of gratitude can turn a neutral situation into a positive one, requiring only your mindful attention to the present environment. 

All of these actions and more have the power to lower the amount of cortisol (known as the “stress hormone”) circulating in your body, and get you out of the all too common fight-or-flight mode. The key here is to practice your chosen stress management techniques even (and especially) when you’re in remission. This will ensure your habits are solidified and you have a strong foundation to fall back on when a flare-up does happen. (Source)

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2. Keep Your Skin Injury-Free

Taking care to keep your skin free from injuries can make all the difference in preventing a psoriasis flare. Anything from a scratch to a sunburn, bug bite, bruise, or coming in contact with a poisonous plant could trigger your psoriasis. As with the Koebner phenomenon mentioned above, when a skin injury triggers your psoriasis you may see a new lesion form near or in the same place as the injury or bite, usually about 2 weeks after the injury occurred. (Source, Source)

Some injuries are unexpected or hard to prevent — even a cut from shaving can cause new areas of psoriasis to appear. Treating familiar daily activities such as shaving with utmost care shows respect for your skin while helping keep flare-ups at bay. Itchy bug bites may be tempting to scratch, but using insect repellent or going outdoors at times when there are fewer bugs out will reduce the chances of getting a bite in the first place. Treating your skin quickly after any harmful event can speed up the healing process. (Source, Source)

Did you know that getting a tattoo or piercing counts as injuring your skin, too? This may open you up to a flare, so if piercings and body art are something that interest you, talk with your primary care provider or dermatologist to see how you can best approach skin care when you engage in body modification. (Source)

3. Prepare for Seasonal Changes

The weather and seasons are constantly in motion, and that means there’s potential for flares to be triggered by the outside environment. The term “environmental exposure” points to things like sunlight and airborne allergens that have the ability to trigger your psoriasis. Do you notice a flare-up at the same time of year each spring, when the trees and flowers are in full bloom? Or maybe your flare-ups happen when there’s smoke from wildfires or wood-stoves in the air? These environmental exposures could be what’s triggering your psoriasis. (Source)

Flares often come along with colder weather, when there’s less sunlight and humidity. Arming yourself with a humidifier, extra moisturizers, and light therapy may help your symptoms. And avoiding sunburn in the summer by wearing sunscreen and breathable, protective clothing will help you enjoy the warmer weather as the natural sunlight improves your skin health and boosts your vitamin D levels. (Source, Source)

When you’re able to recognize that your flare-ups align with seasonal triggers or certain weather patterns, you’ll be better prepared to handle them as they come. Adjusting your skin care routine to account for the seasons will help you enjoy each one without fear of a flare-up.

4. Boost Your Immune System With Nourishing Foods

Similar to the way a cut or scrape can trigger a psoriasis flare, an infection or illness can also cause your psoriasis to rear its itchy, painful head. Getting an infection is a common trigger, especially a streptococcal infection (as with strep throat). But having a cold, the flu, or other viruses (like COVID-19) can weaken and further strain your immune system, making your psoriasis worse. (Source, Source)

Remaining free of illness isn’t always possible, but making healthy eating choices to boost your immune system is 100% within your control. A diet that provides large amounts of antioxidants through a variety of vegetables and fruits is recommended if you’re living with psoriasis. This is mainly because the high antioxidant load helps to clean up the oxidative stress and free radicals that comes with a chronic inflammatory disease. (Source)

And to get more specific, the antioxidant vitamin C plays a powerful role in wound healing and minimizing raised scar formation. Vitamin C gives your skin the necessary nutrients to produce healthy skin cells, and without enough of it, your body won’t be able to synthesize collagen effectively. This can result in skin that’s slow to heal, paving the way for more frustrating flares. Peppers, parsley, brussel sprouts, rosehips, strawberries, and citrus fruits are a few colorful sources of vitamin C. (Source, Source)

Lastly, consider how they do it in the Mediterranean. Experts believe the Mediterranean diet, which is rich in vegetables, fruits, legumes, whole grains, fish, nuts, and extra virgin olive oil, contains lots of foods that have anti-inflammatory properties. This eating pattern may offer you extra protection against psoriasis triggers and flares. There’s no need to change your entire diet all at once, but incorporating more anti-inflammatory foods into your life could help heal your psoriasis symptoms while protecting you from future illness and subsequent flare-ups. (Source, Source, Source)

5. Make a Healthy Lifestyle Part of Your Treatment Plan

There are many psoriasis medications available today, and you and your health care team should work together to find a pharmaceutical treatment that works for you. But going a few steps beyond applying or taking your prescription to consider other lifestyle factors can make a big difference for your overall wellness. (Source)

We’ve already discussed stress management and nutrition as 2 lifestyle factors that help control flare-ups. But there are 4 more factors that round out a healthy lifestyle: 

• getting quality sleep
• engaging in physical activity
• investing time in your social connections
• avoiding risky substances such as alcohol and nicotine, both of which are culprits of psoriasis flares 

(Source, Source)

The Bottom Line on How Psoriasis Spreads

Although psoriasis doesn’t actually spread, it can seem like it does when new lesions pop up on previously healthy skin. Living more of your life in remission than in a flare-up is attainable when you’re taking care of your skin holistically — not just with prescribed treatments, but with the foods you’re consuming, your stress management, your ability to limit skin injuries and environmental factors, and your overall lifestyle choices. Healthy habits will help you limit flare-ups, and control them better when they do happen.

Clearly, there are many angles from which to approach your psoriasis treatment plan. Your health care team, a WellTheory coach or Nutritional Therapy Practitioner, and your own motivation can combine to find lifestyle adjustments that make sense for you. By designing a whole-body autoimmune care plan, you can achieve more healing and see fewer psoriasis flare-ups.