Metformin in dermatology: an overview

Area of Science:

• Dermatology
• Endocrinology
• Pharmacology

Background:

• Metformin is a first-line oral hypoglycemic agent for type 2 diabetes, improving glycemic control by reducing hepatic glucose output and enhancing insulin sensitivity.
• Beyond its glucose-lowering effects, metformin exhibits anti-platelet and antioxidant properties.
• These multifaceted pharmacological actions suggest potential therapeutic applications in non-diabetic conditions, particularly dermatological disorders.

Purpose of the Study:

• To conduct an evidence-based review on the efficacy of metformin in treating various skin disorders.
• To explore the dermatological conditions where metformin has shown therapeutic benefits.
• To document and discuss the cutaneous side effects associated with metformin use.

Main Methods:

• Systematic literature search for studies investigating metformin's use in dermatology.
• Evidence-based review and synthesis of findings on metformin's efficacy and safety in skin conditions.
• Analysis of reported cutaneous adverse events linked to metformin therapy.

Main Results:

• Metformin demonstrates effectiveness in treating conditions such as hirsutism, acne, hidradenitis suppurativa, acanthosis nigricans, and psoriasis.
• The review identifies several cutaneous side effects associated with metformin, including leukocytoclastic vasculitis, bullous pemphigoid, psoriasiform drug eruption, lichen planus, and acute alopecia.
• The pharmacological properties of metformin, such as insulin sensitization and antioxidant effects, underpin its utility in managing these dermatoses.

Conclusions:

• Metformin presents a viable treatment option for a range of dermatological conditions beyond its primary indication in diabetes.
• Clinicians should be aware of both the therapeutic potential and the spectrum of cutaneous adverse effects of metformin.
• Further research may elucidate optimal dosing and patient selection for dermatological applications of metformin.