Can sertraline cause a rash? Understanding skin reactions to the antidepressant

October 12, 2025 •

4 min read

According to FDA drug labeling, rash is listed as a potential adverse effect of sertraline. While many skin reactions are mild, it is crucial to understand if and when can sertraline cause a rash? and what distinguishes a benign irritation from a serious medical emergency.

Quick Summary

Sertraline, an SSRI, can cause skin reactions ranging from common macular rashes to rare but severe hypersensitivity responses like Stevens-Johnson syndrome (SJS) and DRESS.

Key Points

Rash is a potential side effect: Sertraline can cause skin rashes, which may be a mild drug reaction or a serious allergic response.
Mild vs. Severe Symptoms: A mild rash is often maculopapular or hives, while a severe rash involves swelling, blistering, or peeling.
Serious Reactions Require Emergency Care: Blistering, facial swelling, or breathing difficulties alongside a rash are signs of a severe allergic reaction that needs immediate medical attention.
Do Not Stop Abruptly: It is crucial to consult a doctor before discontinuing sertraline due to a rash, as abrupt cessation can cause withdrawal symptoms.
Treatment Varies by Severity: Mild rashes may be treated with antihistamines, but serious reactions often require stopping the medication and emergency care.
SCARs Are Rare But Serious: Severe Cutaneous Adverse Reactions like Stevens-Johnson syndrome (SJS) and DRESS are life-threatening possibilities, though very rare.

Can Sertraline Cause a Rash? An Overview

Yes, sertraline (commonly known by the brand name Zoloft) can cause a rash. As a selective serotonin reuptake inhibitor (SSRI), sertraline can lead to various skin-related side effects, ranging from mild and temporary to severe and life-threatening. Most skin reactions associated with SSRIs, including sertraline, tend to appear within the first few weeks of treatment. Understanding the differences between a common rash and a severe allergic reaction is essential for proper management and a safe treatment course.

Common vs. Severe Sertraline Rashes

A rash can be a result of a mild, non-allergic drug reaction or, in rare cases, a serious allergic response.

Common Rashes

Appearance: Maculopapular rash (flat, red, small bumps), urticaria (hives), or simple redness and itchiness. The rash can appear anywhere, including the face.
Cause: Mild reactions are often linked to increased serotonin concentrations in the skin, which can cause pruritus (itching). It may not be a true allergic reaction.
Symptoms: Primarily skin-related and typically resolve with mild treatment or after discontinuing the medication under a doctor's supervision.

Severe Allergic Reactions (SCARs)

Appearance: A rash that is swollen, raised, blistering, or peeling. Severe reactions can also present with sores in the mouth, eyes, or genitals.
Cause: A severe hypersensitivity reaction, often accompanied by systemic symptoms affecting internal organs. These are rare but require immediate medical attention.
Symptoms: In addition to the rash, symptoms can include fever, swelling (especially of the face, tongue, and throat), joint pain, difficulty breathing, and general malaise.

What to Do if You Develop a Sertraline Rash

If you notice a rash while taking sertraline, it is important to take the right steps based on the severity of the symptoms. Do not stop taking sertraline abruptly without first speaking to your doctor, as this can cause withdrawal symptoms.

For a mild rash: Contact your healthcare provider promptly. They may advise managing the rash with antihistamines or topical corticosteroids while you continue your medication.
For signs of a serious reaction: Seek emergency medical attention immediately. This is particularly important if the rash is accompanied by other severe symptoms.
For confirmed severe allergic reactions: Your doctor will likely discontinue sertraline and may switch you to a different class of antidepressants to avoid potential cross-sensitivity.

Severe Cutaneous Adverse Reactions (SCARs)

In very rare but serious cases, sertraline can trigger severe cutaneous adverse reactions (SCARs), which are medical emergencies.

Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN): These are life-threatening conditions characterized by a widespread, painful blistering and peeling rash. SJS and TEN often begin with flu-like symptoms.
Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome: A delayed and severe drug-induced hypersensitivity reaction. It typically starts with fever, rash, and swelling, progressing to affect internal organs such as the liver, kidneys, and lungs.


Feature	Mild Sertraline Rash	Severe Sertraline Rash (SCARs)
Appearance	Flat, red patches (maculopapular) or itchy hives (urticaria).	Raised, swollen, blistering, or peeling skin.
Itchiness	May be itchy (pruritic).	Often intensely itchy and painful.
Associated Symptoms	Typically none, or mild irritation.	Fever, facial swelling, trouble breathing, blisters in mouth/eyes, flu-like symptoms.
Timeframe of Onset	Within the first few weeks of starting medication.	Variable; DRESS can be delayed for 3–8 weeks.
Treatment Urgency	Consult your doctor promptly for management.	Immediate emergency medical care required.

Potential Mechanisms of Sertraline-Induced Skin Reactions

The exact cause of all sertraline-related rashes isn't fully understood, but several mechanisms are at play:

Hypersensitivity Reaction: In allergic reactions, the body's immune system overreacts to the drug, releasing chemicals that cause skin inflammation and other systemic symptoms.
Serotonin Concentrations: The skin contains serotonin receptors, and an increase in serotonin concentration from an SSRI can sometimes cause pruritus and other dermal side effects. This is not a classic allergic reaction but a physiological response.
Viral Reactivation: For syndromes like DRESS, viral reactivation (such as the herpes family of viruses) may play a role alongside genetic factors and immune responses.

Conclusion

While a rash is a known potential side effect of sertraline, most skin reactions are mild and resolve with appropriate medical guidance. However, it is crucial to recognize the signs of a severe allergic reaction, such as swelling, blistering, and breathing difficulties, which require immediate emergency care. Any new rash that develops while taking sertraline should be brought to a doctor's attention. Always seek your doctor's advice before making any changes to your medication. For more drug information, refer to official resources like MedlinePlus.

Important Signs of a Serious Reaction

Swelling of the face, tongue, lips, or throat.
Difficulty breathing or tightness in the chest.
A rash that is swollen, raised, blistering, or peeling.
Sores in the mouth, eyes, or genitals.
Fever with the rash.
Unusual bruising or bleeding.
Significant general malaise (feeling unwell).

Frequently Asked Questions

A rash is a possible, though not common, side effect of sertraline. It was reported in clinical trials as an adverse event for some patients. The likelihood can range from a mild, non-allergic skin reaction to a rare, but severe, allergic response.

A sertraline-induced rash can vary in appearance. Mild cases may present as red, flat patches (maculopapular rash) or itchy, raised welts (hives). Severe reactions can cause blistering, peeling skin, or swelling.

You should be concerned about a sertraline rash and seek immediate medical help if it is accompanied by facial or tongue swelling, difficulty breathing, blisters, peeling skin, or fever. These are signs of a severe allergic reaction.

SJS (Stevens-Johnson syndrome) and DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) are rare but severe and potentially life-threatening allergic reactions to medications. While they have been reported with SSRIs, they are not common side effects of sertraline.

Treatment depends on the rash's severity. Mild rashes may be managed with antihistamines or topical creams as advised by a doctor. For severe allergic reactions, the medication must be immediately stopped under medical supervision, and emergency care is needed.

No, you should never stop taking sertraline abruptly without a doctor's supervision. This can lead to withdrawal symptoms. If you experience a rash, contact your doctor for advice on how to proceed safely.

Not all SSRIs pose the exact same risk for rash, but skin reactions can occur with any of them due to potential cross-sensitivity. If you have a serious reaction to sertraline, your doctor might recommend an antidepressant from a different class.