Table of ContentsView AllTable of ContentsCausesMedical FactorsLifestyle/Environment Factors
Table of ContentsView All
View All
Table of Contents
Causes
Medical Factors
Lifestyle/Environment Factors
Psoriasis causes are more complex and challenging than you may anticipate. Though it seems like just another skin rash, psoriasis is an autoimmune disease. The red, itchy, scaly plaques of psoriasis are the result of an immune system attack on healthy skin.
Medical researchers are still learning why the immune system malfunctions. However, they’re sure psoriasis develops from a combination of genetic tendencies and lifestyle and environmental triggers that cause skin overgrowth and inflammation.
© Verywell, 2018
Psoriasis Causes
While medical experts know that psoriasis is an autoimmune condition, more studies are needed to determine what causes the immune system to dysfunction. In all autoimmune conditions, the immune system identifies healthy cells as dangerous and attacks them.
In the case of psoriasis, your immune system attacks skin cells and causes inflammation, likely due to a genetic mutation. As a result, the top two causes of psoriasis are inflammation and genetics.
Inflammation
Psoriasis is a long-lasting (chronic) inflammatory condition affecting your skin.Inflammationtypically begins when a specialized white blood cell (T-cell) detects a disease-causing microorganism (pathogen) somewhere in the body. In response, the T-cell moves to the affected tissue and releases an inflammatory protein known astumor necrosis factor (TNF).
With psoriasis, there is no pathogen. Instead, the T-cells migrate to the epidermis (the skin’s outer layer) and secrete TNF as if the body is under attack. This triggers inflammation, which leads to the rapid production of skin cells (keratinocytes).
It usually takes new cells a month to reach the surface. With psoriasis, that time is cut to three to five days.
The accelerated production leads to excessive skin cells that build up at the surface and turn into red, raised patches ofpsoriasis.
Genetics
Genetics is believed to play a central role in the development of psoriasis. While the exact link has yet to be established, scientists have identified at least 80 genetic mutations that increase a person’s risk of the disease.
Among them, a mutation known as CARD14 is believed to be strongly linked to both plaque and pustular psoriasis, as well as a related disorder known as psoriatic arthritis.
2:07
Medical and Genetic Risk Factors
According to a 2015 review inCurrent Dermatology Report, a child with two parents with psoriasis has at least a 50/50 chance of developing the disease.Although genetics may increase your risk of psoriasis, it is possible to have a mutation and never get the condition.
In order for the disease to develop, scientists believe that an environmental or medical trigger is needed to activate the disease.
Infections
Any type of infection can cause psoriasis to flare. This is especially true withguttate psoriasiswhich almost always follows anupper respiratoryorstrep infection. Guttate psoriasis is the second most common type of psoriasis and one that strikes children more frequently than adults.
HIVis another infection commonly associated with psoriasis. While people with HIV don’t have psoriasis more often than people in the general population, the severity of the disease tends to be far worse.
Skin Trauma
Any sort of trauma to the skin (including a cut, scrape, surgical wound, tattoo, burn, or sunburn) can potentially cause a flare. This is known as theKoebner phenomenon, a reaction that occurs along a line of a skin trauma.
Scientists don’t totally understand why this occurs but suspect that inflammatory proteins (cytokines) overstimulate the skin and activate autoimmune antibodies that incite an inflammatory response.
If you have psoriasis, it’s essential to treat minor skin injuries right away. Clean the skin with soap and water, apply an antibiotic ointment, and cover the wound with a bandage. A compression bandage may be especially useful. Doing this may reduce the risk of an acute flare.
Obesity
A 2017 study from Poland suggests that obesity is a significant risk factor for psoriasis.It is known that the excessive accumulation of adipose (fat-storing) cells stimulates the production of inflammatory cytokines. This response is closely linked to increases in a person’sbody mass index (BMI).
Hormones
Changes in female and male hormones (estrogen and androgens) may also affect psoriasis. However, the current evidence reveals contradictory findings. More research is needed to determine the exact relationship between these hormones and psoriasis.
Other Autoimmune Conditions
People with psoriasis often have other autoimmune diseases, such as rheumatoid arthritis, autoimmune thyroiditis, and psoriatic arthritis. It’s common for people with any autoimmune disease to have multiple immune-related conditions.However, more research is needed to define the cause-and-effect relationship between psoriasis and other diseases.
