I've identified lots of triggers. The top 4 triggers for me are:
1) Heat (of course)
2) Caffeine = Equally as bad a trigger as heat!! With caffeine sometimes I flare within the first hour or 2, typically this is with 60mg or more, but consuming any amount of caffeine produces an after affect, which is far more intense flaring, the skin gets hotter, feels tighter, and even looks angrier than normal. I'm guessing once the vasoconstriction effects of caffeine wear off, the blood vessels dilate, exaggerating flaring? Just a theory.
3) Alcohol - I'm always only 1/2 a drink away from lighting up like a Christmas tree, lol
4) Lack of sleep
Sleep is a big one for me. I've only had EM for 2 years now, but prior to my EM surfacing, I had been struggling with insomnia for an entire year. I was averaging 4-5 hours a night, some nights I'd get as little as 3 hours. A whole year of that and BAM, full blown EM. Once I realized my sleep played a huge role in the severity of my flares I made it my number 1 priority to SLEEP. I still struggle with this and have to take a number of supplements to help aid me in falling asleep, I stick with mostly natural stuff now. I've tried lots of different medications at this point, but the side effects were almost never worth it and nothing, I mean NOTHING, took away the burning fire that was my hands, knees, elbows, and feet. Even the bridge of my nose will flare and light up like Rudolph, which actually used to be much worse before I started taking Celebrex. During a flare, the inside of my nose would swell to the point that I would struggle to breath while I was merely sitting, this happened every single day, at least once, but usually numerous times, it became quite debilitating, not to mention highly annoying. Luckily Celebrex has almost entirely eliminated the breathing episodes, exempting when I lift weights or do other strenuous exercise so I have to be careful then because if I push too hard I'll end up feeling like I got punched in the face afterwards...fun-times I tell ya! Lol
So back to sleep...I now average 7 to 9 hours per night and while the severity of my flares have improved, it's far from miraculous. Sleep quality is still an issue, I flare the worst from 6pm on, peak 'burn time' is approx. 1 to 3 a.m. at night and, as you all are likely well aware, it's hell trying to sleep when your whole body feels like its burning. Ooohh the irony; try to get more sleep to avoid flaring, but flaring is the reason you can't seem to get more sleep :::sighs:::
Other triggers for me are:
staying up later than my normal bed time (sleep again)
dehydration seems to play a factor
standing for 10 or more minutes in the evening
over using my hands typing during the day time
stress (fight or flight) or an intense emotional reaction
mild or moderate activity even if I manage to stay cool my feet and hands will usually flare
moderate to intense exercise with the lovely aforementioned swelling of my inner nose and difficulty breathing
The most stable my symptoms have been since their onset was this last winter 2015/2016. I eliminated caffeine, rarely drank alcohol, got more sleep, and as long as it was below 50 outside and 63 or under in the house my EM stayed fairly mild. I still flared but it was much more mild, and far more tolerable. It's May now and I live in Southern Texas...I know, worst place EVER to be suffering from EM. I find myself constantly day dreaming about moving to Alaska and living in an Igloo where I'd hug my icehouse nightly and sleep like I was dead...