Several commonly prescribed drugs can aggravate psoriasis symptoms, such as imiquimod and terbinafine. If you think you’re experiencing drug-induced psoriasis, talk with your healthcare team.

Psoriasis is a common skin condition caused when the immune system attacks the body’s own skin cells. This causes the body to make more cells and leads 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:

Examples of some ACE inhibitorsTrusted Source include:

A 2021 reviewTrusted Source 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.

  • primaquine
  • atovaquone-proguanil
  • artemether-lumefantrine
  • mefloquine
  • quinine gluconate

The 2022 study referenced earlier researchTrusted Source 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:

Commonly prescribed benzodiazepines are:

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 inflammation biomarkers observed in people with psoriasis.

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

They’re also used for:

Some beta-blockersTrusted Source you might be familiar with include:

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.

Biologics for psoriasis include:

There’s little conclusive evidence that biologics cause new or worsening psoriasis. According to a 2021 review, biologics may worsen psoriasis before making it better.

ImiquimodTrusted Source is a topical cream that treats:

The medication can make psoriasis worse in adults. A 2023 study linked imiquimod to aggravated psoriasis symptoms, though most clinical cases are rare.

Interferons are used to treat:

Your body makes alpha, beta, and gamma interferonTrusted Source proteins. Some interferons are 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.

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

A 2022 studyTrusted Source looked at medications that caused reported cases of psoriasis from 2016 to 2021. Lithium — among many of the other drugs in this article — was included, with about 20 reports.

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.

Examples of NSAIDsTrusted Source include:

Some research suggests that long-term use of NSAIDs can make psoriasis worse. NSAIDs may cause the buildup of leukotrienes, molecules that contribute to inflammation and possibly cause psoriasis.

TerbinafineTrusted Source is an antifungal medication commonly used for nail fungal infections.

This drug can cause new psoriasis or worsen existing psoriasis, according to some research. It does this by signaling the cellular release of cytokines, which have a part in psoriasis flare-ups.

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

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.

Another 2023 systematic literature reviewTrusted Source proposes that the drugs may trigger paradoxical cases of psoriasis. It’s believed that TNF inhibitors cause a release of interferon-alpha, which leads to psoriasis.

Exactly 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

What else causes psoriasis flare-ups?

Why your flare-up is happening could be for many reasons:

  • The food you eat: Certain foods like gluten, red meat, dairy, alcohol, and more can all be triggers of flare-ups if you have psoriasis. Try to avoid these foods or eat in moderation.
  • Smoking: This can trigger psoriasis flare-ups. Try to avoid smoking, or try a smoking cessation program if you currently smoke.
  • Another autoimmune disorder: Other autoimmune disorders, such as HIV or rheumatoid arthritis, can trigger flare-ups.
  • Excessive stress: No one chooses to be stressed, but it could be causing your psoriasis flare-ups.

But remember, triggers can vary from person to person, so what might cause flare-ups in one person may not cause flare-ups in you.

It’s important to monitor your flare-ups and note any possible triggers. You can speak with your doctor about other treatments or try to avoid your triggers.

Read more about what triggers psoriasis flare-ups.

Is psoriasis genetic?

More research is needed to determine the root cause of psoriasis. For now, researchers believe that it could be a combination of genetics, environmental triggers, or your diet.

Sometimes, medications used to treat certain symptoms or conditions can lead to new or worsening psoriasis. Occasionally, treatments meant to help with psoriasis can actually 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.