Tamoxifen is a hormonal therapy used to treat breast cancer. More than 7,000 MyBCTeam members report taking this medication. Tamoxifen often causes menopause-like side effects, such as hot flashes. However, some members have noticed an unexpected side effect of tamoxifen that usually only affects adolescents and young adults — acne.

One member asked, “Has anyone else experienced bad acne from tamoxifen? Overall, my side effects aren’t too bad, other than the acne.”

Acne isn’t listed as a side effect of tamoxifen, which is sold under the brand names Nolvadex and Soltamox. However, the drug’s other side effects may explain why some people experience acne while taking it.

What Is Tamoxifen?

Tamoxifen is a selective estrogen receptor modulator (SERM) breast cancer treatment used to treat individuals with hormone receptor-positive breast cancer. Hormone receptor-positive cancer cells use hormones, like estrogen, as a signal to grow and divide. Tamoxifen blocks estrogen from connecting to breast cancer cells so they don’t continue to grow.

Who Takes Tamoxifen?

People can take tamoxifen before or after they’ve gone through menopause. Some individuals who do not have breast cancer may take tamoxifen if they have an increased risk of developing the disease. Those who’ve been diagnosed with hormone-positive breast cancer may take tamoxifen to prevent a recurrence — that is, to prevent the condition from coming back. Tamoxifen is usually taken for five to 10 years after breast cancer surgery.

Tamoxifen Side Effects

People rarely have to stop taking tamoxifen due to its side effects, which are usually mild. Common side effects of tamoxifen include:

• Menopause-like symptoms — such as hot flashes and night sweats
• Vaginal dryness or discharge
• Irregular periods
• Mood swings
• Weight gain
• Fluid retention
• Fatigue
• Headaches
• Nausea

Tamoxifen and Acne

Acne is a condition when your hair follicles get blocked by dead skin cells and oil, causing bumps or pimples. While acne isn’t listed as a possible side effect, some of tamoxifen’s side effects may make you more likely to develop acne.

Skin Changes

Tamoxifen can cause skin changes in some people. In clinical trials, almost 20 percent of participants experienced skin changes while taking tamoxifen. A more recent study from 2018 found that almost 70 percent of participants experienced skin changes.

Other skin-related side effects of tamoxifen include:

• Skin rash — This rash could start to blister or peel.
• Dry skin
• Hair loss
• Skin flushing caused by hot flashes (a sudden feeling of warmth)

The skin-related side effects of tamoxifen may make you more prone to acne breakouts. Anything that damages or irritates your skin may trigger an acne breakout.

Hormonal Changes

Tamoxifen causes hormonal changes that can cause menopause-like symptoms by blocking estrogen. Decreased levels of estrogen are normal in people going through menopause. However, the hormonal imbalance this causes has the potential to cause acne breakouts.

“I’ve got acne,” one MyBCTeam member shared. “Most of them are whiteheads or blackheads, and they are all over (face, chest, back). I definitely think my skin has become more oily on tamoxifen.”

Increased levels of androgen — a type of sex hormone — may be the reason for oilier skin while taking tamoxifen. Tamoxifen can increase androgen levels in some people. The most common type of androgen is testosterone. Increased androgen levels are linked to acne and increased oil production.

Abdominal obesity is also linked to increased androgen levels in women. Weight gain from tamoxifen can also trigger acne breakouts.

Stress

Stress is a well-known trigger for acne. While stress isn’t a side effect of tamoxifen, you may experience increased anxiety and stress before, during, and after your breast cancer treatment. Worrying about treatments, side effects, and the possibility of recurrence can all increase your stress levels.

Managing Acne While Taking Tamoxifen

Although many acne treatments are available over the counter, you should get medical advice from your cancer care team before you start any new treatment for your acne to make sure it doesn’t interact with any of your current medications.

Treating acne in adults can be challenging because most studies are done in adolescents and young adults. You may be referred to a dermatologist — a doctor who specializes in treating skin conditions. A dermatologist can recommend medications or a skin care routine that can help prevent and treat your acne breakouts.

One MyBCTeam member shared, “I’m 38 and suddenly have ugly acne on my face after starting tamoxifen. I wash my face morning and night. I’m wearing the same makeup I’ve always worn. Using the same moisturizers. I’m wondering if I might need to change things up due to hormonal changes.”

Your cancer health care team or dermatologist can make specific recommendations for how to best care for your skin during breast cancer treatment. Following are some tips for caring for your skin while taking tamoxifen:

• Wash your face twice a day with a mild cleanser.
• Use skin care products labeled noncomedogenic (which means “tends not to clog pores”).
• Don’t wash your face too often to avoid irritating your skin and causing more breakouts.
• Remove your makeup every day.
• Apply a moisturizer after washing your face and throughout the day, as needed.
• Apply sunscreen to your face, neck, and other exposed skin before going outside.

Talk With Others Who Understand

MyBCTeam is the social network for people with breast cancer and their loved ones. On MyBCTeam, more than 63,000 members come together to ask questions, give advice, and share their stories with others who understand life with breast cancer.

Have you experienced acne while taking tamoxifen? Share your experiences in the comments below, or start a conversation by posting on your Activities page.