Does Suboxone Cause Acne?
No, Suboxone (buprenorphine/naloxone) is not recognized as a cause of acne in established dermatology guidelines or drug-induced acne literature.
Evidence from Drug-Induced Acne Literature
The most comprehensive review of drug-induced acne does not list buprenorphine or naloxone as causative agents 1. Drug-induced acne typically presents with specific features including:
- Monomorphic pattern of lesions 1
- Unusual location beyond seborrheic areas 1
- Unusual age of onset 1
- Resistance to conventional acne therapy 1
- Recent drug introduction 1
Known Medications That Cause Acne
The established culprits for drug-induced acne include 2, 1:
- Hormonal agents: testosterone, progesterone, corticosteroids
- Neuropsychiatric drugs: lithium, phenytoin
- Antituberculosis drugs: isoniazid
- Vitamins: B2, B6, B12
- Targeted cancer therapies: epidermal growth factor receptor inhibitors 3, 1
- Immunosuppressants: ciclosporin 3
- mTOR inhibitors 3
Notably, buprenorphine/naloxone does not appear in any of these established lists.
Clinical Context
While the available research on buprenorphine focuses primarily on its efficacy for opioid dependence treatment 4, 5, 6 and potential toxicities related to dopaminergic activity 4, dermatologic side effects, specifically acne, are not documented in the medical literature.
Important Caveats
If a patient on Suboxone develops acne, consider:
- Coincidental timing: Acne affects 85% of teenagers and up to 50% of adults aged 20-30 years 2, making temporal association with any medication common
- Other contributing factors: hormonal changes, stress, other medications, or underlying conditions 2
- Standard acne evaluation and treatment should proceed according to established guidelines 3
Management Recommendation
Do not discontinue Suboxone for acne. Instead, treat the acne with evidence-based therapies including topical retinoids, benzoyl peroxide, or oral antibiotics as indicated by severity 3. The benefits of maintaining opioid use disorder treatment far outweigh any potential cosmetic concerns.