Does Sertraline cause acne? (3+ factors)

In this article, we will answer the question, “Does Sertraline cause acne?”. We will also discuss what research suggests, the contributing factors to Sertraline-induced acne and what to do if Sertraline causes acne.

Does Sertraline cause acne?

Yes, Sertraline may cause acne. Although this is not reported to be a common side effect of Sertraline, it still may cause acne in some individuals taking the medication for depressive illnesses. However, each person reacts differently to each medication and not all individuals taking Sertraline will experience this side effect.

Sertraline (also known as Zoloft), is an antidepressant belonging to the class of selective serotonin reuptake inhibitors (SSRIs), approved by the FDA for the treatment of depressive illnesses like major depressive disorder (MDD), obsessive-compulsive disorder (OCD), social anxiety disorder (SAD), panic disorder (PD), posttraumatic stress disorder (PTSD) and premenstrual dysphoric disorder (PMDD) (1).

Sertraline has been used ‘off-label’ by healthcare professionals for the management of bulimia nervosa (BN), body dysmorphic disorder, generalised anxiety disorder (GAD), binge eating disorder and premature ejaculation (2).

Acne is a very common skin condition that develops when the pores or hair follicles beneath the skin become clogged with sebum or dust. This can cause infections and pus formations, leading to acne. There can be many different causes of acne, some of which include sunlight exposure, drug-induced acne, cosmetics and genetic factors (3).

How Sertraline may contribute to acne?

There is not much research on how Sertraline may cause acne. Some proposed mechanisms are as follows:

Increased serotonergic activity:

Sertraline has been found to cause acne in some individuals taking the medication. The cause of Sertraline-induced acne is presumed to be related to the increased activity of serotonin at the skin receptors (4).

Sertraline increases the levels of serotonin within the body, These increased levels of serotonin cause increased serotonergic activity at the dermal and epidermal-dermal junction, and as a result, can cause acne (4).

Change in hormonal levels:

Another proposed mechanism through which acne may occur is the changes in hormonal levels. Antidepressants, particularly SSRIs like Sertraline affect androgen levels and may cause them to increase.

Increased sweating:

One reason for Sertraline-induced acne can be the side effect of increased sweating. Medications like Paroxetine and Sertraline can cause sweating in individuals which can clog pores with dead skin cells leading to acne.

These hormones are responsible for oil production, and increased levels result in more oil production. Excessive oil can clog pores and lead to infections and acne.

What does research suggest?

Existing studies and research findings suggest that acne is a side effect caused by Sertraline. Not everyone experiences this side effect, but a few studies assessing Sertraline-induced acne have been published.

A case report of a 38-year-old woman taking Sertraline for her depressive illness was published. This report stated the occurrence of acneiform lesions on the patient’s face after 12 days of taking Sertraline 50mg/day. As there was no history of dermatological conditions Sertraline-induced acne was diagnosed, which resolved after discontinuing Sertraline treatment (4).

Another research study examining the adverse cutaneous reactions caused by antidepressants also concluded that Sertraline tends to cause acne and skin rash in some individuals using the medication. This study suggested that treatment of such reactions should be symptomatic unless any other severe reaction occurs (5).

Acne may be induced by antidepressants like Sertraline, Paroxetine, Desvenlafaxine, Citalopram, Fluvoxamine, Duloxetine, Trazodone, Escitalopram and Bupropion. However, more research is needed to assess the detailed mechanism of this side effect.

What factors can contribute to acne while taking Sertraline?

Many factors can influence the occurrence of acne in Sertraline users. Some of them are as follows:

What to do if Sertraline causes acne?

If you are taking Sertraline and experience acne, you should inform your healthcare provider of your situation. Your doctor will assess your condition and diagnose the cause of your symptoms. Your doctor may also suggest the following steps to help with your condition.

Alternative medication:

Your healthcare provider will devise a plan to manage your condition while on Sertraline. However, if your condition does not improve, or the acne gets worse, Sertraline may be substituted with other antidepressants that may help with your depressive illness.

Alternatives that can be used instead of Sertraline are as follows:

• Paroxetine
• Fluoxetine
• Venlafaxine
• Mirtazapine
• Doxepin

These medications have a lower incidence of acne, but should still be used with caution in individuals seeking treatment.

Topical acne treatments:

Your healthcare provider may prescribe you topical treatments like antibiotics, retinol and benzyl peroxide to help reduce your acne.

Hormonal therapies:

Acne due to hormonal disturbances can be managed by hormonal therapies like ethinyl estradiol and progestin.

Herbal formulations:

Herbal oils like tea tree oil and formulations containing alpha- and beta-hydroxy acids are also helpful in reducing acne and related inflammation.

What tips should be followed to prevent Sertraline-induced acne?

The following tips should be followed to prevent the occurrence of acne while on Sertraline:

• Keep a consistent water intake. Staying hydrated can improve your overall skin health.
• Wash your face at least two times a day with a gentle cleanser. Avoid harsh face washes and scrubs.
• Avoid skincare products and cosmetics that irritate your skin. Oily or greasy makeup can increase acne, so try replacing them with non-comedogenic products.
• Use sunscreen daily. Protection from the ultraviolet rays of the sun is very important for healthy skin.
• Do not touch or pick any acne-affected region. This may result in increased infection.
• Always take a shower after a workout or any other sweat-producing activity.
• Take a balanced diet and decrease processed and carbohydrate-rich food from your diet.
• Change bedding and towels regularly, as they can accumulate dirt and sweat, leading to acne.

Understanding Sertraline-induced acne

In my experience and according to research studies available, Sertraline may cause acne in some individuals taking the medication. However, Sertraline-induced acne is not a commonly reported side effect and more evidence and research are required on the mechanism of this side effect.

Lifestyle changes can help prevent or reduce the occurrence of acne while taking Sertraline. Although Sertraline-induced acne can be managed in various pharmacologic and non-pharmacologic ways it is advised to always consult a healthcare professional before starting or stopping any type of medication.

References