Hydrochlorothiazide and Skin Cancer – Is There a Connection?

The Food and Drug Administration (FDA) recently recommended a label change for the prescription diuretic, hydrochlorothiazide. The FDA approved the label change to reflect recent findings that show patients who use hydrochlorothiazide have a higher risk of developing non-melanoma skin cancer. This article will discuss what this drug is used for as well as why the FDA decided to approve the change.

What is Hydrochlorothiazide?

Hydrochlorothiazide is a prescription diuretic (water pill). It is often used to treat high blood pressure, as well as water retention (edema) in patients with other conditions such as congestive heart failure, cirrhosis of the liver, or a kidney disorder. It is also used to address water retention issues in patients taking steroids or estrogen. Since nearly half of all adults in the U.S. meet the criteria of hypertension, hydrochlorothiazide is a fairly common prescribed medication.

Hydrochlorothiazide and Skin Cancer

If a patient uses hydrochlorothiazide and does develop skin cancer, it will most likely come in the form of squamous cell carcinoma. Long term use of hydrochlorothiazide seems to be the greatest factor in determining whether a person taking the prescribed diuretic also has a higher risk of developing skin cancer.

Still, the FDA notes the risks associated with uncontrolled hypertension can be severe and even life-threatening. In contrast, the death rates associated with a non-melanoma skin cancer are generally low. Specifically, hydrochlorothiazide appeared to produce one additional non-melanoma skin cancer per 16,000 patients per year. It is for this reason that the FDA did not recommend that the drug be pulled from the market.

Instead, the FDA recommends that doctors counsel their patients about the potential risks associated with using the diuretic. This includes instructing patients to limit their amount of sun exposure, and to protect their skin by using a broad-spectrum sunscreen before going out in the sun, along with wearing protective clothing. The FDA also recommends that patients taking hydrochlorothiazide receive regular skin cancer screenings.


Patients who now have questions about using hydrochlorothiazide should voice their concerns with their doctor. In some cases, a doctor may be able to recommend another diuretic or they may simply counsel their patients on how to protect themselves from the sun.

If a patient does notice anything unusual on their skin, they should either check with their doctor or consult with a dermatologist. Skin cancer can form on any part of the body including the lips, nose, fingers, etc.

Patients should become familiar with their skin and note any changes in the size, shape, and color of a mole, or if they develop a red, scaly patch that doesn’t heal. Squamous cell carcinoma in particular may present as a firm, red nodule that bleeds on occasion or develops a pus-like crust.


If you or someone you know if taking hydrochlorothiazide especially on a long-term basis, it’s important to remain diligent about obtaining a regular skin exam. If you would like more information on how to prevent or treat skin cancer, please contact us today.

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