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Medications That Cause Hair Loss

Hair loss can be a side effect of many medications, causing patients and those undergoing treatment a lot of stress. Telogen effluvium is the most common type of medication-induced hair loss [1]. It’s a type of hair loss that can also be caused by stress, trauma, and illness.

Telogen effluvium is characterised by thinning hair, bald patches that aren’t patterned like androgenetic alopecia. You may find large amounts of hair on your pillow after waking up, in the shower, and when running your hands through your hair.

Though telogen effluvium is the most common type of hair loss associated with medication, it’s not the only one. Androgenetic alopecia, alopecia areata, and anagen effluvium can also be caused by starting a course of treatment.

How medications cause hair loss

Anagen effluvium

Anagen effluvium is a type of non-scarring alopecia. It’s usually caused by the powerful medications used in chemotherapy. Hairs that are in the anagen growth phase are damaged by the toxic nature of the medications that treat cancer [2]. This causes a fracture in the hair shaft, usually beginning within 14 days of starting treatment.

Considered one of the most severe forms of medication-induced hair loss, hair loss from chemotherapy can have severe emotional effects on those undergoing treatment. 47% of female patients in one study considered hair loss to be one of the most traumatising factors of chemotherapy [2].

Telogen effluvium

Telogen effluvium caused by medication usually manifests itself 2 to 4 months after starting a particular course of treatment [3]. It’s also a little unclear as to whether it’s the medications causing the hair loss, as there’s only a few medications with proven links to hair loss [4].

Telogen effluvium hair loss isn’t just caused by starting medication – it can also be caused by stopping medication such as oral contraceptives, and hair loss treatment Minoxidil.

Androgenetic alopecia

Androgenetic alopecia — also known as male pattern baldness and female pattern hair loss —  is linked to hormones, so hormonal treatments like the contraceptive pill and testosterone replacement therapy can exacerbate existing hair loss [5, 6a].

Alopecia areata

Alopecia areata can be triggered by high cortisol levels [19]. Weight loss drugs and ADHD medication such as Adderall contain amphetamine, which can lead to high cortisol levels.

Medications that can cause hair loss

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Vitamin A

Vitamin A is an essential nutrient, supporting the maintenance of healthy bones, skin, teeth, and hair. It also supports the correct functioning of the body’s immune and reproductive systems. However, excessive vitamin A can cause hair loss.

This is because vitamin A is a fat-soluble vitamin, so it’s stored in the liver. Unlike water-soluble vitamins which are excreted by the body, excess vitamin A will build up in the body. This causes vitamin A toxicity, which has a host of negative side effects — including hair loss.

If you’re taking acne medication which contains vitamin A (retinoid medications like Accutane, for example) high levels of it could build up in your body and cause hair loss.

NSAIDs

NSAIDs (non-steroidal anti-inflammatory drugs) are painkillers such as ibuprofen, naproxen and aspirin. These drugs can cause hair loss by creating stress, which then causes hair to go into the telogen stage prematurely. Hair loss may be noted about 2 months after the medication was started [17].

One study measured iron and zinc levels in rats after ibuprofen was administered for 60 days. Iron and zinc are important metals in regards to hair growth. Researchers found the rat’s iron and zinc levels were significantly depleted, and 70% of the rats studied had alopecia [18].

If you undergo a hair transplant procedure, it’s not advised to take NSAIDs as they may interfere with the success of the treatment.

Antibiotics

Antibiotics can cause hair loss by depleting the body’s vitamin B and haemoglobin levels. Deficiencies in biotin (vitamin B7) are linked to hair loss, but this is usually due to an underlying condition.

There are no direct studies that prove a link between antibiotics and hair loss. Antibiotics also have a negative effect on gut bacteria, causing microbiome imbalances [7]. Recent research has suggested a link between poor gut microflora and poor hair growth, but more conclusive research is needed.

The contraceptive pill

There is a wealth of anecdotal evidence that stopping taking the pill results in hair loss. The scientific literature out there remains a subject of debate. One study suggests that hair loss from taking oral contraceptives is dependent on the type of contraceptive medication. It states that contraceptive medications with high androgenic indexes such as levonorgestrel can cause alopecia in women that are already susceptible to hair loss [5].

Why would this be? Genetic susceptibility is one factor. Also, women who have already experienced alopecia or female pattern hair loss are more likely to experience it again.

Chemotherapy medications

As we’ve already established, the strong medications prescribed as treatment for cancer cause hair loss. Designed to attack the cancer causing cells within your body, they don’t just cause hair loss from your head – the strong medications can also make hair fall out from your eyelashes, eyebrows, and whole body. It’s estimated that 65% of chemotherapy patients suffer from hair loss [6].

Antifungal medications

Used to treat fungal infections, antifungal medications such as voriconazole can cause alopecia. In one study, 82% of patients reported hair loss [8]. 96% of those patients experienced hair loss from the scalp, with other participants reporting hair loss from their arms and legs. A smaller number of patients also found their eyelashes and eyebrows were falling out.

