Does fluoxetine cause skin hyperpigmentation? (3+ findings)
By
Dr Milena Locci de Oliveira (PhD)
Author bio
Dr Milena Locci de Oliveira is a Pharmacist and Doctor of Philosophy in Sciences from the University of São Paulo (USP). She has experience in microbiology, analytical toxicology, and clinical pharmacokinetics. She writes and reviews content on these topics.
Dr Milena’s Highlights:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration in the areas of Pharmacometrics and Population Pharmacokinetics, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
“Science can be translated, and it is essential that everyone has access to quality information to make informed decisions” – Dr Milena Oliveira, PhD.
Professional Experience:
With a decade-long career as a researcher, Dr Milena has amassed extensive experience in conducting research projects in microbiology, analytical toxicology, and clinical pharmacokinetics.
Her expertise also extends to the preparation of technical and scientific reports, literature reviews, data analysis, and scientific communication, both oral and written.
Dr Milena has served as a Clinical Pharmacist, providing expert supervision and guidance to teams during the challenging times of the COVID-19 pandemic, particularly in the ICUs of two reference hospitals for patient hospitalization.
In her most recent role, Dr Milena worked on the implementation of the deliberatives of the São Paulo State Government Pharmaceutical Assistance Coordination. These decisions were aimed at ensuring medication access within the Unified Health System.
A widely multidisciplinary background enabled Dr Milena to become a professional capable of integrating scientific knowledge into private initiatives, education, and healthcare, delivering consistent services in patient safety and population health.
Professional Memberships & Affiliations:
Dr Milena Oliveira is a member of the Regional Council of Pharmacy of the State of São Paulo, Brazil.
Education:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
Relevant Published Work & Citations:
Oliveira ML de, Rocha A, Nardotto GHB, Pippa LF, Simões BP, Lanchote VL. Analysis of daunorubicin and its metabolite daunorubicinol in plasma and urine with application in the evaluation of total, renal and metabolic formation clearances in patients with acute myeloid leukemia. Journal of Pharmaceutical and Biomedical Analysis. Nov 2020. 191:113-124.
Abstracts. CPT: Pharmacometrics & Systems Pharmacology. 2020 Nov; 9 (S1).
Pippa LF, Oliveira ML de, Rocha A, de Andrade JM, Lanchote VL. Total, renal and hepatic clearances of doxorubicin and formation clearance of doxorubicinol in patients with breast cancer: Estimation of doxorubicin hepatic extraction ratio. Journal of Pharmaceutical and Biomedical Analysis. 2020 Jun 5; 185:113-231.
Godoy ALPC, De Jesus C, De Oliveira ML, Rocha A, Pereira MPM, Larangeira DF, Lanchote VL, Barrouin-Melo SM. Determination of Allopurinol and Oxypurinol in Dogs Plasma by High-Performance Liquid Chromatography with an Ultraviolet Detector: Application for Pharmacokinetic Studies. J Chromatogr Sep Tech. 2017; 8 (4).
Clímaco EC, Oliveira ML de, Pitondo-Silva A, Oliveira MG, Medeiros M, Lincopan N, et al. Clonal complexes 104, 109 and 113 playing a major role in the dissemination of OXA-carbapenemase-producing Acinetobacter baumannii in Southeast Brazil. Infection, Genetics and Evolution. 2013 Oct;19:127–33.
Conference Papers:
Oliveira, M. L.; NARDOTTO, G. H. B.; PIPPA, L. F.; ROCHA, A.; SIMOES, B. P.; LANCHOTE, V. L. . Daunorubicin metabolism and urinary excretion in patients with acute myeloid leukemia. In: 84th Annual Meeting of the German Society for Experimental and Clinical Pharmacology and Toxicology (DGPT) and the 20th Annual Meeting of the Association of the Clinical Pharmacology Germany (VKliPha), 2018, Göttingen. Naunyn-Schmiedeberg’s Arch Pharmacol, 2018. v. 391. p. S76-S76.
Oliveira, M. L.; NARDOTTO, G. H. B. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . The low contribution of urinary excretion in the elimination of daunorubicin and its metabolite daunorubicinol in patients with acute myeloid leukemia. In: 49th Brazilian Congress of Pharmacology and Experimental Therapeutics., 2017, Ribeirão Preto. Livro de Resumos, 2017. p. 64-64.
Oliveira, M. L.; PIPPA, L. F. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . Quantification of daunorubicin and its metabolite daunorubicinol in human plasma by LC-MS/MS. In: I International Meeting of Environmental Health and Toxicology (IMEHTOX), 2016, Ribeirão Preto. Livro de Resumos, 2016.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. . PFGE typing of Carbapenem-Resistant Acinetobacter baumannii isolated from different University Hospitals. In: V International Postgraduate and Research Symposium, 2012.
Clímaco, E.C. ; SILVA, A. P. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. Relação clonal entre linhagens de Acinetobacter baumannii produtoras de carbapenemases da família OXA em quatro hospitais no Brasil. In: XXI Latin American Congress of Microbiology, 2012, Santos. XXI Latin American Congress of Microbiology, 2012.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Darini A.L.C. . Dissemintion of OXA carbapenemases genes in carbapenem-resistant Acinetobacter baumannii in University Hospital of Juiz de Fora, MG. In: 8th CIFARP – International Congress of Pharmaceutical Sciences, 2011, Ribeirão Preto.
