Dear Dr. Fritz,

I HOPE this finds you doing well. I am Enamorata. I have been diagnosed of psoriasis about two years ago. I have been trying to contain it, though. But, sometimes they would really flare up and I feel like it’s the end of the world again for me. I would really be embarrassed to go out and be with my friends – especially with those scaly patches on my skin. I really dreaded those days. Now, I just wanted to know what causes them to flare up, so I would be able to avoid them.

Thank you and have a wonderful day.

Enamorata 1980


Dear Enamorata 1980,

I understand how you feel. It is not easy to have those skin eruptions when you do have flare-ups with psoriasis. But, don’t fret. It’s not the end of the world. Well, you knew that the underlying cause of psoriasis is due to the problem with the immune system, but certain triggers can really make them worse. Now, I would lay down some triggers that you have to avoid – so, that those flare-ups will miss you.

1. Cold and dry weather

This kind of weather can dry out your skin, which can make the flare-up worse. So, avoid getting out in the cold. A hot, sunny weather can help you though. This means that you have to embrace the sun. As a matter of fact, this kind of weather appears to help control the symptoms of psoriasis for most people.

2. Stress

Stress can really cause psoriasis outbreaks. The problem is, having psoriasis itself causes the stress. The moral of the story is, even if you have psoriasis, you do really have to relax. That’s the key ingredient here.

3. Some medications

There are drugs which can cause flare-ups of psoriasis symptoms. The list includes lithium which is the treatment for bipolar disorder, drugs for malaria, and some beta-blockers, like metoprolol, propranolol, etc. which are used to treat high blood pressure, heart disease and some heart arrhythmias.

4. Infections

There are infections like strep throat or tonsillitis that can result in guttate (small, salmon-pink droplets) or other types of psoriasis two to three weeks after the infection. The symptoms of psoriasis may worsen in people who have HIV.

5. Trauma to the skin

Some people who have psoriasis, and who have trauma to the skin -- which would include cuts, bruises, burns, bumps, vaccinations, tattoos, and other skin conditions -- would lead to flare-up of psoriasis symptoms at the site of the injury. This is what is known as "Koebner phenomenon."

6. Alcohol

Better consume alcohol to a minimum amount as it may increase the chances of psoriasis break-outs.

7. Smoking

A number of inflammatory immune-related conditions have been associated with smoking, which includes psoriasis. This is the reason why psoriasis can get worse if you smoke.

Good luck!

Dr. Fritz

(Dr. Fritz Legarde Espedilla is an aesthetic dermatologist and surgeon and a clinical sexologist. She is also trained in hypnotherapy and Medical Acupuncture. She has been in the broadcast media for more than a decade and has written a book based on her 15 year stint with her radio program, “Healthy is Sexy Secrets ni Dr. Fritz.” She is the program host of Secrets with Dr. Fritz over For your questions, you may send them to Dear Dr. Fritz, c/o Sunstar-Davao Publishing Inc., Ebro-Pelayo Building, Jacinto St., Davao City, (former Department of Foreign Affairs office), across Ateneo de Davao University and beside Holy Child School of Davao, or you e-mail them to If you don’t wish your letter to be published, we regret that we cannot answer them. Thank you for your understanding.)