Medications
Certain medications can trigger psoriasis symptoms or make existing symptoms worse.Some of the common culprits include:
Tumor necrosis factor-a (TNF-a) inhibitors used to treat autoimmune disorders—including Remicade (infliximab),Humira (adalimumab), and Enbrel (etanercept)—can also trigger psoriasis symptoms in the first couple of months of treatment as the body adapts to the medication.
Oral corticosteroidsused to treat psoriasis can trigger severe “rebound” symptoms if you stop abruptly. If the corticosteroids are no longer needed, your healthcare provider will help you gradually taper off the drug so that this doesn’t occur.
Psoriasis Healthcare Provider Discussion GuideGet our printable guide for your next healthcare provider’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.
Download PDF
Email AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Sign Up
Thank you, {{form.email}}, for signing up.
There was an error. Please try again.
Lifestyle and Environment Risk Factors
How (and even where) you live can play a role in your risk of psoriasis and your ability to manage the disease. These are five common lifestyle variables associated with a higher risk of developing psoriasis.
Smoking
Given how harmful cigarettes are to your general health, it’s no surprise that they can also increase your risk of psoriasis. In fact, research published in the journalPsoriasissuggests that the amount you smoke per day is directly linked to your risk for new or recurrent symptoms.
Stress
Stresshas an enormous impact on your immune system and can play a significant role in the development of psoriasis. On the flip side, acute psoriatic flares can induce stress and make your condition worse. For some people, stress both triggers and perpetuates the disease.
Even though stress is not entirely avoidable, there are things you can do to control it, including regular exercise, yoga, meditation, and deep breathing.
Physical stress—from surgery or childbirth, for example—is also a common trigger for psoriasis outbreaks.
Cold Weather
People with psoriasis often experience flares during the winter months or when they visit a cold, dry climate. Cold temperatures sap the air of moisture, leading to dry skin, a common psoriasis trigger.
Winter is also associated with less sunlight, which deprives the body of ultraviolet (UV) radiation beneficial to psoriatic skin. However, too much sun (whether natural sunlight or from tanning beds) causes skin damage and inflammation.
The best way to benefit from ultraviolet light is with supervisedphototherapydelivered in a dermatologist’s office.
Alcohol
Excessive alcohol use is associated with a higher risk of psoriasis and more severe flare-ups.Alcohol may also decrease the effect of your psoriasis treatments.
Gluten
People with psoriasis have a higher risk of developingceliac disease. Celiac disease is an autoimmune condition in which gluten (a protein in wheat, rye, and barley) triggers an immune attack in the small intestine. Studies suggest that both conditions may share common genetic and inflammatory pathways.
More research is needed to verify their connection. However, if it exists, gluten may also trigger psoriasis and a gluten-free diet may improve symptoms.
Summary
There are many psoriasis causes. Numerous genetic mutations have a potential role in causing the condition. The known genetic mutations must typically interact with various lifestyle, environmental, and health factors before activating an immune response leading to psoriasis.
20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Zhang LJ.Type1 Interferons Potential Initiating Factors Linking Skin Wounds With Psoriasis Pathogenesis. Front Immunol. 2019;10:1440. doi:10.3389/fimmu.2019.01440
National Psoriasis Foundation.About psoriasis.
Zalesak M, Danisovic L, Harsanyi S.Psoriasis and Psoriatic Arthritis-Associated Genes, Cytokines, and Human Leukocyte Antigens.Medicina (Kaunas). 2024 May 16;60(5):815. doi:10.3390/medicina60050815.
Boehncke W-H, Schön MP.Psoriasis.The Lancet.2015;386(9997):983-994. doi:10.1016/s0140-6736(14)61909-7.
Gupta R, Debbaneh MG, Liao W.Genetic Epidemiology of Psoriasis.Curr Dermatol Rep. 2014 Mar;3(1):61-78. doi:10.1007/s13671-013-00
Zeng J, Luo S, Huang Y, Lu Q.Critical role of environmental factors in the pathogenesis of psoriasis. J Dermatol. 2017;44(8):863-872. doi:10.1111/1346-8138.13806
National Psoriasis Foundation.Guttate Psoriasis.
Ceccarelli M, Venanzi rullo E, Vaccaro M, et al.HIV-associated psoriasis: Epidemiology, pathogenesis, and management. Dermatol Ther. 2019;32(2):e12806. doi:10.1111/dth.12806
Sagi L, Trau H.The Koebner phenomenon. Clin Dermatol. 2011;29(2):231-6. doi:10.1016/j.clindermatol.2010.09.014
Owczarczyk-saczonek A, Placek W.Compounds of psoriasis with obesity and overweight. Postepy Hig Med Dosw (Online). 2017;71(1):761-772. doi:10.5604/01.3001.0010.3854
Liu S, He M, Jiang J, et al.Triggers for the onset and recurrence of psoriasis: a review and update.Cell Commun Signal. 2024 Feb 12;22(1):108. doi:10.1186/s12964-023-01381-0.
