From the Guidelines
SGLT2 Inhibitors and Skin Effects
SGLT2 inhibitors are associated with an increased risk of genital mycotic infections, including vulvovaginal candidiasis and balanitis, particularly at higher doses 1.
- The incidence of these skin-related adverse events is generally dose-dependent and more common during the initial treatment period, typically within the first 6-12 months of therapy.
- Post-marketing reports have suggested a possible link between SGLT2 inhibitors and rare cases of bullous pemphigoid, a chronic autoimmune skin disorder, although the exact relationship remains unclear 1.
- Additionally, SGLT2 inhibitors may cause volume depletion, which can be a concern in older adults or those prone to orthostasis 1.
- There is also emerging data that SGLT2 inhibitor use may cause an increase in osteoporotic bone fractures, and clinicians should consider minimizing SGLT2 inhibitor use in older adults at high fracture risk 1.
- Daily hygienic measures may lessen the risk of genital mycotic infections, and most genital mycotic infections are easily treated 1.
- However, severe cases of Fournier gangrene have been reported, highlighting the importance of monitoring and prompt treatment 1.
- The risk of genital mycotic infections is higher for women than men 1.
- SGLT2 inhibitors can facilitate initiation and persistent use of other guideline-directed medical therapies, but their use requires thoughtful selection to avoid adverse effects in individuals at elevated risk 1.
From the Research
SGLT2 Inhibitors and Skin Effects
- There is no direct evidence in the provided studies that SGLT2 inhibitors have a significant impact on the skin, except for an increased risk of genital mycotic infections, which is a common adverse event associated with SGLT2 inhibitors 2, 3, 4, 5.
- The most frequently reported adverse events with SGLT2 inhibitors are female genital mycotic infections, urinary tract infections, and increased urination 4.
- SGLT2 inhibitors are generally well tolerated, with a favorable safety profile similar to that of placebo, but they are associated with an increased risk of genital mycotic infections, as well as the potential risk for serious adverse events such as dehydration, development of diabetic ketoacidosis, serious urinary tract infections, and bone fractures 6, 5.
- There is no mention of any other skin-related effects or adverse events in the provided studies, suggesting that SGLT2 inhibitors may not have a significant impact on the skin beyond the increased risk of genital mycotic infections 2, 3, 6, 4, 5.