Can Lexapro Cause Dry Skin?
Dry mouth is a well-documented side effect of Lexapro (escitalopram), occurring in a significant proportion of patients, but dry skin is not listed as a recognized adverse effect in the FDA labeling or clinical trial data. 1, 2
Evidence from FDA Labeling and Clinical Trials
The official FDA prescribing information for escitalopram lists the most common side effects, which include nausea, sleepiness, weakness, dizziness, anxiety, insomnia, sexual problems, sweating, dry mouth, and constipation. 1 Notably absent from this list is dry skin or any dermatological manifestations beyond sweating. 1
Clinical trial data from the drug's development program showed that the most frequent adverse events (occurring in >10% of patients) included only nausea, with dry mouth being a common complaint, but no mention of dry skin or xerosis. 2
Understanding the Distinction
It is critical to distinguish between dry mouth (xerostomia), which is a documented anticholinergic-type side effect of SSRIs including escitalopram, and dry skin (xerosis cutanea), which is not associated with this medication class. 1, 2
- Dry mouth occurs due to decreased salivary gland secretion and is reported as a common side effect of escitalopram 1, 2
- Dry skin is not listed among the dermatological adverse reactions in the safety database for escitalopram 2
Dermatological Side Effects of Other Medications
While dry skin is not associated with Lexapro, it is important to recognize that certain other medication classes do cause xerosis:
- Anticancer agents (particularly EGFR inhibitors) cause xerotic skin in 4-100% of patients, with symptoms typically appearing 1-2 months after initiation 3
- Retinoids (such as acitretin) cause mucocutaneous dryness including dry skin as a dose-related effect 3
- Antipsychotic medications can cause various cutaneous reactions in approximately 5% of patients, though dry skin is not prominently featured 4
Clinical Approach
If a patient on Lexapro reports dry skin, investigate alternative causes rather than attributing it to the medication:
- Evaluate for environmental factors (low humidity, excessive bathing with hot water, harsh soaps) 5
- Consider age-related physiological dry skin, particularly in elderly patients 6
- Review all concurrent medications for known xerosis-inducing agents 7, 8
- Assess for underlying dermatological conditions or systemic diseases 6
Management if Dry Skin Occurs
Should dry skin develop in a patient taking Lexapro (likely coincidental rather than causative):
- Do not discontinue escitalopram based solely on dry skin, as this is not an established adverse effect 1, 2
- Apply fragrance-free moisturizers containing petrolatum or mineral oil immediately after lukewarm bathing 5
- Use gentle, soap-free cleansers with pH-neutral formulations 5
- For persistent symptoms, refer to dermatology to identify the actual underlying cause 5