Blood pressure medications can have a range of side effects. Now researchers may have uncovered a new one resulting in dry, itchy skin.
Key Takeaways
- Adults over 60 who start new blood pressure medications may be at increased risk for developing eczema.
- Changes in aging skin, as well as increased susceptibility to sunburns, may contribute to this risk.
- People who develop eczema after starting a blood pressure drug can talk to their doctor about switching to a different medication.
A new study of adults 60 and older has found a link between starting blood pressure medication for hypertension and an increased risk of developing eczema, a condition characterized by dry, itchy, inflamed skin that may “weep” liquid.[1]
Rates of new-onset eczema have been rising in older adults, but researchers aren’t sure why. To investigate potential causes, scientists at the University of California in San Francisco (UCSF) analyzed data on over 1.5 million U.K. adults ages 60 and older without a diagnosis of eczematous dermatitis (eczema-related skin inflammation) at the start of the study.
“We found that blood pressure medications were associated with a small increase in rates of eczematous dermatitis,” says Katrina Abuabara, MD, senior study author and an associate professor of dermatology at UCSF.
The association was the largest for people taking diuretics and calcium channel blockers; they had a 16 to 24 percent higher risk of developing eczema. The smallest association was for ACE inhibitors and beta-blockers, which increased the risk of developing eczema by 2 to 4 percent.
“Therefore, if an older adult is experiencing dermatitis that doesn’t respond to treatment, and a clinical workup does not identify another cause, clinicians should weigh the risks and benefits of switching between blood pressure meds,” says Dr. Abuabara.
Drug Reactions Are a Common Cause of Eczema
Adam Friedman, MD, a professor of dermatology at George Washington School of Medicine and Health Sciences in Washington, DC, who was not involved in the study, says the results are not strong enough to prove that high blood pressure medication causes eczema.
But, he adds, the research is helpful when evaluating a patient who has unexplained eczema.
“If we’re dealing with an older patient who is developing what looks like eczema later in life, you’re going to go through: ‘What are the things this could be?’” says Dr. Friedman.
There could be a number of reasons for eczema-like symptoms, ranging from other inflammatory diseases, to cancer or nutritional deficiencies. “Drug reactions should be considered too,” Friedman says “If someone is on 15 different medications, knowing that certain blood pressure medications like calcium channel blockers could be the cause is helpful.”
While calcium channel blockers have been known for causing other reactions like lower leg swelling, Friedman says the UCSF study is the first to link the medications with eczema.
Because there are many different forms of eczema, Abuabara says it is debatable whether drug-induced rashes that look like eczema should be considered as part of the eczema spectrum or as separate entities.
“In addition to blood pressure meds, drugs that modulate the immune system that are used for conditions like psoriasis, arthritis, and bowel disease, as well as antiviral medications and chemotherapies, often cause eczematous drug rashes,” she says.
Aging Skin Can Be Prone to Eczema
Different types of eczema stem from different causes. The eczema experienced by the subjects in this study may be related to aging.
“Our skin has a lot of functions, and one of them is keeping moisture out and keeping some in,” says Friedman. “As we age, our skin’s ability to create that outer layer diminishes, so it’s a lot easier as you get older for your skin to dry out. Then depending on your unique makeup, if you scratch, that can create inflammation, and then atopic [allergic] eczema results from really dry skin.”
As skin ages, its ability to ward off external irritants also diminishes.
“This may be related to antihypertensive medications, because some of them make you more sensitive to the sun, and sunburns or sun injury damage the skin barrier,” he says.
Don’t Stop Taking Blood Pressure Medication Because of Eczema
If you take blood pressure medication and are worried about developing eczema, Friedman says managing hypertension should take priority.
“I don’t want people to be afraid if their doctor proposes medications that have decades of supporting evidence, that have an impact on outcomes when it comes to cardiovascular disease, on the off-chance that they might get an itchy rash,” he says.
If you do develop eczema, he stressed the importance of telling your doctor.
“You can certainly say, ‘I was started on this blood pressure medicine a couple months ago and now I have this rash. Could it be connected?’ That’s how patients can advocate for themselves,” Friedman says.
Sources
- Ye M et al. Antihypertensive Medications and Eczematous Dermatitis in Older Adults. JAMA Dermatology. May 22, 2024.
Important Notice: This article was also published at www.everydayhealth.com by Cathy Cassata where all credits are due.
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