Use of antiepileptic drugs and risk of skin cancer: A nationwide case-control study

J Am Acad Dermatol. 2020 Feb;82(2):326-335. doi: 10.1016/j.jaad.2019.05.055. Epub 2019 May 28.


Background: Several antiepileptic drugs are photosensitizing; however, it is not known whether this confers an increased risk of skin cancer.

Objective: To examine the association between common antiepileptic drugs and basal cell carcinoma, squamous cell carcinoma (SCC), and malignant melanoma.

Methods: We conducted a nested case-control study identifying skin cancer patients in Denmark from 2004 through 2015 matched 1:10 with disease-free controls. We estimated odds ratios (ORs) for skin cancer associated with high cumulative use of antiepileptic drugs (≥500 defined daily doses) compared with nonuse.

Results: Most antiepileptic drugs were not associated with skin cancer. SCC was associated with use of carbamazepine (OR, 1.88; 95% confidence interval, 1.42-2.49) and lamotrigine (OR, 1.57; 95% confidence interval, 1.12-2.22) with evidence of a dose-response relationship for carbamazepine. The estimated absolute risks were low; for example, 6335 person-years of high cumulative exposure to carbamazepine were required for 1 additional SCC to occur.

Limitations: Data on important risk factors for skin cancer, such as sun exposure, were not available.

Conclusions: Most antiepileptic drugs were not associated with skin cancer; however, carbamazepine and lamotrigine were associated with SCC. These findings need to be replicated and characterized further in other settings and have no direct clinical implications.

Keywords: adverse effects; antiepileptic drugs; cancer risk; epidemiology; malignant melanoma; nonmelanoma skin cancer; pharmacology; skin cancer.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anticonvulsants / adverse effects*
  • Carbamazepine / adverse effects
  • Carcinoma, Basal Cell / chemically induced
  • Carcinoma, Basal Cell / epidemiology*
  • Carcinoma, Squamous Cell / chemically induced
  • Carcinoma, Squamous Cell / epidemiology*
  • Case-Control Studies
  • Denmark / epidemiology
  • Epilepsy / drug therapy
  • Female
  • Humans
  • Incidence
  • Lamotrigine / adverse effects
  • Male
  • Melanoma / chemically induced
  • Melanoma / epidemiology*
  • Middle Aged
  • Registries / statistics & numerical data
  • Risk Factors
  • Skin Neoplasms / chemically induced
  • Skin Neoplasms / epidemiology*


  • Anticonvulsants
  • Carbamazepine
  • Lamotrigine