Thin Skin? Medications That Could Be to Blame

Skin changes are common as we start to age. Skin can look different for everyone depending on lifestyle, health conditions, and other factors such as genetics. Typically, skin will become thinner, dry, and papery over the years, especially on the arms and legs. Thin skin also tends to bruise more easily.

Another cause of thinning skin can be due to the side effects of some medications.

Continue reading to learn about what medications can cause thinning skin, treatment options to get rid of thin skin, as well as how to prevent thin skin altogether.

What is thin skin?

While thinning skin is concerning, keep in mind that skin thickness may vary between different areas of the body. This means even with completely healthy skin, the skin is naturally thinner on some parts of our body than others. For example, the skin on the eyelids is just 0.5 millimeters (mm) thick, while the thickness of the skin on the heel of the foot is about 2 mm to 4 mm.

The skin comprises three layers, including the hypodermis, dermis, and epidermis.

The hypodermis is the innermost layer of the skin that is made up of sweat glands and fat. The middle layer is the dermis, which contains the blood vessels and nerves.

The epidermis is the outermost layer of the skin, which serves as a barrier to protect us against dirt, bacteria, and other external factors. The term thin skin specifically refers to the thinning of the epidermis.

Thin skin, by itself, does not cause serious medical problems. However, the thinning of the epidermis can make the skin more vulnerable to damage and injury due to its compromised function as the protective barrier of the body. Therefore, you may get bruises more easily.

In general, maintaining healthy skin is important for the overall health. Therefore, it is important to be aware of the common factors, including certain medications, that can cause thin skin as their side effects.

What are the symptoms of thin skin?

When the skin begins to thin, it may start to look transparent. Veins, tendons, and bones may be visible. Loss of fat from the hypodermis may cause the skin to look saggy and less full, along with more wrinkles. A person with thin skin may also notice multiple skin tears and bruises after minor injuries, as the skin has less elasticity.

The extent of these symptoms depends on certain lifestyle factors, such as sun exposure, hydration, diet, and exercise.

What causes thinning skin?

Skin typically becomes thinner due to a variety of factors. Below are the most common reasons for increasingly fragile skin.

Age: This is the most common reason for thinning skin. With time, skin starts to lose elasticity, develop wrinkles like laugh lines and crow’s feet, and become dry and vulnerable to damage.

Sun exposure: If someone spends a lot of time outside for their career, hobbies, or if they live in an area with a lot of sun, they are more likely to have thin skin due to ongoing sun damage. UV rays (ultraviolet rays) can kill or damage the skin cells, leading to wrinkles and thin, dry skin.

Alcohol and Smoking: Drinking alcohol and smoking cigarettes can speed up the process of aging, causing skin to mature quickly. Therefore, long-term exposure to cigarette smoke and alcohol can contribute to skin changes that cause the matured appearance of the skin.

Medications: Certain types of medication can cause skin thinning as a side effect of long-term use, such as medicine used to treat skin conditions like eczema and psoriasis.

What medications can cause thinning skin?

Some medications can affect the fat layer in the hypodermis, damaging the epidermis and causing thin skin.

The prolonged use of these medications can also put you at risk for other problems such as dry skin, bruises, and altered skin complexion.

However, it is important to remember that not all people who use these medications develop thin skin. People may react to the same medication differently. In other words, one drug may be more effective for some people, or some may experience side effects while others do not, or the side effects are not as significant. All medications carry potential side effects, and healthcare providers analyze these risks prior to initiating certain treatment for patients. The benefits associated with the use of these drugs should be weighed against the possible side effects before determining whether a certain medication is the best option to use.

Below is a list of medications that can cause skin thinning as a potential side effect.

1. Oral steroids

Oral steroids, such as prednisone, are known to cause thin skin. These drugs are typically prescribed to patients who suffer from conditions like asthma or autoimmune disorders such as systemic lupus erythematosus (SLE), inflammatory bowel disease (IBD), and rheumatoid arthritis (RA).

As these conditions are chronic, patients need to use oral steroids for a long period of time, making the development of side effects like thin skin more likely.

Oral steroids can also lower the collagen production in the skin. Collagen is a type of protein that helps to keep the skin, hair follicles, and nails strong and resilient. The inadequate collagen production causes the skin to tear and stretch excessively, causing it to thin out over time.

2. Asthma and COPD inhalers

Inhalers, used for the treatment of asthma and COPD (chronic obstructive pulmonary disease), are associated with skin thinning.

Keep in mind that this is not applicable to the rescue inhalers which contain albuterol. Rescue inhalers are to be used on an as-needed basis for shortness of breath and wheezing. Daily inhalers for asthma and COPD, also referred to as controller inhalers, are the ones that can cause skin thinning. Daily inhalers are designed to be used daily to prevent asthma attacks or COPD flares and reduce the need to use rescue inhalers. The reason is that these inhalers contain steroids as their active ingredient.

Examples of daily inhalers, such as budesonide (Pulmicort), fluticasone (Flovent, Arnuity Ellipta), beclomethasone (Qvar Redihaler), and mometasone, are found to make the skin thinner, thus making patients vulnerable to bruises.

