Acne due to medicines

Acne can occasionally be caused by, or aggravated by, medications (drugs).

Hormones

A number of hormone medications may be responsible:

• Oral steroids may cause steroid acne.
• Contraceptive agents: medroxyprogesterone injection (Depo-Provera™), implanted progesterone (e.g. Mirena™) and oral contraceptives which reduce circulating sex hormone binding globulin (SHBG), can aggravate acne in females.
• Testosterone
• Anabolic steroids such as danazol, stanozolol can cause severe acne including acne conglobata and acne fulminans.

Athletes and body-builders sometimes abuse anabolic steroids because they result in increased muscle bulk - severe acne is one of the undesirable results.

Other medication

It is not known why some other medicines cause or aggravate acne; theories include effects on white blood cells and direct effects on the hair follicle.

Medications known to aggravate acne include:

• Halogens (iodides, chlorides, bromides, halothane)
• Antiepileptics (carbamazepine, phenytoin, phenobarbital)
• Antituberculous drugs (ethionamide, isoniazid, rifampicin)
• Antidepressants (lithium, amoxapine)
• Ciclosporin
• B vitamins (B12, cyanocobalamin)