You’ve just started taking a new course of medication, and while you may be feeling better physically or mentally, there’s something going on with your skin: It’s only been a week or so, but it feels like you have a minefield of angry red bumps all over your shoulders or deep, painful cysts taking up residence on your chin.

Unfortunately, some medications and supplements can trigger breakouts, which can be pretty upsetting for someone trying to make a positive difference in their health. “Acne due to a medication is usually driven by increased oil production, hormonal signaling, increased inflammation, or altered turnover of skin cells,” explains  , DO, a board-certified internist and primary care physician at Houston Methodist West Hospital.

Medication-related breakouts generally show up fast, often within two weeks of starting a new drug, though they can take a month or longer to crop up, says , MD, a board-certified dermatologist at Schweiger Dermatology Group in Calabasas and Beverly Hills, California. But don’t worry, you likely won’t be breaking out forever.

“One important reassurance I give my patients is that medication-related acne may not be entirely avoidable, but it is very treatable,” Dr. Luftman says. “The goal is never to stop an important medication prematurely but to support the skin while the body adjusts from any number of vantage points.”

Ahead, learn more about which medications may cause acne breakouts and how to handle them.

Medications that commonly cause acne

Doctors note that if you’re experiencing medication-related acne, you’ll likely notice a lot of activity all at once, versus just one or two zits. “Drug-induced breakouts are often more uniform in size and shape across many areas, appearing rapidly after a medication cycle begins,” explains Dr. Luftman. Doctors refer to these as acneiform eruptions. You’ll typically see uniform papules (small, solid, raised bumps) and pustules (small, inflamed, pus-filled bumps) versus blackheads or whiteheads, she notes.

However, not all drug-related breakouts are acneiform eruptions. Some medications that affect hormone levels can cause true acne (with blackheads or whiteheads) and may require slightly different treatments to resolve. Here are some common culprits of both types of skin freak-outs.

Steroids

Steroid-related acne is pretty common, so much so that doctors often simply call it “steroid acne.” Frequently prescribed oral steroids like prednisone and dexamethasone may trigger “monomorphic inflammatory papules,” or small, uniformly sized red bumps, explains  ,MD, a board-certified dermatologist in New York City. Sometimes papules can develop into pustules, which have a white or yellow pus-filled tip, so you may notice both are present in the affected areas. If you’re dealing with a steroid-related breakout, you’ll typically see red, inflamed bumps across the arms, shoulders, back, and chest, Dr. Reszko says, calling that a “characteristic inflammatory breakout pattern.”

“Steroids such as prednisone or anabolic steroids stimulate the oil glands in the skin, which leads to acne formation,” explains Dr. Tomasco. Anabolic steroids, which are used to treat conditions like endometriosis and osteoporosis, are more likely to cause acne due to increased hormone activity, which in turn impacts your oil glands, she notes. “Think of when during puberty, hormones start to change and fluctuate, which often results in the acne so many of us experience as teenagers,” Dr. Tomasco says. “This is also the reason many women experience hormonal acne depending on where they are in their cycle.”

Hormonal medications

Hormonal medications, including certain progestin-dominant contraceptives or therapies that contain testosterone, can drive breakouts by increasing oil production, Dr. Reszko says. But wait, isn’t birth control supposed to clear up your skin? Usually, combination birth control pills (that contain the hormones estrogen and progestin) help improve acne, says Dr. Tomasco. She notes that patients on progestin-only pills would be more likely to break out due to the androgenic effects of the progestin; some of the “older” progestins are derived from testosterone, which is why they’re more likely to have androgenic activity. Newer options like drospirenone are better for acne-prone patients, Dr. Tomasco adds.

Lithium

Mood-stabilizing medications formulated with lithium can also cause breakouts, though the reason why isn’t well-understood. One possible explanation is that these drugs increase white blood cell activity, which then leads to clogged follicles that turn into pustules and papules. Like steroid acne this often appears on the shoulders, chest, and back, though it can also pop up on the face, including around the hairline. If you’re acne-prone in general, lithium may make your skin issues more prevalent, Dr. Reszko says.

Isotretinoin

Yes,  meant to help clear your skin can also cause breakouts. For example, vitamin A derivatives like isotretinoin—more commonly known as Accutane, though that brand has been discontinued—can  . This may feel pretty defeating, given the fact that you’re taking the medication to reduce acne, but the purge phase is usually just part of the journey. How long it lasts varies from person to person, though many patients find it resolves after about six weeks.

JAK inhibitors

JAK inhibitors are drugs used across several broad categories, including autoimmune and inflammatory conditions like rheumatoid arthritis, explains Dr. Tomasco. (Xeljanz and Cibinqo are two JAK inhibitors you may be familiar with.) These medications may also cause acne, but she says it’s not fully understood why. “We know that JAK proteins are overexpressed in acne lesions, so you would expect a JAK inhibitor to decrease acne,” Dr. Tomasco notes. However, in many patients, it appears to increase acne. “There are only hypotheses out there about why this happens, but research has not yet revealed why this occurs,” she says.

Supplements

Though supplements aren’t medications, many people take them alongside or in place of their prescriptions. If you’re suddenly breaking out and have just started a new routine, your supplement of choice could be the reason. Dr. Reszko says supplements like high-dose vitamin B12 and whey protein are known to cause skin breakouts for some individuals. Dr. Tomasco reiterates that B12 is a common culprit, saying it “changes gene expression in the bacteria that causes acne.”

When to talk to your doctor

Doctors acknowledge that medication-related breakouts can be super annoying to deal with. “It can be frustrating, especially when the medication is necessary,” says Dr. Reszko. But don’t stop your medication just because your skin is freaking out. Talk to the doctor who wrote you the prescription first to plot out a course of action, whether that means adjusting your dose, switching up your medication, or in some instances, staying the course.

For example, lithium-induced breakouts are often dose-related, Dr. Luftman explains. “Higher blood lithium levels can correlate with increased skin inflammation and acne breakouts,” she explains. Sometimes, though not always, reducing your lithium levels may help your skin clear up. “In many cases, dermatologists can successfully manage lithium-induced acne without changing the medication,” Dr. Luftman says. Your doctor can let you know what will be best for you.

Alternatively, depending on the drug you’re taking and your health concerns, your doctor may encourage you to stick with it. “Often, the focus is on controlling the skin while maintaining the needed therapy,” says Dr. Reszko. It’s worth noting that how long you may experience breakouts depends on the trigger. It’s also possible that your skin will adjust to your new regimen. Dr. Tomasco notes that “sometimes patients may notice that acne calms down after their body becomes accustomed to the medication.”

However, Dr. Tomasco says that if the acne is “persistent or bothersome,” consider speaking with your doctor about your options. Birth control is one instance where your physician may recommend trying something else, like switching from a progestin-only pill to one of the newer versions, Dr. Tomasco says.

One thing to note: If breakouts are sudden, severe, painful, widespread, cystic, or scarring, it is worth contacting both the prescribing physician and a dermatologist ASAP, says Dr. Reszko. She also advises giving your derm and doc a call if your breakout doesn’t resemble typical acne, as some drug-related acneiform eruptions may require different treatment.

How to calm a medication-related breakout

“Treatment may include   washes, prescription anti-inflammatory topicals, or oral therapies, depending on severity,” Dr. Reszko says. If you’re concerned about medication-related acne, it’s best to give your doctor a call so you can decide on a plan together. Some breakouts improve within weeks, she says, while others can continue as long as you’re taking the medication. But, Dr. Reszko adds, “the good news is that medication-related breakouts are usually very manageable once the cause is identified.”