Do Antidepressants Change Your Appearance?

October 5, 2025 •

3 min read

A study of long-term antidepressant users found that 65.3% reported weight gain as a side effect. While effective for mental health, the question remains for many: do antidepressants change your appearance through other effects on skin and hair?

Quick Summary

Antidepressants can alter one's appearance, most commonly through weight gain. Other potential changes include skin issues like acne and dryness, and temporary hair loss. The specific effects vary by medication type and individual response.

Key Points

Weight Gain: The most common appearance-related side effect, with some studies showing over 65% of long-term users experience it. Mirtazapine and some TCAs carry the highest risk.
Skin Changes: Acne, rashes, and dryness are possible side effects. SSRIs may disrupt hormones, leading to acne, or cause dryness by reducing saliva production.
Hair Loss: A rare and typically temporary side effect known as telogen effluvium, which is often reversible after adjusting medication.
Medication Matters: The risk of side effects varies greatly. Bupropion is often weight-neutral or leads to weight loss, while TCAs and mirtazapine are linked to significant weight gain.
Management is Possible: Side effects can often be managed through lifestyle changes, skincare routines, or by working with a doctor to adjust the medication.
Emotional Blunting: Some antidepressants can cause emotional blunting, which may lead to reduced facial expressions, known as a 'flat affect'.
Consult a Professional: Never stop or change your medication without consulting your doctor, who can help weigh the benefits against the side effects.

The Connection Between Antidepressants and Physical Appearance

Antidepressants are crucial medications for managing depression and other mental health conditions by balancing neurotransmitters in the brain. While primarily impacting mood, they can also cause physical side effects that may change a person's appearance, mainly involving weight, skin, and hair. These effects differ depending on the type of antidepressant and the individual.

Weight Fluctuations: The Most Common Change

Weight gain is a common side effect, with almost all classes of antidepressants carrying a risk, although some pose a higher risk than others. Antidepressants can increase appetite or cravings, particularly for carbohydrates, and some may slow metabolism. TCAs, for example, can interfere with feeling full. Conversely, improved mood can restore appetite in those who lost weight due to depression. Medications like mirtazapine and certain TCAs are linked to a higher risk of weight gain, while bupropion is often associated with weight neutrality or loss. SSRIs like fluoxetine may initially cause weight loss but can lead to gain with long-term use.

Skin-Related Side Effects

Skin changes are less common but possible, given the link between the mind and skin. Acne, hives, itching, and rashes are the most frequent skin issues. SSRIs might cause acne by affecting hormones and increasing oil production. Some antidepressants can also alter skin pH or increase sweating, contributing to breakouts. Dry skin and lips are also reported side effects. Less often, increased bruising and redness can occur. Serious skin reactions are rare.

Hair Loss (Telogen Effluvium)

Hair loss is an uncommon and usually temporary side effect. This type of hair loss, telogen effluvium, is often triggered by stress from a new medication, causing premature shedding that typically starts within three months of beginning treatment and resolves as the body adjusts. Bupropion and SSRIs like fluoxetine and sertraline have been associated with hair loss. However, the risk varies; some studies suggest bupropion has a higher risk than SSRIs, and paroxetine may have a lower risk among SSRIs. Hair loss is almost always reversible after stopping or switching the medication.

Comparison of Antidepressant Classes


Feature	SSRIs (e.g., Sertraline, Paroxetine)	TCAs (e.g., Amitriptyline)	Atypical (e.g., Bupropion)	Atypical (e.g., Mirtazapine)
Weight Gain	Varies; Paroxetine has a higher risk. Long-term use often leads to gain.	High risk; associated with significant weight gain.	Low risk; often associated with weight loss or neutrality.	High risk; known for appetite stimulation.
Skin Issues	Can cause acne, dry skin, and increased sweating.	Less common than SSRIs, but can cause skin reactions.	Acne is a possible side effect.	Less data, but rashes are possible.
Hair Loss	Uncommon, but reported with fluoxetine and sertraline. Paroxetine has a lower risk.	Possible, but less common.	Higher risk compared to SSRIs in some studies.	Possible, but less documented.

Managing Appearance-Related Side Effects

If you experience these side effects, consult a healthcare provider before changing your medication. Management strategies include:

Lifestyle Adjustments: Diet and exercise can help manage weight gain.
Skincare Routine: Non-comedogenic products for acne and moisturizers for dry skin can be beneficial.
Medication Adjustment: Your doctor may suggest switching to a different medication, adjusting the dose, or adding another treatment to counteract side effects.

Conclusion

Antidepressants, while vital for mental health, can affect appearance through weight changes, skin issues, and temporary hair loss. These effects depend on the medication and individual. Discussing side effects with a healthcare provider is crucial to find an effective treatment that minimizes unwanted physical changes. Often, the mental health benefits outweigh the manageable impact on appearance.

For more information on the effects of antidepressants, you can visit the National Institute of Mental Health (NIMH).

Frequently Asked Questions

Mirtazapine (Remeron), paroxetine (Paxil), and certain tricyclic antidepressants like amitriptyline are among the most likely to cause weight gain.

No, hair loss from antidepressants is usually temporary. It's a type of shedding called telogen effluvium that typically resolves on its own or after stopping or switching the medication under a doctor's guidance.

Yes, acne is a potential side effect. Some antidepressants, particularly SSRIs, can cause hormonal fluctuations or increased sweating, which may lead to breakouts.

Bupropion (Wellbutrin) is the antidepressant most consistently associated with weight neutrality or even weight loss.

Many side effects, like temporary hair loss, can go away as your body adjusts or if the medication is changed. Others, like weight gain, may require active management through diet and exercise or a medication switch.

Besides potential skin changes like acne or dryness, some people experience emotional blunting, which can result in reduced facial expressions, sometimes called a 'flat affect'. Weight gain can also alter facial appearance.

You should talk to the doctor who prescribed the medication. They can help you manage the side effects through lifestyle changes, skincare advice, or by adjusting your treatment plan. Do not stop taking your medication without consulting them.