Global Autoimmune Institute.Comorbidities in Autoimmune Disease & Multiple Autoimmune Syndrome.
Vashist S, Mahajan VK, Mehta KS, et al.Association of Psoriasis with Autoimmune Disorders: Results of a Pilot Study.IndianDermatol Online J.2020 Sep 19;11(5):753-759. doi:10.4103/idoj.IDOJ_648_19.
Kim GK, Del Rosso JQ.Drug-provoked psoriasis: is it drug induced or drug aggravated? Understanding pathophysiology and clinical relevance.J Clin Aesthet Dermatol. 2010;3(1):32-8.
Naldi L.Psoriasis and smoking: links and risks. Psoriasis (Auckl). 2016;6:65-71. doi:10.2147/PTT.S85189
Rousset L, Halioua B.Stress and psoriasis.Int J Dermatol. 2018;57(10):1165-1172. doi:10.1111/ijd.14032
Rácz E, Prens EP.Phototherapy of Psoriasis, a Chronic Inflammatory Skin Disease. Adv Exp Med Biol. 2017;996:287-294. doi:10.1007/978-3-319-56017-5_24
Svanström C, Lonne-Rahm SB, Nordlind K.Psoriasis and alcohol.Psoriasis (Auckl). 2019 Aug 21;9:75-79. doi:10.2147/PTT.S164104.
Bhatia BK, Millsop JW, Debbaneh M, et al.Diet and psoriasis, part II: celiac disease and role of a gluten-free diet.J Am Acad Dermatol.2014 Aug;71(2):350-8. doi:10.1016/j.jaad.2014.03.017.
Balak, D. and Hajdarbegovic, E.Drug-induced Psoriasis: Clinical Perspectives.Psoriasis(Auckl). 2017;7:87-94. doi:10.2147/PTT.S126727Bhatia, B., Millsop, J.; Debbaneh, M. et al.Diet and Psoriasis, Part Ii: Celiac Disease and Role of a Gluten-free Diet.J Am Acad of Dermatol.2014;71(2):350-8. doi:10.1016/j.jaad.2014.03.017Boehncke, W. and Schon, M.Psoriasis.Lancet.2015 Sept;382(9997);983-94. doi:10.1016/S0140-6736(14)61909-7Gupta, R.; Debbaneh, M.; and Wilson Liao, M.Genetic Epidemiology of Psoriasis.Curr Dermatol Rep.2014 Mar;3(1):61-78. DOI: 10.1007/s13671-013-0066-6.Naldi, L.Psoriasis and Smoking: Links and Risks.Psoriasis(Auckl). 2016; 6:65-71. DOI: 10.2147/PTT.S85189.Owczarczyk-Saczonek, A and Placek, W.Compounds of Psoriasis With Obesity and Overweight.Postepy Hig Med Dosw.2017;71(1):761-772. PMID: 28894050.
Balak, D. and Hajdarbegovic, E.Drug-induced Psoriasis: Clinical Perspectives.Psoriasis(Auckl). 2017;7:87-94. doi:10.2147/PTT.S126727
Bhatia, B., Millsop, J.; Debbaneh, M. et al.Diet and Psoriasis, Part Ii: Celiac Disease and Role of a Gluten-free Diet.J Am Acad of Dermatol.2014;71(2):350-8. doi:10.1016/j.jaad.2014.03.017
Boehncke, W. and Schon, M.Psoriasis.Lancet.2015 Sept;382(9997);983-94. doi:10.1016/S0140-6736(14)61909-7
Gupta, R.; Debbaneh, M.; and Wilson Liao, M.Genetic Epidemiology of Psoriasis.Curr Dermatol Rep.2014 Mar;3(1):61-78. DOI: 10.1007/s13671-013-0066-6.
Naldi, L.Psoriasis and Smoking: Links and Risks.Psoriasis(Auckl). 2016; 6:65-71. DOI: 10.2147/PTT.S85189.
Owczarczyk-Saczonek, A and Placek, W.Compounds of Psoriasis With Obesity and Overweight.Postepy Hig Med Dosw.2017;71(1):761-772. PMID: 28894050.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
