Is there an arthritis medication that won't cause a skin rash?

Gannie asked...

I have arthritis and the medicines that I take are causing a skin rash. They are for inflammation: methotrexate and hydroxychloroquine. What else can I take that will work? I don't want prednisone because it makes a person gain weight and I am trying to avoid that.


Expert Answer

Dr. Leslie Kernisan is the author of a popular blog and podcast at She is also a clinical instructor in the University of California, San Francisco, Division of Geriatrics.

Usually when people say they have arthritis they are referring to the most common type of arthritis: osteoarthritis, also known as degenerative joint disease.  Methotrexate and hydroxychloroquine are never used for osteoarthritis however, so I will assume you have been diagnosed with rheumatoid arthritis or another similar autoimmune joint disease.

Unfortunately without knowing more about you and your case, it’s very hard to say what medication might provide treatment for your arthritis without causing a rash.  There are alternative medications which might be appropriate for you, but only a doctor who is familiar with your case would really be able to make good recommendations.  I imagine you are seeing a rheumatologist (joint/auto-immune disease specialist) for your condition. I would encourage you to express your concerns about your rash to your rheumatologist.  

Some questions you could ask include:

  • Have doctors determined whether it’s the methotrexate or the hydroxychloroquine that's giving you a rash?   Is there a substitution for one or both of these medications that you could try?  
  • Is it possible that a medicine other than methotrexate or hydroxychloroquine is giving you a rash?  (Just about any drug can cause a skin reaction in certain sensitive people.)

You probably already know that for diseases such as rheumatoid arthritis, taking medications indefinitely is usually needed to prevent permanent joint damage.  Many of the useful medications can cause minor side effects, so it can take a while for a patient and his/her doctor to figure out what combination of medicines provides the best balance between benefits and side effects. I encourage you to continue working with your doctor to find a mix that's best for you.