Psoriatic arthritis (PsA) is a type of arthritis that can cause swollen, painful joints. Certain things like stress, trauma, or smoking can cause periods of worsening symptoms called flares.

PsA is a type of arthritis that can affect people with the skin condition psoriasis. PsA can cause pain, swelling, and stiffness in the joints. Over time, it can lead to joint damage and impair quality of life.

In this article, we discuss the triggers associated with PsA, how to prevent PsA flare-ups, and where to find support.

PsA symptoms can sometimes get worse over a period of time. This is called a flare-up. During a PsA flare-up, it’s possible to experience increased:

How often do flare-ups typically occur?

A 2020 survey study including 2,238 people with PsA in the United States and Europe found that 22% of respondents had experienced a PsA flare-up in the past 12 months. Respondents reported an average of 2.2 flares over the past 12 months.

A variety of things can trigger PsA flare-ups. Because the immune response is dysregulated in PsA, flare-up triggers are often things that increase inflammation in the body, particularly if they affect the skin or joints.

Some PsA flare-up triggers include:

  • skipping or stopping your psoriasis or PsA medications
  • stress
  • strain on your joints due to things like physical labor or overweight or obesity
  • physical injury or trauma such as bumps, blows, or falls
  • dry skin
  • injury or trauma to your skin, which can happen due to things like:
    • cuts or scrapes
    • sunburns
    • dermatitis
    • bug bites
    • skin infections
    • getting a tattoo or piercing
  • smoking
  • frequent or heavy alcohol consumption
  • cold, dry weather
  • certain medications, such as:

Researchers report COVID-19 can trigger PsA flares in some people. Other bacterial and viral infections, like strep throat or the flu, may trigger flares as well, according to 2019 research.

The things that trigger a PsA flare-up can vary between individuals. If you have PsA, it’s important to determine what your flare-up triggers are so you can take steps to avoid them.

While not all PsA flare-up triggers can be avoided, there are some lifestyle changes you can implement in your daily life to help prevent PsA flare-ups from happening.

Protect your skin

Injury or trauma to the skin can trigger flare-ups of PsA. There are many things you can do in your day-to-day life to help protect your skin. Some tips include:

  • Use a moisturizing lotion or cream regularly to keep your skin from drying out. Some times when it’s important to moisturize include:
    • after bathing or showering
    • after swimming
    • during weather that’s cold or dry
  • When bathing or showering, try to keep the water temperature warm, not hot.
  • Be sure to choose fragrance-free laundry and skin care products, which are less likely to lead to skin irritation.
  • Use sunscreen and sun-protective clothing to prevent sunburn whenever you go outside.
  • If you have dermatitis or a bug bite, use a cool compress or anti-itch cream to ease itching. Resist the urge to scratch, as this can further irritate your skin.
  • Treat any cuts or scrapes promptly.
  • Avoid getting tattoos or piercings.

Take steps to lower stress

Stress is a very common trigger for PsA flare-ups, so it’s important to explore effective ways to reduce stress in your day-to-day life. Some examples of things to consider include:

Consider what you eat and drink

Drinking alcohol frequently or heavily can affect how your psoriasis or PsA medications work, potentially leading to a flare-up. Because of this, aim to consume alcohol in moderation if you do drink.

It may also be helpful to introduce more anti-inflammatory foods into your diet. Some examples of such foods include:

  • fresh vegetables like broccoli, spinach, and kale
  • fresh fruits, such as berries, grapes, and tomatoes
  • healthy fats like those found in fatty fish, avocados, and extra virgin olive oil
  • whole grains
  • spices with anti-inflammatory properties, such as turmeric and ginger

It’s also a good idea to limit or avoid foods that can lead to inflammation. Some examples include fried foods, refined carbohydrates, and processed meats.

Quit smoking

Smoking is a risk factor for a variety of conditions and may also lead to PsA flare-ups. As such, it’s important to take steps to quit smoking. If you smoke, work with your doctor to develop a quit plan that you can stick to.

Take your medications

Skipping or stopping your PsA medications can cause a flare-up. Because of this, always take your medications exactly as directed by your doctor.

Some types of medications can trigger PsA flare-ups. If you think a medication is causing your PsA to flare, discuss it with your doctor. It’s possible that they can adjust the dosage or switch you to a different type of medication.

Never stop taking any medications without first consulting your doctor. Doing so could potentially be harmful to your health.

Keep a symptom journal

If it’s still unclear what triggers your PsA flare-ups, it may be helpful to keep a symptom journal to log things that happen in your day-to-day life. Some examples of things to include in your journal are:

  • diet
  • stress levels
  • skin-care routines
  • sleep quality
  • recent illnesses
  • medications or supplements you’ve taken
  • any recent bumps, blows, or skin injuries

You can refer back to this journal when you experience a PsA flare-up to pinpoint what may be triggering your flare-ups to occur.

While medical management for PsA is important, social support is also vital. Many people with PsA can report feelings of anxiety or depression. Seeking support and connecting with others can help.

The National Psoriasis Foundation has a great deal of educational information about psoriasis and PsA. It also provides many types of support resources, such as:

  • the Patient Navigation Center, which can be accessed using phone, email, or online chat and aims to help you:
    • find a healthcare professional in your area
    • learn about PsA treatment options
    • discuss health insurance and ways to lower the cost of medications
    • connect with other individuals with PsA
  • MyPsoriasisTeam, which is a secure online community with over 133,000 members where you can connect with other individuals around the world living with psoriasis or PsA
  • a library of podcasts that provide up-to-date information about various psoriasis and PsA topics
  • a list of events, either in person or online, where you can interact with others living with psoriasis or PsA

The Arthritis Foundation provides information and resources for individuals with all types of arthritis, including PsA. Some of its support resources include the Live Yes! Arthritis Network. It offers an online community and virtual group chat where you can meet other people who are sharing similar experiences.

It may also be helpful to talk with your doctor about support resources. They can refer you to a mental health professional who specializes in helping people with chronic conditions and may also have information about PsA support groups near you.

You may also want to see a registered dietitian or nutritionist with experience working with individuals who have chronic inflammatory or autoimmune conditions.

PsA is an auto-inflammatory disease in which the immune system mistakenly attacks healthy tissue. The exact cause of PsA is unknown, but experts believe it involves a complex combination of genetic and environmental factors.

Several risk factors may also increase the risk of PsA in people with psoriasis. Some examples include family history, age, and certain types of psoriasis symptoms.

Individuals living with PsA can also have periodic flare-ups, during which their symptoms worsen. These can have a variety of triggers, such as stress, skin injury, or skipping PsA medications.

You can do several things in your daily life to help prevent PsA from flaring up. Examples include protecting your skin and reducing your stress levels. If you find that your PsA flares up frequently, be sure to talk with your doctor.