Several commonly prescribed drugs can aggravate psoriasis symptoms. If you think you’re experiencing drug-induced psoriasis, it’s important to talk with your healthcare team.

Psoriasis is a common skin condition that happens when your immune system attacks your own skin cells, causing the body to make more cells and leading to psoriatic lesions.

There are many possible triggers for psoriasis flares, such as stress, injury to the skin, and infections. Many people also get psoriasis after taking certain medications.

Below are medications that have been found to possibly trigger psoriasis flares.

Angiotensin-converting enzyme (ACE) inhibitors are prescribed for high blood pressure. They’re also used in the management of:

  • heart disease
  • kidney disease
  • diabetes

A 2021 meta-analysis of studies suggested that there’s a significant association between ACE inhibitor use and psoriasis. The authors suggested that ACE inhibitors increase the levels of the protein bradykinin in the body. When bradykinin levels are increased, certain inflammatory agents that cause psoriasis also increase.

Antimalarials are typically used to treat malaria.

A 2022 study found that the antimalarial drug hydroxychloroquine was one of the top four drugs reported to the Food and Drug Administration (FDA) for adverse psoriasis events.

The 2022 study referenced earlier research from 2010 that found that antimalarials make psoriasis worse by stopping transglutaminase enzymes in the skin. This leads to the production of more cells on the skin.

Benzodiazepine receptor agonists (BZRAs) are prescribed for a number of conditions including:

  • anxiety disorders
  • insomnia
  • seizures
  • alcohol withdrawal

Results from a 2021 study suggested that high dose BZRAs could make psoriasis worse in those with mild forms of the condition. The study noted that BZRAs can raise some biomarkers of inflammation that are observed in people with psoriasis.

Doctors typically prescribe beta-blockers for heart conditions, such as:

  • hypertension
  • arrhythmia (irregular heart rate)
  • coronary artery disease

They’re also used for:

  • migraine
  • tremors
  • anxiety

According to a 2020 literature review, beta-blockers can worsen psoriasis and trigger psoriasis to develop in people who didn’t have it before. These drugs influence the pathways involved in the production of skin cells. Beta-blockers may also affect markers of inflammation.

Biologic medications target a part of your immune system. Because of this precision, they generally cause fewer side effects than other drugs. Biologics are prescribed to treat a number of conditions, including psoriasis.

There’s little conclusive evidence that says biologics cause new or worsening psoriasis. There are a few case reports suggesting “anecdotal associations” between psoriasis and a few specific biologic drugs, according to a 2017 review.

Another 2017 study of 10 cases of biologic-induced psoriasis proposed that, in some people, the drugs may trigger an autoimmune response that leads to the skin condition.

Imiquimod is a topical cream that treats:

  • warts
  • rough skin patches
  • basal cell carcinomas

The medication can make psoriasis worse in adults. A 2017 review cited older research that linked imiquimod to psoriasis worsening in adults and to drug-induced psoriasis in children.

Interferons are used to treat:

  • viral infections
  • some cancers
  • autoimmune conditions, such as multiple sclerosis

They are proteins made by your body and also administered as medications.

Interferon therapy is not recommended for people with psoriasis.

Psoriasis can be triggered by viral infections or skin wounds. Interferon activity during these events can lead to psoriasis or make existing psoriasis worse. Receiving interferon therapy for a different condition like multiple sclerosis can also cause psoriasis.

Lithium is a mood-stabilizing medication used in the treatment of bipolar disorder. Several older reports link lithium to worsening psoriasis and new-onset psoriasis.

Although it’s not fully understood how lithium causes psoriasis, older research suggests it may reduce the body’s levels of inositol, a vital sugar involved in cell signaling.

It can take about 5 months for lithium to make psoriasis worse and up to a year for new psoriasis to develop.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are available in prescription and nonprescription forms. They’re common pain relievers and are often used by people with psoriasis.

Some research suggests that long-term use of NSAIDs can make psoriasis worse.

In an older study from 2015, researchers reported that people who used NSAIDs or acetaminophen regularly for at least 10 years were at higher risk of developing psoriasis or psoriatic arthritis.

A 2010 paper noted that NSAIDs may cause the buildup of leukotrienes, molecules that contribute to inflammation and possibly cause psoriasis.

Terbinafine is an antifungal medication commonly used for nail fungal infections. This drug can bring on new psoriasis or make existing psoriasis worse.

Researchers in a 2017 study analyzed data from over 3,800 people who developed psoriasis over a 6-year period. Those with psoriasis were significantly more likely than matched controls to have used terbinafine or itraconazole, another antifungal medication.

Tumor necrosis factor (TNF) inhibitors are medications that target TNF, a protein that causes inflammation. TNF inhibitors treat inflammatory conditions, such as:

  • rheumatoid arthritis
  • inflammatory bowel disease
  • psoriasis
  • psoriatic arthritis

For some, these drugs actually cause or worsen psoriasis. New psoriasis may develop in areas of the skin that had never before been affected, or a person may develop a new kind of psoriasis.

How TNF inhibitors cause psoriasis is unknown. However, researchers have several theories.

  • People taking TNF inhibitors may already be at risk for psoriasis.
  • These drugs may increase the amount of a specific type of interferon.
  • They may increase interleukin-23, a protein that causes inflammation.
  • People taking TNF inhibitors are at increased risk for infections, and infections are also a risk factor for psoriasis.

Sometimes, medications used to treat certain symptoms or conditions can lead to new or worsening psoriasis. On occasion, treatments meant to help with psoriasis can make it worse.

If you’re taking any of these medications or you start a new treatment that appears to cause your psoriasis symptoms to flare, speak with your dermatologist or a member of your healthcare team. They can help you adjust your treatment plan, if necessary.