Adults are more prone to developing eczema on their hands and feet. Blood pressure medications can come with a variety of side effects, and now researchers might have discovered a new one: dry, itchy skin.
Key Points to Consider:
- Adults over the age of 60 who begin taking new blood pressure medications may face a heightened risk of developing eczema.
- The increased risk may be attributed to changes in aging skin and a greater susceptibility to sunburn.
- Those who develop eczema after starting a blood pressure medication should consult their doctor about potentially switching to an alternative treatment.
New Insights on Blood Pressure Medications and Eczema Risk in Older Adults
A recent study has identified a potential link between initiating blood pressure medication for hypertension and an increased risk of developing eczema among adults aged 60 and older. Eczema, a skin condition marked by dry, itchy, and inflamed patches that can exude fluid, has been on the rise in this age group. Despite this trend, the underlying causes have remained elusive.
Investigating the Surge in Eczema Cases
Researchers at the University of California, San Francisco (UCSF) embarked on a comprehensive study to explore possible causes behind the increase in eczema cases among older adults. The team, led by Katrina Abuabara, MD, analyzed data from over 1.5 million UK adults aged 60 and above, none of whom had a prior diagnosis of eczema-related skin inflammation at the study’s inception. “We found that blood pressure medications were associated with a small increase in rates of eczematous dermatitis,” noted Dr. Abuabara, an associate professor of dermatology at UCSF.
Blood Pressure Medications and Eczema Risk
The research highlighted that certain blood pressure medications are linked with a higher risk of developing eczema. Specifically, diuretics and calcium channel blockers were associated with a 16 to 24 percent increased risk, while ACE inhibitors and beta-blockers posed a smaller risk increase of 2 to 4 percent. Dr. Abuabara emphasized the need for clinicians to consider these findings when treating older adults with persistent dermatitis that does not respond to conventional treatments. “If an older adult is experiencing dermatitis that doesn’t respond to treatment, and a clinical workup does not identify another cause, clinicians should weigh the risks and benefits of switching between blood pressure meds,” she advised.
Drug Reactions: A Noteworthy Cause of Eczema
While the UCSF study presents compelling evidence, it does not conclusively prove that blood pressure medications cause eczema, according to Adam Friedman, MD, a professor of dermatology at George Washington School of Medicine and Health Sciences. However, he acknowledges the study’s value in clinical evaluations of unexplained eczema in older patients. “If we’re dealing with an older patient who is developing what looks like eczema later in life, you’re going to go through: ‘What are the things this could be?’” Dr. Friedman explained.
Eczema-like symptoms can stem from various causes, including other inflammatory diseases, cancer, or nutritional deficiencies. “Drug reactions should be considered too,” Dr. Friedman added. “If someone is on 15 different medications, knowing that certain blood pressure medications like calcium channel blockers could be the cause is helpful.”
Calcium channel blockers have been previously associated with side effects such as lower leg swelling, but the UCSF study is pioneering in linking these medications with eczema. Dr. Abuabara noted the ongoing debate over whether drug-induced rashes that resemble eczema should be classified within the eczema spectrum or as distinct conditions. She pointed out that other medications, including those that modulate the immune system for conditions like psoriasis, arthritis, and bowel disease, as well as antiviral medications and chemotherapies, often cause eczematous drug rashes.
The Vulnerability of Aging Skin
The type of eczema identified in the UCSF study may be related to the aging process. Dr. Friedman highlighted the diminishing capacity of aging skin to retain moisture and its heightened susceptibility to dryness and subsequent inflammation. “Our skin has a lot of functions, and one of them is keeping moisture out and keeping some in,” he said. “As we age, our skin’s ability to create that outer layer diminishes, so it’s a lot easier as you get older for your skin to dry out. Then depending on your unique makeup, if you scratch, that can create inflammation, and then atopic [allergic] eczema results from really dry skin.”
Aging skin is also less effective at protecting against external irritants. Some blood pressure medications increase sensitivity to the sun, potentially exacerbating skin damage and compromising the skin barrier, which may contribute to the development of eczema.
Prioritizing Hypertension Management Despite Eczema Risks
Despite the potential risk of developing eczema, experts stress the importance of continuing blood pressure medication to manage hypertension. “I don’t want people to be afraid if their doctor proposes medications that have decades of supporting evidence, that have an impact on outcomes when it comes to cardiovascular disease, on the off-chance that they might get an itchy rash,” Dr. Friedman emphasized. He encouraged patients to communicate with their doctors if they develop eczema after starting blood pressure medication. “You can certainly say, ‘I was started on this blood pressure medicine a couple months ago and now I have this rash. Could it be connected?’ That’s how patients can advocate for themselves,” he said.
In summary, while there is an observed link between blood pressure medications and an increased risk of developing eczema in older adults, the priority should remain on managing hypertension effectively. Patients should be aware of this potential side effect and maintain open communication with their healthcare providers to ensure comprehensive and personalized care.
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