The older adult suffers from age-related organ dysfunction, multimorbidities, and functional impairments. Typically, older people are on multiple medications for complex illness. The excessive and inappropriate prescribing of medications, termed polypharmacy, results in medication errors and adverse drug events relating to drug-disease, drug-nutrient, and drug-drug interactions, including dermatological adverse drug events. Adverse drug-related events result in emergency room visits, hospitalizations, morbidity, and mortality. Altered pharmacokinetics and pharmacodynamics with aging are predisposing factors. Many adverse drug events are under-recognized and treated with more medications, known as the prescribing cascade. The Beers criteria provide a set of medications including cautionary remarks with regard to prescribing or avoiding in older people. Dermatological reactions to medications are highly variable and range from mild to severe and life-threatening. Prevention of cutaneous adverse drug events is through appropriate prescribing, recognition of the drug reaction, and deprescribing of all medications not clearly necessary.