3. Topical steroids

Topical steroids (skin creams and ointments containing steroids) such as triamcinolone, clobetasol, hydrocortisone, or betamethasone can cause thinning skin.

These medications are usually prescribed to patients who suffer from eczema or autoimmune conditions affecting the skin, like psoriasis.

Topical steroids help to modify the immune system and reduce inflammation in the skin. This can provide relief from symptoms such as itching, redness, scaling, and swelling. Low-potency topical steroids are also used short-term to treat skin conditions like poison ivy, nickel allergy, or ringworm infection. For ringworm infection, the use of topical steroids is not recommended without antifungal medication.

Therefore, always consult your healthcare provider before you use any topical medications containing steroids.

4. Heart medicine and high blood pressure treatment

Even though the cardiac medications discussed below do not directly cause thin skin, they can affect the integrity of the skin, which can contribute to the worsening of skin thinning, especially if you already have thin skin due to other factors such as other medications or UV ray exposure.

Statin medications such as atorvastatin (Lipitor) and simvastatin (Zocor) can cause the skin to be drier. Thiazide medications (a class of water pills) are also considered anti-hypertensives (or blood pressure medications) because they are used to treat high blood pressure by helping the body eliminate extra fluid. Hydrochlorothiazide is a commonly prescribed thiazide diuretic. It is believed that thiazide diuretics can increase the risk of certain types of skin cancer.

If you are taking a blood thinner like warfarin (Coumadin) or even baby aspirin, it can increase the risk of bruising even without apparent trauma.

If you take any medication for cholesterol or high blood pressure or are currently on blood thinners, it could be beneficial to talk to your doctor about the effect of these medications on your skin.

5. Steroid Injections

Steroid injections can cause skin thinning at the site of administration.

Local steroid injections are usually prescribed to patients who suffer from chronic pain in the back or joints. These injections are often used in combination with nonsteroidal anti-inflammatory drugs (NSAIDs).

A healthcare provider injects steroids directly into the affected tissues of the joint to help the patient derive relief from pain. Steroid injections can reduce inflammation and relieve pain and swelling but can cause skin thinning around the site of administration.

How do you treat thin skin?

While there is no cure for thin skin, there are ways to restore some of the elasticity and fullness your skin once had and prevent further damage.

Microneedling

You can consider advanced skin treatments such as microneedling to reverse or slow down skin thinning. These treatments can be performed in a dermatology office on an outpatient basis.

The needles used in these therapies cause small points of bleeding without causing damage to the skin.

Multiple sessions of microneedling in combination with laser treatments can boost collagen production in the skin and increase the skin’s elasticity and suppleness, thereby improving the appearance of skin thinning.

Dermal fillers and laser treatments

Advanced skin treatments such as dermal fillers can help relieve the symptoms of skin thinning by filling or replenishing the skin cells, and tissue lost due to aging and sun damage.

Dermal fillers can give the skin a plumper, firmer, and more youthful appearance. However, these treatments do not provide lasting results for medication-induced skin thinning.

In addition, laser treatments, intense pulsed light, and photodynamic therapy have also been found to provide relief from the symptoms of medication-induced thin skin.

Preventing skin thinning

It is not possible to reverse the thinning skin caused by aging or the side effects of medications. However, there are ways you can prevent skin from thinning over time.

Consistent moisturizing: Dry and aging skin tends to be less flexible and can get damaged easily. Applying moisturizers, lotions, and creams and staying well-hydrated can go a long way in maintaining healthy skin. Moisturizing and getting enough water can help make the skin soft, supple, and more flexible, thus lowering the risk of cuts, tears, and bruises to the skin.

Reduce sun exposure: Protect your skin against sun damage from UV rays by applying an SPF sunscreen regularly and wearing sun-protective clothing, like hats, long sleeves, and sunglasses.

Vitamins: Make sure your body is getting enough vitamins and minerals to support skin health. Apply creams and ointments that contain a form of vitamin A called retinol or retinoids. Incorporate more vitamin C, D, and E into your diet and lifestyle. Eating foods rich in vitamin C and E, such as citrus fruits, avocados, and almonds, can help promote skin health and slow down skin thinning.

Biotin: The deficiency of biotin in your diet can cause thinning skin and hair follicles. Biotin is one of the B vitamins that are commonly used in hair, skin, and nails vitamins. Eating foods rich in biotin, such as sweet potatoes, eggs, mushrooms, and green leafy vegetables, or the use of supplements containing biotin can help restore the appearance of healthy skin.

Does thin skin improve over time?

While there is no cure for skin thinning, studies have demonstrated that some treatments could be effective in preventing or slowing down the thinning of the skin. For example, topical spironolactone might improve skin thinning caused by steroid use. However, there is no data to support the safety and efficacy of this specific use of topical spironolactone; more research is necessary to evaluate the role of topical spironolactone.

Hyaluronic acid fillers, collagen supplements, and retinol treatments might also help to lessen skin thinning and restore optimum skin health.

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