Can Propranolol Cause Dry Skin?
Propranolol does not typically cause dry skin as a recognized adverse effect. The FDA-approved drug label and clinical guidelines do not list dry skin among propranolol's documented cutaneous side effects 1.
Documented Skin Side Effects of Propranolol
The actual dermatologic adverse effects associated with propranolol include:
- Cold extremities are the most common skin-related side effect, occurring due to peripheral vasoconstriction from beta-blockade 2, 3, 4
- Arterial insufficiency (usually Raynaud-type phenomenon) from peripheral vasoconstriction 1
- Psoriasiform rashes and exacerbation of existing psoriasis 1, 5, 6
- Erythematous rashes and various hypersensitivity reactions 1
- Stevens-Johnson Syndrome and toxic epidermal necrolysis (rare but serious) 1
- Exfoliative dermatitis and erythema multiforme 1
- Alopecia (hair loss) 1
- Dry eyes (not dry skin) 1
Important Clinical Distinctions
Cold extremities should not be confused with dry skin. While propranolol commonly causes cold hands and feet through peripheral vasoconstriction, this represents a vascular phenomenon rather than a change in skin moisture or texture 2, 4. Patients may describe their skin as feeling different when cold, but this is mechanistically distinct from xerosis (true dry skin).
Evidence Quality Assessment
The FDA drug label, which represents the highest quality regulatory documentation, specifically lists multiple cutaneous reactions but does not include dry skin or xerosis 1. Multiple clinical guidelines for propranolol use in pediatric populations (where skin monitoring is particularly rigorous) similarly do not report dry skin as an adverse effect 7, 2.
Clinical Recommendation
If a patient reports "dry skin" while taking propranolol, consider alternative explanations:
- Misinterpretation of cold extremities as dryness
- Coincidental environmental factors (winter weather, low humidity)
- Other medications or underlying conditions causing xerosis
- Unrelated dermatologic conditions
The symptom is unlikely to be directly caused by propranolol based on current evidence 1, 2.