Medications that can increase your skin cancer risk

As someone with a pale complexion, I need to be especially careful when I spend time outdoors. It’s a lesson I learned at a very young age.

So, in addition to limiting my exposure and wearing lightweight clothing to keep my skin covered, I always carry an EWG-approved sunscreen in my purse and keep a hat in my car.   

I thought I was doing all the right things…

But imagine my dismay when I learned that certain medications could cancel out some of my sun-proofing efforts and leave me open to elevated skin cancer risk.

Here’s your heads up, too  — in case you’re taking a medication that increases your photosensitivity…

Photosensitivity, blisters and skin cancer

“Most people have no idea that their medication could be making them more sensitive to the sun,” Dr. Emily Alfonsi, medical director of Shade Skin in Australia, told The New York Post. “They might notice they’re burning faster or developing unusual rashes, but they don’t immediately connect it to their medication.”

Dr. Alfonsi said she has seen patients develop second-degree sunburns with blistering, unexplained rashes or dark patches of skin, even in indirect sunlight.

“For people on photosensitizing medications, a few minutes in the sun without protection can have serious consequences,” Alfonsi told The Post.

To avoid worst-case scenarios, it’s important to identify medications that make your skin especially sensitive to the sun’s effects…

Antibiotics

Tetracycline and fluoroquinolone antibiotics can cause severe sunburn even after brief exposure to ultraviolet (UV) radiation. That’s because they cause photosensitivity.

In other words, they make the skin much more sensitive to UV light, which can cause exaggerated reactions such as rashes, blisters, swelling, peeling, burning, itching or sustained hyperpigmentation.

Both tetracyclines and fluoroquinolones are used for bacterial infections. Tetracyclines like doxycycline and minocycline are also commonly used to treat acne, so if you use them for that purpose, you’ll want to be extra careful about spending time in the sun.

Fluoroquinolones like ciprofloxacin used to be a first-line treatment for urinary tract infections (UTIs), but they’re no longer recommended for that use because of antibiotic resistance.

Diuretics

Also known as “water pills,” diuretics help the body eliminate excess salt and water and treat high blood pressure and fluid retention.

Some studies have linked diuretics like hydrochlorothiazide with an increased risk of squamous cell carcinoma, the second most common skin cancer in the U.S. Their use also has been connected with a higher risk of malignant melanoma, the deadliest type of skin cancer.

Immunosuppressants

Azathioprine is an immunosuppressant commonly used in transplant patients to prevent organ rejection as well as to reduce symptoms of rheumatoid arthritis and irritable bowel disease. This drug also causes photosensitivity and can weaken the skin’s natural defenses against UV damage.

Other rheumatoid arthritis drugs in this class that cause photosensitivity include methotrexate, leflunomide and hydroxychloroquine.

Non-steroidal anti-inflammatory drugs (NSAIDs)

Nonprescription NSAIDs such as ibuprofen and naproxen reduce pain, inflammation and fever. They’re often used chronically for pain, particularly arthritis-related pain. Unfortunately, long-term use can cause photosensitivity.

Other drugs that can cause photosensitivity include:

• Antiarrhythmics (amiodarone, quinidine)
• Certain antifungals (griseofulvin)
• Antihistamines (cetirizine, diphenhydramine, loratadine, promethazine and cyproheptadine)
• Cholesterol-lowering medicines (atorvastatin, simvastatin, lovastatin and pravastatin)
• Oral contraceptives and estrogens
• Phenothiazines (tranquilizers and anti-emetics like chlorpromazine, fluphenazine and promethazine)
• Psoralens (methoxsalen and trioxsalen)
• Retinoids (acitretin and isotretinoin)
• Sulfonamides (“sulfa” drugs like acetazolamide, sulfadiazine, sulfamethizole and sulfamethoxazole)
• Sulfonylureas for type 2 diabetes (glipizide and glyburide)
• Alpha-hydroxy acids (AHAs) in cosmetics

How to protect yourself

As scary as this is, don’t stop taking any prescribed medications without consulting your doctor. Instead, as Dr. Alfonsi noted, the key to protecting against photosensitivity is to prevent the reaction from occurring in the first place…

“A few extra precautions can significantly reduce your risk of long-term skin damage and skin cancer,” she told The Post.

Here are some protective actions you can take:

• Wear sunscreen with an SPF of 30 or higher every day — even in winter (although Alfonsi cautioned that this isn’t “a free pass to stay in the sun all day”).
• Wear UV-blocking sunglasses, wide-brimmed hats and other protective clothing (make sure your clothing has an ultraviolet protection factor (UPF) of at least 30).
• Avoid peak sun hours (anywhere from 10 a.m. to 4 p.m., depending on the time of year).
• Visit your dermatologist annually and monitor your skin for unusual changes.

You can also help fight photosensitivity with foods that have photo-protective properties.

Sources:

Most people ‘have no idea’ that these 4 common medications can increase their risk of skin cancer — New York Post

Tetracycline (class) (oral route, parenteral route) — Mayo Clinic

Avoid using a fluoroquinolone antibiotic for the first-line treatment of uncomplicated UTIs in women. — American Family Physician

Fluoroquinolone-Induced Photosensitivity: A Chemical Fragment-Based Approach by a Case/Non-case Study in VigiBase — Drug safety

Use of Thiazide Diuretics and Risk of All Types of Skin Cancers: An Updated Systematic Review and Meta-Analysis — Cancers (Basel)

Azathioprine and Photosensitivity — Crohn’s UK

Arthritis Medications and Sun Sensitivity — Arthritis Foundation

Azathioprine and Risk of Skin Cancer in Organ Transplant Recipients: Systematic Review and Meta-Analysis — American Journal of Transplantation

Photosensitivity Report Medications — Skin Cancer Foundation

The Sun and Your Medicine — U.S. Food and Drug Administration