Dermatological manifestations associated with chemsex
Journal of the European Academy of Dermatology and Venereology July 11, 2026 Pablo Balado-Simó, E Gimeno, Josep Riera‐monroig et al.
Chemsex—the use of psychoactive substances to enhance sexual activity, especially among gay, bisexual, and other men who have sex with men—is linked to a range of skin and mucosal complications. Dermatologists often encounter these manifestations first. Lesions vary by substance and route of administration: poppers dermatitis is common and frequently misdiagnosed as impetigo; MDMA causes oral mucositis and painful aphthous-like ulcers from bruxism and xerostomia; injection-related lesions from mephedrone and ketamine can resemble infections or vasculitis, leading to delayed diagnoses; cocaine with levamisole can cause cutaneous necrosis and vasculitis; GHB/GBL may lead to traumatic genital injuries due to reduced pain sensitivity; and constricting devices can cause mechanical trauma and penile deformities. Increased awareness of these signs supports earlier recognition and non-stigmatizing risk-reduction advice.