What skin changes are associated with SGLT2 (Sodium-Glucose Linked Transporter 2) inhibitors?

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Last updated: February 19, 2025View editorial policy

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From the Guidelines

SGLT2 inhibitors are associated with an increased risk of genital mycotic infections, such as yeast infections, which can cause itching, redness, and rash in the genital area, as reported in the most recent study 1. The most common skin-related side effect of SGLT2 inhibitors is genital mycotic infections, which can be caused by Candida species, and can lead to symptoms such as itching, redness, and rash in the genital area.

  • These infections are more common in women than men, and can be treated with antifungal agents.
  • Additionally, SGLT2 inhibitors may increase the risk of urinary tract infections, which can sometimes manifest with skin symptoms.
  • Some patients may also experience a generalized rash or urticaria (hives) as an allergic reaction to the medication.
  • In rare cases, SGLT2 inhibitors have been associated with more severe skin reactions like Stevens-Johnson syndrome or necrotizing fasciitis of the perineum (Fournier's gangrene), although these are extremely uncommon, as noted in earlier studies 1. Patients taking SGLT2 inhibitors should be advised to monitor for any unusual skin changes, particularly in the genital area, and report them promptly to their healthcare provider, as recommended in the latest guidelines 1.
  • Daily hygienic measures may help reduce the risk of genital mycotic infections.
  • It is essential to weigh the benefits and risks of SGLT2 inhibitors, considering the individual patient's medical history and risk factors, as suggested by recent research 1.

From the Research

Skin Changes Associated with SGLT2 Inhibitors

The use of SGLT2 inhibitors has been associated with several skin changes, including:

  • Genital mycotic infections, which are considered a classwide effect of SGLT2 inhibitors 2
  • Genital tract infections, with point estimates ranging from 2.5 to 9.8 compared to placebo 3
  • Urinary tract infections, with dapagliflozin being the only agent associated with a statistically significant increased risk 3
  • Increased risk of bladder cancer with empagliflozin, although this finding was susceptible to detection bias 3

Risk Factors for Skin Changes

Several risk factors have been identified for skin changes associated with SGLT2 inhibitors, including:

  • Female sex, which is associated with a higher risk of genital mycotic infections 2
  • Prior history of genital mycotic infections, which increases the risk of developing these infections while taking SGLT2 inhibitors 2
  • Uncircumcised males, who are at a higher risk of SGLT2 inhibitor-induced genital mycotic infections compared to circumcised males 2

Management of Skin Changes

Several strategies can be used to manage skin changes associated with SGLT2 inhibitors, including:

  • Personal hygiene advice, which can reduce the risk of genital mycotic infections 2
  • Treatment of genital mycotic infections, which is often mild and responsive to treatment 2
  • Avoiding SGLT2 inhibitors in female patients with a history of severe, recurrent genital mycotic infections 2

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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