This month’s question can be answered with one word: yes.However, we do not know which adolescents and young adults will develop acne when they start chemotherapy -- and it certainly doesn’t happen to everyone.We do know that acne is normally caused by a combination of active oil glands (called sebaceous glands), blockage of the skin pores, activity of normal skin bacteria, and inflammation.An increase in hormones (like testosterone and estrogen) can lead to hyperactive oil glands which contribute to pimple formation; this is why acne is so common during puberty when we all experience a surge in these so-called sex hormones.Some of the most-effective and common chemotherapeutic agents used to treat cancers in adolescents and young adults include steroids, which are a type of hormone that also increase the activity of the oil glands in the skin and lead to increased acne.
Several different cancer drugs have been reported to be associated with acne, although we only really understand the connection between pimples and steroids explained above.Some of the chemotherapeutic agents related to pimples include: Gefitinib (25-33% of the time), Efalizumab (4% of the time), Cetuximab (80% of the time), Cyclosporine (<5% of the time), Dactinomycin (<5% of the time), Methotrexate (<5% of the time), Sirolimus (>20% of the time), Tacrilomus (<5% of the time), Dasatinib (handful of reports), and of course, all of the steroids (including ACTH, prednisone, methylprednisone, dexamethasone) have been associated with acne.It is important to remember that any acne related to chemotherapy will resolve when your therapy ends and your chemotherapy is stopped.Although potentially embarrassing and always annoying, most patients agree that the possibility of a little acne is worth the cost of curing their cancer.
As an aside, because chemotherapy can decrease the function of the immune system and the body’s inflammatory response (which is needed to form pimples), it is not unusual for many patients to experience a decrease in their acne during treatment.In fact, I have had several teenage patients who had their acne resolve completely during cancer treatment, only to have their pimples return when they completed their chemotherapy!
