Hydrochlorothiazide and skin cancer: prevention first!1
Press release from the French National Academy of Medicine
November 13, 2025
Hydrochlorothiazide (HCTZ) is one of the most commonly prescribed diuretics in France and in Europe due to its good tolerability and validated efficacy against high blood pressure. In France, more than one million patients are exposed to HCTZ annually, either alone or in combination (1). The network of Centres Régionaux de Pharmacovigilance en France (Regional Pharmacovigilance Centres in France) (2) has shown that the risk of skin cancer induced by HCTZ is dose-dependent and increases with the duration of treatment (cumulative dose greater than 50,000 mg).
Recent experimental data (3,4) confirm its photosensitizing and phototoxic role on the risk of squamous cell carcinomas of the skin and lips.
Consequently, the French National Academy of Medicine:
– Recalls the prevention recommendations issued by the Agence nationale de sécurité du médicament et des produits de santé, ANSM (French National Agency for
Medicines and Health Products Safety) (5): a skin examination represents an essential opportunity for early prevention.
– Recommends, in this context, regular skin monitoring:
1- By the doctor:
– At the start of treatment, by checking for any history of skin carcinoma and examining the skin and lips; a history of squamous cell skin cancer is not a contraindication to HCTZ but requires stricter skin monitoring (twice a year);
– When renewing prescriptions, by including a skin examination (once or twice a
year), especially of exposed areas of skin that are targeted by ultraviolet (UV) rays and therefore prone to the development of skin carcinomas.
2- By the patient:
– Through regular self-screening of the skin and lips, which should be encouraged;
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1 Rapid Communication Platform Press Release
– By practicing regular photoprotection of skin areas exposed to the sun:
covering clothes, broad-spectrum sunscreen creams protecting against UVB and UVA
particularly concerned in the development of these skin cancers
.
3- By the pharmacist:
– Who, with each dispensing of the treatment, must remind patients of the measures for photoprotection and self-screening, and convince patients to promptly report any suspicious lesions to their attending physician.
References
– Caisse Nationale d’Assurance Maladie. Open Medic: supplementary databases on drug expenditure and beneficiaries (2014–2024) [dataset]. 2025.https://www.data.gouv.fr/fr/datasets/open-medic/
– Agence nationale de sécurité du médicament et des produits de santé (ANSM). Hydrochlorothiazide-based medicinal products: information on the European safety signal assessment. 18 January 2018; Updated 06 01 2021
– Karkoszka M., Rok J., Rzepka Z. et al., Phototoxic Reactions Inducted by Hydrochlorothiazide and Furosemide in Normal Skin Cells—In Vitro Studies on Melanocytes and Fibroblasts, Int J Mol Sci. 2024;25(3):143. Doi:10.3390/ijms25031432
– Tao L., Xu Y., Cui Y. et al., Hydrochlorothiazide disrupts DNA damage response to exacerbate skin photosensitivity, Environ Saf., 2024;287:117314. Doi: 10.1016/j.ecoenv.2024.117314
– Centre de Pharmacovigilance de Nancy, Hydrochlorothiazide and skin cancer risk – what about other antihypertensive drugs? Pharmacovigilance Echoes
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