Drugs that cause hair loss
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Drugs That Cause Hair Loss: An Overview
Introduction to Drug-Induced Hair Loss
Hair loss, or alopecia, can be a distressing side effect of various medications. Drug-induced hair loss typically presents as a diffuse, nonscarring, and reversible condition that affects the scalp. The type and severity of hair loss depend on the drug, its dosage, and the individual's susceptibility1 2 7.
Mechanisms of Drug-Induced Hair Loss
Anagen Effluvium
Anagen effluvium occurs when drugs cause an abrupt cessation of mitotic activity in rapidly dividing hair matrix cells. This type of hair loss usually happens within days to weeks of drug administration and is a prominent adverse effect of antineoplastic agents, which are used in cancer treatment1 7.
Telogen Effluvium
Telogen effluvium is characterized by the premature transition of hair follicles into the resting phase, leading to hair shedding 2 to 4 months after starting the medication. This type of hair loss can be triggered by a wide range of drugs, including anticoagulants, retinoids, interferons, and antihyperlipidemic drugs1 2 7.
Common Drugs Associated with Hair Loss
Anticancer Agents
Anticancer agents are well-known for causing anagen effluvium due to their toxic effects on rapidly dividing cells. This type of hair loss is usually severe but reversible upon discontinuation of the drug1 6 7.
Psychotropic Drugs
Several psychotropic drugs, including antipsychotics, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), lithium, carbamazepine, and valproic acid, have been associated with hair loss. The risk of hair loss with these drugs varies, and in some cases, such as with lithium, the evidence is more convincing4 5 9.
Antihypertensive and Cardiovascular Drugs
Beta-adrenoceptor antagonists, commonly used for hypertension, and other cardiovascular drugs have been reported to cause hair loss in some patients. The incidence is generally low, but it is a recognized side effect10.
Anticoagulants and Antithyroid Drugs
All anticoagulants and antithyroid drugs can produce hair loss, typically presenting as telogen effluvium. This type of hair loss is usually reversible after stopping the medication1 10.
Other Medications
Other drugs that have been occasionally reported to cause hair loss include systemic or topical beta-blockers, salicylates, nonsteroidal analgesics, oral contraceptives, cimetidine, retinoids, amphetamines, bromocriptine, and levodopa. The relationship between these drugs and hair loss is less well-documented but should be considered in patients experiencing unexplained hair loss10.
Conclusion
Drug-induced hair loss is a complex condition influenced by the type of drug, dosage, and individual susceptibility. While many drugs can potentially cause hair loss, the most commonly implicated are anticancer agents, psychotropic drugs, antihypertensive drugs, anticoagulants, and antithyroid drugs. Understanding the mechanisms and identifying the offending drug is crucial for managing and potentially reversing this distressing side effect.
Sources and full results
Most relevant research papers on this topic
Drug-Induced Hair Loss and Hair Growth
Drug-induced hair loss can be reversible after interruption of treatment, with hirsutism and hypertrichosis being common side effects.
Highly CitedDrug reactions affecting hair: diagnosis.
Drug-induced hair loss is usually reversible, but some drugs may cause permanent hair loss.
Highly CitedDrugs and hair loss.
Hair loss may be caused by medications, but other factors, such as fever, hemorrhage, severe illness, stress, and childbirth, also contribute to hair loss.
Changes in Growth and Distribution of Hair Associated with Psychotropic Drug Use
Psychotropic drug use may cause hair loss and hypertrichosis, but the risk of hair loss during drug use is difficult to assess and should be consulted with a dermatologist.
A case of mirtazapine-associated hair loss.
Mirtazapine, a prototypical noradrenergic and specific serotonergic antidepressant, can cause temporary hair loss in female patients.
Case ReportDrug-induced hair loss.
Drug-induced hair loss is often reversible after discontinuing the drug, but may persist for a few months after discontinuing the drug.
Drug-induced hair disorders.
Drug-induced hair loss is usually reversible and caused by a toxic effect on the hair follicle matrix, but in rare cases it may be permanent.
DRUG‐ASSOCIATED ALOPECIA
Drug-induced alopecia is a common, reversible side effect of drug therapy, with severity and prevalence depending on the drug and individual predisposition.
Severe hair loss associated with psyc hotropic drugs in psychiatric inpatients—Data from an observational pharmacovigilance program in German-speaking countries
Severe hair loss related to psychotropic drugs was reported in 43 cases (0.01%) in psychiatric inpatients, with valproic acid being the most common risk factor, and is more common in female patients than male patients.
Observational Study
Rigorous Journal[Drug-induced alopecia: review of the literature].
Drug-induced alopecia can be a difficult side effect to diagnose, with a wide range of drugs potentially causing hair loss.
Literature Review