10 Medications That Can Cause Psoriasis Flare-Ups

Psoriasis is a chronic autoimmune disorder that causes thick scales to build up on your skin. It’s associated with other medical conditions, like heart disease and diabetes. For people living with psoriasis, many things can trigger worsening symptoms. Triggers can include specific foods, smoking, and stress. But medications are one of the most common causes of psoriasis flaring up.

In addition to worsening existing psoriasis symptoms, some medications can also cause new psoriasis. When this happens, it’s called drug-induced psoriasis. 

Let’s review 10 common medications that can trigger psoriasis — and why. 

Keep in mind: The medications below don’t cause psoriasis in everyone. And, there are other medications not included in this list that can trigger psoriasis. 

1. Beta-blockers

Beta-blockers are a common class of medications used to treat high blood pressure, heart failure, and migraines. Examples include:

• Atenolol (Tenormin)

• Metoprolol (Lopressor, Toprol XL)

• Propranolol (Inderal LA) 

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Beta-blockers can worsen existing psoriasis. It’s also possible they may cause new psoriasis, but the evidence for this is much less clear-cut. 

2. Lithium

Lithium is a medication used to treat bipolar disorder. Studies have shown that lithium can cause psoriasis in some people who’ve never had it. It can also worsen skin symptoms in people who already have psoriasis.

3. Terbinafine

Terbinafine (Lamisil) is a pill used to treat fungal infections of the skin, hair, and nails. Some people have noticed their psoriasis flaring after starting terbinafine.

4. Antimalarials

Chloroquine and hydroxychloroquine (Plaquenil) are medications used to treat and prevent malaria, a serious blood disease transmitted by mosquitoes. Hydroxychloroquine is also used to treat some autoimmune disorders, like lupus and rheumatoid arthritis. Chloroquine and hydroxychloroquine have been linked to worsening psoriasis symptoms, and much less commonly, new psoriasis development.

5. Imiquimod

This is a medicated cream used to treat skin cancers, certain precancers, and genital warts. In some people, worsening psoriasis has been triggered after starting imiquimod (Aldara).

6. Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are a class of medications that treat pain and lower inflammation. They’re used to treat many different conditions, like fever, headaches, and menstrual cramps. They can be applied directly on the skin (like gels), taken as pills, or received as injections. Examples include:

• Ibuprofen (Advil, Motrin)

• Indomethacin (Indocin)

• Naproxen (Aleve, Naprosyn)

NSAIDs can trigger worsening psoriasis symptoms, although this isn’t as common as other skin side effects. 

7. TNF-alpha inhibitors

TNF-alpha inhibitors (“TNF blockers”) are biologic medications used to treat inflammatory health conditions, like psoriasis and Crohn’s disease. They work by blocking certain signals in your immune system. Examples include infliximab (Remicade), adalimumab (Humira), and etanercept (Enbrel), which are given as injections or intravenous (IV) infusions.

Even though many of these medications are used to treat psoriasis, they can also make psoriasis worse in some people. Other types of biologics, like vedolizumab (Entyvio) and rituximab (Rituxan), have been linked with developing psoriasis.

8. Anti-PD1 medications

Nivolumab (Opdivo) and pembrolizumab (Keytruda) are types of biologic medications used to treat different cancers, like liver cancer and some lung cancers. They’re given as IV infusions, and they fight cancer by interfering with proteins called PD-1.

Some people have noticed psoriasis develop or get worse after starting these medications. 

9. Bupropion

Bupropion (Wellbutrin, Zyban) is a pill used to treat depression and to help people stop smoking. Some people have noticed their psoriasis gets worse after starting bupropion.

10. Other medications

There are some other medications that can also cause a psoriasis flare. These are much less common, but they’re good to know about:

• Ace-inhibitors (like lisinopril and ramipril)

• Amoxicillin

• Benzodiazepines (like lorazepam and temazepam) 

• Interferons (like interferon-alfa)

How do medications make psoriasis worse?

Several different medications can make psoriasis worse or cause you to develop psoriasis. This can happen even if you’ve never had it before. Medications have been linked to all different types of psoriasis, from the most common (plaque psoriasis) to the least common (erythrodermic psoriasis).

It’s not clear how most medications make psoriasis worse. Some medications may have a direct effect on your skin and cause worsening psoriasis patches or new patches to develop. Other medications may have an indirect effect by causing an allergic reaction or sun sensitivity that can then trigger psoriasis to develop. 

When you stop the medication, sometimes the psoriasis will get better and sometimes it won’t. Every person is different, and you may need additional psoriasis treatment to improve symptoms.

How fast does psoriasis flare up?

It depends. Psoriasis flares from a medication can vary depending on the person and the medication.

For example, some medications (like terbinafine) can cause psoriasis to flare within 2 weeks, while others (like beta-blockers) can take up to 12 months.

Since this can vary so much from person to person, it may be difficult to know which medications — if any — are causing your psoriasis to worsen.

How long does a psoriasis flare-up last?

This also depends. For some people, a psoriasis flare will go away a few weeks after stopping the offending medication. For others, the flare-up may last even longer or not go away at all. 

Will drug-induced psoriasis go away?

Yes. For many people, drug-induced psoriasis will go away after the medication is stopped. In some situations, however, treatment is needed to get the flare under control. 

What to do if your medication triggers your psoriasis

Psoriasis that is caused or worsened by a medication can look similar to regular psoriasis. So, it can be hard to know if a medication is to blame for your flare. It’s important to keep in mind that other things — like stress or an illness — can also trigger psoriasis.

If you think a medication is making your psoriasis worse, your first step is to talk to your prescriber about your options for treating your psoriasis flare-up. It’s important that you don’t stop any medications on your own. Your prescriber will help you come up with a plan to stop the medication and start a new one if needed. 

In some situations, just stopping the medication will improve or reverse the psoriasis flare. In other situations, you’ll need to treat the psoriasis even after stopping the medication. If this happens, your healthcare professional will help you come up with the best treatment plan for you.

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Written by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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