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 While the drug, hydrochlorothiazide, has long been linked to an
increased risk of sunburns, the current study offers fresh evidence
that this commonly prescribed medication may also make people more
likely to develop two types of skin cancer: basal cell carcinoma and
squamous cell carcinoma.
For the study, researchers examined national prescription registry
data on hydrochlorothiazide use from 1995 to 2012 as well as cancer
registry records on skin malignancies diagnosed from 2004 to 2012.
Overall, people who took hydrochlorothiazide daily for at least six
years were 29 percent more likely to develop basal cell carcinoma
and almost four times more likely to get squamous cell carcinoma
than individuals who didn’t take this medication, the study found.
“We already knew that hydrochlorothiazide makes the skin more
vulnerable to damage from UV light of sun or sunbeds,” said senior
study author Anton Pottegard of the University of Southern Denmark.
“However, we did not know that hydrochlorothiazide use also appears
to translate into an increased risk of non-melanoma skin cancer,”
Pottegard said by email.
The study included more than 71,000 people with basal cell
carcinoma, 8,600 patients with squamous cell carcinoma, and a
control group of more than 313,000 people in the Danish population
who didn’t have these malignancies but were otherwise similar to the
cancer patients.
About 2.7 percent of patients with basal cell carcinoma and 2.1
percent of the control group were high users of hydrochlorothiazide,
with a lifetime cumulative dose of at least 50,000 milligrams, or
roughly six years of daily use.
Ten percent of squamous cell carcinoma cases were high users, as
were 2.8 percent of people in the control group.
With the highest cumulative hydrochlorothiazide exposure -
approximately 24 years of daily use - patients were 54 percent more
likely to develop basal cell carcinoma and more than seven times
more likely to get squamous cell carcinoma.
The study wasn’t a controlled experiment designed to prove whether
or how hydrochlorothiazide might cause skin cancer.
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Another limitation is that researchers lacked data on two main
factors that influence the risk of skin cancer: ultraviolet light
exposure and skin type, the study authors note in the Journal of the
American Academy of Dermatology.
“There may be a relationship between taking hydrochlorothiazide and
risk for skin cancer,” said Dr. Aaron Farberg of the Icahn School of
Medicine at Mount Sinai in New York City.
“However, the relationship may not be directly causative,” Farberg,
who wasn’t involved in the study, said by email.
Even so, the findings add to the evidence suggesting that patients
taking hydrochlorothiazide should take extra precautions to protect
their skin from damage caused by the sun, said Dr. Elizabeth Martin,
president of Pure Dermatology & Aesthetics in Hoover, Alabama.
“Everyone can reduce their skin cancer risk by avoiding unprotected
exposure to UV light,” Martin, who wasn’t involved in the study,
said by email. “Don’t use indoor tanning devices, and protect
yourself from the sun by seeking sunscreen with an SPF of 30 or
higher.”
Patients taking hydrochlorothiazide shouldn’t stop without first
seeing a doctor, Pottegard cautioned. While there are other safe,
affordable options to manage high blood pressure, patients already
taking hydrochlorothiazide won’t meaningfully alter their skin
cancer risk by staying on the drug for a few months until a
physician can advise them, he said.
“If you are at an increased risk of skin cancer, due to high
exposure to sunlight, have already experienced skin cancer, or are
otherwise predisposed to skin cancer, you should consider consulting
your physician regarding a potential therapy shift,” Pottegard said.
SOURCE: http://bit.ly/2kHQG5g Journal of the American Academy of
Dermatology, online December 3, 2017.
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