Question
What is causing my HIV+ partner’s skin to darken?
2 September 2016. Related: All topics, Drug interactions, Side effects, Starting treatment.
My partner was diagnosed with a very low cd4 count of 6 back in May 2016. We lives in Vietnam and having very difficulty in finding experience HIV doctors or treatment centre. Anyhow; he was put on ARV therapy starting in June so it is slightly over 2 months now. He was very sick prior to treatment, but now we see a huge improvement.
We recently noticed that his skin has turned darken like as if he had had a tan or something. He did not go outside or exposed to the sun very much. Is this a cause to concern or is it a common side effect of the ARV? please help.
The ARV therapy he is on is one tablet daily contaning: Tenofovir disoproxil fumarate 300mg; Lamivudine USP 300mg; Efavirenz USP 600mg.
He is also on Itraconazole 100mg ( twice/day with a total of 4 tablets) ;
Cotrim 980mg once /day
Vitamine B complex
Ferrovit (iron tablet) twice/day
So is his darkened skin a cause for concern? we asked the doctor at the clinic where he receives his treatment, but he isn’t really answering. Communication between doctors and patients here is almost next to non-existence or very poorly explained. It is expected that patients shouldn’t ask questions, but just taking treatment from doctors as is. I am not sure if the doctor is not familiar with the problem?
Answer
Thanks for all of the detailed information.
It’s great that your partner was able to start treatment and that you are seeing a big improvement.
Although a handful of ARVs have been associated with pigment changes, these don’t include the ones you have listed your partner as taking. This does not mean that the ARVs aren’t causing the skin darkening, but that more investigation is needed. It could also be caused by something completely unrelated such as a low level of vitamin D. Unfortunately, this is best explored by a supportive doctor and well connected health system which is something you are struggling with.
It’s therefore best to provide as much clear information to the doctor/clinic as possible. This could be by taking photographs in the same light over time. You will also benefit from tracking any changes together, in case it regresses on it’s own. Using photographs may also help with any language barriers or doctors that aren’t very good at communicating verbally and you have a record in case you want to go to a new doctor.
Hopefully this will start to help you and your partner feel more in control of your health and please get back in touch if you need anymore information.
Hi Zoliswa, what is the name of the treatment you are taking? As with all skin changes, you should speak with your doctor to have this investigated and treated as appropriate.
Some people do report that they notice skin changes when taking a medication called dolutegravir, however there are a number of other causes that will need to be ruled out before it can be assumed treatment is the cause.
The of my skin i.e. on the forehead and on the neck changes black while I’m using his treatment
So what must I do
Please help
Hi Ouma, how long have you been noticing that your skin has been getting darker? and what ARVs are you taking?
As with all skin changes, you should speak with your doctor.
Please see this previous question: https://i-base.info/qa/803
My skin darkened so bad..can I stop arvs for my pigment to get better and supplement.
Eat healthy and do some exercise
Hi Philipina, I am sorry you have experienced this. What was the older medication you were taking? Some older combinations can unfortunately lead to changes in body fat as you have experienced. Switching can help but is not always a definitive treatment. More information can be found here: https://i-base.info/guides/side/fat-loss-lipoatrophy
Has the colour of your face changed much since 2009? and was this while you were on your new or old combination of drugs? Some people do report changes in the skin while on dolutegravir based regimens. A previous answer about this can be found here: https://i-base.info/qa/803