Medications that cause hair loss
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Medications That Cause Hair Loss: An Overview
Hair loss, or alopecia, can be a distressing side effect of various medications. Understanding the mechanisms and types of drug-induced hair loss is crucial for both patients and healthcare providers. This article synthesizes findings from multiple research papers to provide a comprehensive overview of medications that cause hair loss.
Mechanisms of Drug-Induced Hair Loss
Anagen Effluvium and Telogen Effluvium
Medications can disrupt the hair growth cycle, leading to two primary types of hair loss: anagen effluvium and telogen effluvium. Anagen effluvium occurs when drugs cause an abrupt cessation of mitotic activity in rapidly dividing hair matrix cells, leading to hair loss within days to weeks of drug administration. This type is commonly associated with antineoplastic agents used in cancer treatment 26. Telogen effluvium, on the other hand, involves the premature transition of hair follicles into the resting phase, resulting in hair loss 2 to 4 months after starting the medication. This type is linked to a wide range of drugs, including anticoagulants, retinoids, interferons, and antihyperlipidemic drugs 236.
Common Medications Associated with Hair Loss
Anticancer Agents
Anticancer drugs, particularly those used in chemotherapy, are well-known for causing anagen effluvium. These drugs target rapidly dividing cells, including hair matrix cells, leading to significant hair loss 27. Adriamycin, for example, is notorious for causing marked alopecia when administered in cumulative doses .
Psychotropic Drugs
Many psychotropic medications, including mood stabilizers, antidepressants, and antipsychotics, can induce hair loss. Lithium, valproic acid, and carbamazepine are notable mood stabilizers that can cause alopecia, with lithium affecting up to 19% of long-term users . Antidepressants such as tricyclics, SSRIs, and SNRIs have also been implicated in hair loss 48. Antipsychotics like olanzapine and risperidone have been reported to cause hair loss, although cases are relatively rare 58.
Other Medications
A variety of other drugs can also lead to hair loss. These include anticoagulants, retinoids, interferons, and antihyperlipidemic drugs, which are primarily associated with telogen effluvium 26. Immunosuppressants, azole antifungals, and certain antihypertensive drugs like minoxidil (when used topically) can also cause hair loss 710.
Reversibility and Management
Reversibility of Hair Loss
Drug-induced hair loss is usually reversible upon discontinuation of the offending medication. The hair growth cycle typically resumes its normal pattern, and hair regrowth occurs over time 236. However, the time frame for recovery can vary depending on the type of hair loss and the individual's response to the cessation of the drug.
Preventive Measures and Alternatives
In some cases, preventive measures can be taken to mitigate hair loss. For instance, scalp ischemia induced by a sphygmomanometer cuff has been shown to reduce hair loss in patients undergoing Adriamycin therapy . Additionally, switching to alternative medications with a lower risk of causing hair loss or adjusting the dosage may be beneficial 45.
Conclusion
Drug-induced hair loss is a multifaceted issue influenced by the type of medication, dosage, and individual susceptibility. While it is often reversible, the psychological impact can be significant. Awareness and early intervention are key to managing this side effect effectively. By understanding the mechanisms and common culprits, healthcare providers can better support patients experiencing medication-induced hair loss.
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