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Drugs That Increase Sun Sensitivity and Skin Cancer

Research has shown that certain medications (such as the diuretic HCTZ) can increase sun sensitivity and may predispose people to squamous cell skin cancer.
Drugs That Increase Sun Sensitivity and Skin Cancer

Are you looking forward spending some time outside during the summer. Maybe you have a beach vacation planned. Or perhaps you will be doing some walking outdoors. If you are a golfer or a tennis player, you will likely be soaking up some rays even with sunscreen. Is your medicine making you more susceptible to sunburn? A surprising number of common medications can increase sun sensitivity.

Which Medicines Boost Sun Sensitivity?

Blood Pressure Pills:

Frequenlty prescribed blood pressure medications can sensitize the skin to ultraviolet radiation from the sun. The diuretic hydrochlorothiazide or HCTZ is found in dozens of blood pressure pills. You may not even realize that your medicine contains HCTZ. Here are just a few examples:

• Atacand HCT
• Benicar HCT
• Benazepril/HCTZ
• Bisoprolol/HCTZ
• Diovan HCT
• Exforge HCT
• Lisinopril/HCTZ
• Lopressor HCT
• Losartan/HCTZ
• Lotensin HCT
• Micardis HCT
• Monopril-HCT
• Tekturna HCT
• Teveten HCT
• Triamterene/HCTZ

A study suggests that hydrochlorothiazide as well as other antihypertensive medications (lisinopril and nifedipine) may increase the risk of lip cancer (Archives of Internal Medicine, Sept. 10, 2012). This is no doubt related to the increased sun sensitivity these drugs produce.

The authors of this article note:

“Thiazide diuretics, triamterene, some ACE inhibitors and lisinopril are photosensitizing drugs. Photosensitizing drugs are believed to absorb energy from ultraviolet and/or visible light causing release of electrons. This leads to the generation of reactive oxygen intermediates and free radicals which damage DNA and other components of skin cells and produce an inflammatory response. The causation of squamous cell skin cancer by the treatment of psoriasis with repeated exposures to photosensitizing psoralen and ultraviolet radiation (PUVA) and the association of HCTZ and other antihypertensive drugs with risk of squamous cell skin cancer both support the biological plausibility of an increased risk of lip cancer due to photosensitizing antihypertensive drugs.”

Photosensitizing drugs absorb ultraviolet energy and increase the likelihood of cellular damage. Previous research has shown that such medications may predispose people to squamous cell skin cancer. People taking diuretics like hydrochlorothiazide should be especially careful to protect their skin and lips from ultraviolet sun exposure. Another popular diuretic, furosemide (Lasix), may also be linked to an increased risk of skin cancer (Journal of Investigative Dermatology, Aug., 2013).

Tetracycline:

Research from New Hampshire confirms this link,  as well as an increased risk of basal cell carcinoma, a different type of skin cancer, for people taking the antibiotic tetracycline.  The risk is highest for people who tend to burn rather than tan when exposed to sunshine.

Archives of Internal Medicine, online, Aug., 2012;   Journal of Investigative Dermatology, August 2013; Gomez-Bernal et al, Actas Dermo-sifilograficas, May 2014

Ketoprofen:

Ketoprofen is an NSAID (nonsteroidal anti-inflammatory drug) prescribed to relieve the pain of arthritis, bursitis and similar problems. Some people taking this medication end up with a rash on sun-exposed skin (Loh & Cohen, Indian Journal of Medical Research, Dec. 2016). Octocrylene, found in some sunscreens, may make this rash worse.

Report from A Readers re: Sun Sensitivity:

Jean shares this experience with HCTZ:

“Well, well. I have been ingesting HTCZ for probably 20 years. About 6 yrs ago I was diagnosed with Basal Cell cancer on the end of my nose. I had to have surgery, of course. Not a pretty site but the work was done in a doctor’s office and I went home loaded with bandages on my face and of course, discomfort.

“I was told my problem was most likely from my teen years and onward into the sun through later years. Maybe it developed from my love of sunbathing plus the HTCZ medication I still take even though my blood pressure seems to be pretty good in these later years.

“My husband is down at the pool sunning, swimming and reading and visiting at this very moment. After my experience I have lost my umph for this great relaxing way to spend some time. Never thought of this darn HTCZ being a culprit.

We both love you Graedons and have been faithful listeners to your Public Radio shows (for years now) and thank you so much for the way you help us all take care of ourselves, when possible. Keep up the good work. We need you.”

Revised 7/13/2017

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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