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Common Triggers for Psoriatic Arthritis

Reviewed by: HU Medical Review Board | Last reviewed: June 2022

Psoriatic arthritis (PsA) is a chronic, inflammatory form of arthritis. It often occurs along with a skin condition known as psoriasis. Symptoms include joint pain, inflammation in and around the joints, fatigue, and changes to the nails.1

The exact cause of PsA is unknown. But research shows that there are genetic and environmental factors that may trigger the disease.1

Genetic factors

Both PsA and psoriasis are more common in people who have a family history of the conditions. About 40 percent of people with PsA have at least one close relative who lives with either psoriasis or psoriatic arthritis.1,2

Researchers have identified certain genes that may make a person more likely to develop PsA. Human leukocyte antigen (HLA) genes have been studied for their link to PsA. HLA genes help the immune system differentiate between the body’s own cells and invaders such as viruses or bacteria. Each HLA gene has many variations.1

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Experts believe that in people with PsA, certain variations in HLA result in the immune system confusing healthy cells and harmful invaders. Because it cannot tell the difference between the body’s cells and foreign substances, the immune system causes the body to attack and damage healthy cells. This process leads to symptoms of PsA.1

Other genes may also influence the development of psoriasis and PsA. These genes play a role in how the immune response works and include:1

  • CARD14
  • IL23R
  • IL12B
  • IL13
  • TRAF3IP2

Environmental factors

Things in the environment can also cause PsA to develop, especially in people who have a family history of psoriasis, PsA, or both. These environmental factors include:2

  • Viral or bacterial infection – Catching a virus or bacterial infection may activate PsA. For example, developing strep throat may spur PsA symptoms in some people.
  • Physical injury or trauma – For example, a break, sprain, or muscle tear

Triggers that may cause flare-ups

Once a person has PsA, they often experience periods of activity (flare-ups) and periods of inactivity (remission). It can be hard to predict flare-ups.3

Understanding what triggers a flare-up can reduce the number of active periods someone has. It can also help to reduce painful symptoms. Common triggers include:3

  • Stress
  • Illness, like a cold or the flu
  • Skin trauma, like sunburns, cuts, bruises, and tattoos
  • Diet, such as processed foods or foods that trigger food allergies
  • Alcohol
  • Cigarette smoke
  • Certain medicines, like antibiotics

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If you live with PsA, it can be helpful to keep track of anything that triggers a flare-up. Keep a food journal where you log your meals. Note any changes to your sleep patterns. And be mindful about any increase in stress or anxiety.sup>3

Triggers are unique

PsA triggers are not the same for everyone. If you have psoriasis and are concerned about your risk for PsA, talk with your doctor about your concerns. If you live with PsA, chat with your healthcare team about triggers that may cause a PsA flare-up. They may have tips on ways to reduce them.

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