If you have psoriasis, you know how important it is to keep the condition under control. The autoimmune disease causes flares of dry, itchy, scaly patches on your skin. When the flares subside, your symptoms can lessen or clear up. You probably know that infections, stress, injuries and cold weather can make your symptoms worse. But you may not realize that many common medications can also lead to psoriasis flares.
Paul Thompson, PharmD, a pharmacist with Banner Health, said that some drugs could either lead to an initial case of psoriasis or can make the condition worse in people who already have it.
ACE inhibitors
Angiotensin-converting enzyme (ACE) inhibitors such as Lisinopril are prescribed to people with hypertension to help control their blood pressure. People aged 50 and older and people with a family history of psoriasis may be at higher risk for flare-ups from these drugs.
Beta-blockers
Like ACE inhibitors, beta-blockers such as Metoprolol are used to treat high blood pressure. They are one of the drugs most likely to cause psoriasis flares. They can trigger the condition in people who never had it and can cause flare-ups that are severe enough to require hospitalization. The link between beta-blockers and psoriasis can be tricky to spot since it can take a long time between the time you start taking beta-blockers and when you see a psoriasis flare. If a beta-blocker triggers a flare for you, it’s likely another one will as well. So, your doctor probably won’t recommend trying another one. It’s possible that you could try a different kind of medication to help control your high blood pressure.
Antimalarials
Antimalarials like hydroxychloroquine are sometimes prescribed to treat rheumatoid arthritis and lupus, not just malaria. They can trigger psoriasis flares within a few weeks, and after you stop taking them, it can take a month for your symptoms to subside. It’s generally not recommended that people with psoriasis take antimalarials.
Methotrexate
Methotrexate is a rheumatoid agent that’s sometimes used to treat psoriasis that’s not responding to light treatments or medication you apply to your skin. But taking too much of it can cause your symptoms to flare.
Biologics
Biologics are medications including Dupilumab (Dupixent) and Tocilizumab (Actemra) that can treat rheumatoid arthritis (RA), inflammatory bowel disease (IBD) and some types of cancer. However, they are also linked with flare-ups of psoriasis.
Benzodiazepine receptor agonists (BRZAs)
These medications, which include Temazepam and Zolpidem, treat insomnia and anxiety. If they make your psoriasis worse, talk to your doctor about other options for treating these health conditions.
Lithium
Lithium treats serious mental health conditions such as bipolar disorder, but it can cause psoriasis flares in about half of people with the disease. Flares don’t generally appear until you’ve taken lithium for a long time. Lithium is an essential treatment for mental health conditions, so your doctor may want you to continue to take it as long as you can manage your psoriasis flares.
Interferons
These drugs, used to treat hepatitis, multiple sclerosis (MS), leukemia, melanoma and other cancer, are linked with psoriasis. The conditions they treat are serious, so your doctor will probably recommend that you keep taking the medication as long as you can tolerate your psoriasis symptoms.
Terbinafine
This drug treats fungal skin infections such as jock itch and athlete’s foot. Taking it by mouth can lead to psoriasis flares throughout your body while applying it to the skin is linked to the area where you’re using it.
TNF blockers
Tumor necrosis factor (TNF) blockers treat Crohn’s disease, ankylosing spondylitis and rheumatoid arthritis. They can cause psoriasis symptoms to flare for a few months before they get better.
What can you do if you have these flares?
“Contact your dermatologist or health care provider if you experience flares while taking these medications, or if you start a new medication that you think has caused your symptoms to worsen,” Dr. Thompson said.
Don’t overlook the effects psoriasis can have on your mental health, either. “Living with a visible skin condition can lead to feelings of embarrassment, self-consciousness, depression or anxiety. The emotional effects of this disorder should not be overlooked,” Dr. Thompson said.
You might be able to switch to another medication that doesn’t cause these types of side effects. Or there may be other ways to keep psoriasis under control. “But triggers can vary widely, and you may need additional treatment depending on the source and severity.”
The bottom line
If you have psoriasis, controlling the itchy, flaky skin is crucial. But some medications can cause flare-ups. If you’re taking any of these medications and your psoriasis is getting worse, talk to your doctor about your options.
Need help managing your psoriasis?
Schedule an appointment with a primary care provider near you.
Schedule an appointment with a dermatologist.
