Certain medications are considered as major source of acne in some people or we can say acne is caused by the reaction of certain medications.
Lithium is one of them. Lithium is known to cause a variety of dermatological problems, common ones being acneiform eruptions, folliculitis and psoriasis including its pustular form. Lithium is used for the treatment of bipolar disorders and severe depressive illnesses. Lithium also has prophylactic effects in recurrent depressive and schizoaffective disorder. It is available commercially as the carbonate salt.
Patients who were on lithium for bipolar affective disorder repoted hidradenitis suppurativa and acne conglobata during therapy, which subsequently decreased once lithium was stopped. The serum lithium level was 0.869 mEq/L. Hence though within the therapeutic range, these concentrations of lithium in the serum triggered an inflammatory cascade, leading to the development of HS and AC.
HS was initially thought to involve principally the apocrine glands. However, subsequent histopatho-logical observations have demonstrated minimal to absent apocrine involvement. It has been suggested that follicular obstruction, folliculitis and subsequent cystic dilatation may represent important early changes in HS, which could be brought about by lithium. Apocrine glands do not always open directly onto the skin surface, and may discharge into the superficial portion of the pilosebaceous duct, proximal to the ostium for the sebaceous gland. In such instances, superficial follicular obstruction may cause dilatation of both the apocrine and sebaceous glands, inflammation and subsequent bacterial infection.
In this condition consult your psychiatrist, he will lower your lithium level as he cannot change your medicine. As we told you before that as soon as you stop the medication your acne would clear but in certain cases it stays even after stopping lithium and has to be treated separately..
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