Can oral minoxidil (hypertension medication) cause acne?

From the Guidelines

Oral minoxidil can potentially cause acne as a side effect, though it's not among the most commonly reported adverse reactions. Minoxidil, originally developed as a medication for hypertension (typically dosed at 2.5-10 mg daily for blood pressure), affects hormone levels and sebum production in some individuals, which may trigger or worsen acne breakouts. The medication works by dilating blood vessels, but it can also influence androgen pathways that regulate oil production in the skin.

Key Points to Consider

• If you develop acne while taking oral minoxidil, don't stop the medication abruptly as this could cause dangerous blood pressure fluctuations.
• Instead, consult your healthcare provider who might adjust your dosage, recommend topical acne treatments, or consider alternative hypertension medications if the acne is severe or bothersome.
• It's worth noting that individual responses vary significantly, and many people take oral minoxidil without experiencing any skin issues.
• Proper skincare and keeping your face clean may help minimize potential acne while on this medication. According to the most recent guidelines for the management of acne vulgaris 1, there is no direct mention of oral minoxidil as a cause of acne. However, the guidelines do discuss the use of spironolactone, which has antiandrogen properties, as a potential treatment for acne in women 1.

Management of Acne

• The guidelines recommend a multimodal approach to treating acne, including the use of topical retinoids, benzoyl peroxide, and antibiotics 1.
• Oral antibiotics, such as doxycycline, may also be used to treat moderate to severe acne 1.
• In cases where oral minoxidil is suspected to be causing acne, alternative hypertension medications may be considered, such as those listed in the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults 1.

From the Research

Oral Minoxidil and Acne

• There is no direct evidence in the provided studies that oral minoxidil causes acne 2, 3, 4, 5, 6.
• The studies primarily focus on the treatment of acne using various topical and oral medications, such as benzoyl peroxide, retinoids, antibiotics, and hormonal therapies 2, 3, 4, 5, 6.
• One study mentions the use of oral minocycline, which is a different medication from minoxidil, in the treatment of moderate to severe acne vulgaris 6.
• Minoxidil is a medication commonly used to treat hypertension and alopecia, but its potential effects on acne are not discussed in the provided studies.

Acne Treatment and Medications

• The studies discuss various treatments for acne, including topical therapies such as benzoyl peroxide, retinoids, and antibiotics, as well as oral medications like minocycline and hormonal therapies 2, 3, 4, 5, 6.
• Combination therapies, such as the use of oral antibiotics with topical retinoids and benzoyl peroxide, have been shown to be effective in treating moderate to severe acne 6.
• Moisturizers can also be used as adjunctive treatments for acne, and some contain anti-inflammatory properties and anti-acne medications like salicylic acid and benzoyl peroxide 5.