Clímaco, E.C. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Darini A.L.C. . Avaliação do sequenciamento parcial do gene rpoB e de seus flanqueadores para identificação de espécies de Acinetobacter na rotina laroratorial. In: 2° International Symposium on Clinical Microbiology, 2010, Florianópolis.
You can view some of Dr Milena’s work below and links to her professional profile.
Linkedin: https://www.linkedin.com/in/dra-milena-locci-de-oliveira-28986042/?locale=en_US
ResearchGate: https://www.researchgate.net/profile/Milena-Oliveira-6
Escavador: https://www.escavador.com/sobre/5394254/milena-locci-de-oliveira
Lattes: https://buscatextual.cnpq.br/buscatextual/busca.do
Scopus: https://www.scopus.com/authid/detail.uri?authorId=57199779361
Scholar: https://scholar.google.com/citations?view_op=list_works&hl=pt-BR&user=1YUBDIQAAAAJ
This article will cover a number of topics, including whether or not fluoxetine causes skin hyperpigmentation, research on the drug’s potential association with skin reactions, additional factors that may contribute to skin hyperpigmentation, and the best course of action for treating skin hyperpigmentation while taking fluoxetine.
Does fluoxetine cause skin hyperpigmentation?
Fluoxetine can cause skin hyperpigmentation but there is no evidence or proof that fluoxetine causes spots or other skin issues in a direct way.
However, some individuals may notice skin changes while taking fluoxetine, as studies have shown that fluoxetine may induce skin hyperpigmentation in certain individuals. (1)
Fluoxetine may also result in hormone changes and stress level changes, which in turn may cause skin hyperpigmentation in certain individuals.
It is essential to consult your healthcare provider or dermatologist if you experience skin issues while taking fluoxetine. Your dermatologist will assess your condition in order to identify the source of the pigmentation and take the appropriate action.
What does research suggest?
The evidence that fluoxetine produces skin problems is not well-supported by research findings. Nevertheless, it has been reported that fluoxetine can increase hair follicle pigmentation and that antidepressants’ mechanism of action causes hyperpigmentation of the skin.
According to study findings, R-fluoxetine (fluoxetine stereoisomer) was exposed to fish eggs and increased their pigment production (this pigment depends on fluoxetine concentration).
Research revealed that fluoxetine stimulates the melanogenesis (production of melanin pigment) associated with the serotonin receptor. Fluoxetine is a member of the SSRI (Selective Serotonin Reuptake Inhibitors) class of drugs. SSRIs such as fluoxetine and citalopram affect the levels of neurotransmitters such as serotonin as well as norepinephrine in the brain. These medications including Prozac (fluoxetine) can increase your energy levels and cause hyperactivity.
Serotonin reuptake is inhibited by fluoxetine, and serotonin receptors are found in melanocytes. Melanogenesis and hyperpigmentation of the skin may result from inhibiting serotonin reuptake. (1)
What causes skin hyperpigmentation while taking fluoxetine?
There are several factors that can contribute to skin hyperpigmentation, some of which include:
Pregnancy. Endocrinological and hormonal changes frequently cause skin hyperpigmentation and spots during pregnancy.
Underlying medical conditions. Medical conditions such as Addison’s disease can increase melanin production and lead to skin hyperpigmentation as a result of diminished function of the adrenal gland.
Sunlight. Sun exposure darkens skin areas and is a key factor in skin hyperpigmentation.
Medications. A number of medications such as certain anti-malarial treatments, antiarrhythmics, and antibiotics can cause skin darkening and patches. (2)
How should skin hyperpigmentation be treated while taking fluoxetine?
There are several ways to treat skin hyperpigmentation but first, you must consult your healthcare provider in order to properly assess your situation and see if fluoxetine is the cause of your skin hyperpigmentation or not.
If fluoxetine is the cause of your skin hyperpigmentation, your healthcare provider might opt to reduce your fluoxetine dose or discontinue the medication and switch you to a medication with fewer adverse effects.
Additionally, they could advise you to adopt certain lifestyle modifications, such as:
- Applying sunblock or sunscreen and avoiding the sun.
- Wear sun-protective clothes.
- Taking supplements and vitamins.
- OTC (Over The Counter) topical treatment if needed such as glucocorticoid creams or ointments.
- Other therapies to help reduce skin hyperpigmentation such as synthetic peels and laser therapy for pigmented lesions.
- Skin hyperpigmentation can be reduced with cryotherapy, a procedure in which the physician uses extremely low temperatures to freeze and remove abnormal tissue. (3)
Conclusion
My understanding and knowledge indicate that fluoxetine may make some people’s skin more pigmented. While using fluoxetine, a number of factors, however, may be causing skin hyperpigmentation.
See your physician right away if you develop skin hyperpigmentation while taking fluoxetine so they can appropriately evaluate your condition and take appropriate action.
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References
1.-
Liu L, Fu M, Pei S, Zhou L, Shang J. R-Fluoxetine Increases Melanin Synthesis Through a 5-HT1A/2A Receptor and p38 MAPK Signaling Pathways. International Journal of Molecular Sciences [Internet]. 2018 Dec 25 [cited 2023 Nov 1];20(1):80–0. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6337216/
2.-
Hyperpigmentation, Hypopigmentation, and Your Skin [Internet]. WebMD. WebMD; 2006. Available from: https://www.webmd.com/skin-problems-and-treatments/hyperpigmentation-hypopigmentation
3.-
Hyperpigmentation: Age Spots, Sun Spots & Liver Spots [Internet]. Cleveland Clinic. Available from: https://my.clevelandclinic.org/health/diseases/21885-hyperpigmentation
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