Statins

Statins are medications that treat high levels of low-density lipoproteins (LDL), or ‘bad’ cholesterol in the blood. Hair loss has been reported when taking these medications, though it only tends to be in about 1% of patients [9].

Anticonvulsants

Anticonvulsants are mainly used in the treatment of epilepsy. One study looked at the medication levetiracetam and its effect on patients with epilepsy. They found hair loss was reported by the 5 patients studied within two months of starting treatment [10]. However, the hair loss was believed to resolve itself after stopping treatment.

Anticoagulants

Anticoagulants such as warfarin and heparin help to prevent blood clots in people that are at a high risk of their blood clotting. This can be dangerous, as it can lead to strokes and heart attacks.

Heparin and warfarin are medications that are known to cause hair loss. This hair loss is defined as alopecia but could also be linked to telogen effluvium [11]. It’s not fully understood why these medications cause hair loss. Other studies state that telogen effluvium occurs in up to 50% of patients taking anticoagulants [1].

Beta blockers

Hair loss from taking beta-blockers for high blood pressure is a rare but upsetting side effect. It’s been associated with the medication Propranolol, and likely to be caused by a toxicity affecting hair follicles [12].

Antidepressants

A comparative study compared different selective serotonin reuptake inhibitors (SSRIs), medications which increase levels of serotonin in the brain. They found some SSRI medications caused more hair loss than others, with bupropion having the highest risk of hair loss [13].

Learn more about how the anti-depressant sertraline can cause hair loss.

Testosterone therapy

The evidence for testosterone therapy and hair loss is more anecdotal. The increase in dihydrotestosterone (DHT) levels from testosterone treatment may cause hair loss. DHT is a byproduct of testosterone. It can cause hair follicles to diminish and eventually stop producing hair.

Weight loss medications

Some amphetamine-derived medications for weight loss can cause alopecia areata. While the exact mechanism linking the two hasn’t yet been established, it may be related to high cortisol levels caused by amphetamines. High cortisol levels may be a trigger for alopecia areata.

However, hair loss can also be caused by rapid weight loss [15]. This usually manifests as telogen effluvium rather than alopecia areata, so it’s important to get a diagnosis of your hair loss to establish the true cause.

Learn more about why your hair is falling out.

Treatments and prevention for medication-induced hair loss

Hair loss from chemotherapy

One treatment for chemotherapy related hair loss is scalp cooling. Chemotherapy patients wear a cooling cap filled with a cold gel or other liquid while they are undergoing treatment.

Though the research is limited, some studies do suggest scalp cooling helps to prevent hair loss from the scalp, and patients will be less likely to wear a wig after treatment. (14) Scalp cooling works by reducing blood flow to the hair follicles, meaning the harsh medications won’t damage the hair follicles.

Hair loss from other medications

Usually, hair grows back after stopping the course of treatment or medication. Never stop taking prescription medication without discussing it with your doctor or specialist, as there can be dangerous side effects.

If you stop treatment or finish your course of medication but the rate of hair falling out doesn’t slow down, you may need to look at other treatments. It’s good to wait at least 3 months, as medications can stay in your system due to their half-life. If you’re feeling self-conscious during that time, we’ve put together a list of solutions to hide thinning hair.

Diet and lifestyle

Eating a healthier diet can help prevent hair loss. If you or your doctor aren’t entirely sure if the medication is the root cause, adapting your diet could be an excellent way to make sure nutritional deficiencies aren’t causing hair loss. More extreme dieting practices like intermittent fasting have been linked with hair loss [16].

It’s always worth including healthy hair growth foods in your diet. Foods like avocado, chilli oil, eggs, and oily fish can help hair regrowth, and assist in managing hair loss from medications.

Also, the chemicals found in cigarette smoke can cause hair loss, as they damage hair follicles and stop hair from growing. Smoking more than doubles the likelihood of hair loss, so it’s always worth considering trying to quit.

If you need more advice, take a look at our natural remedies to combat hair loss.

Topical treatments

Topical treatments like Minoxidil and Finasteride are used to treat medication-induced hair loss. Part of the list of alternative hair loss treatments, these topical applications are proven to help treat hair loss from a number of sources, including from medications. Always ensure that any treatments don’t interfere with the medications you’re already taking. Learn more about medications that work as an alternative to a hair transplant.

Hair transplant

Looking for a more permanent solution to your hair loss?

Our hair transplant success rate is 97% – 100%. So if you’re experiencing medication induced hair loss that doesn’t regrow after stopping treatment, why not speak to one of our specialists. Book a free consultation to find out more.

Medications That Cause Hair Loss, Wimpole Clinic

Sources:

  1. Drug Reactions Affecting Hair: Diagnosis
  2. Anagen Effluvium
  3. Drug induced hair loss and hair growth. Incidence, management and avoidance.
  4. Drug-induced hair disorders
  5. Testosterone Treatments: Why, When, and How?
  6. Alopecia due to high androgen index contraceptives
  7. Stress and the Hair Growth Cycle: Cortisol-Induced Hair Growth Disruption
  8. Arthritis Medications and Hair Loss
  9. Underlying biochemical explanation for ibuprofen induced alopecia through study on zinc and iron kinesis in treated rats
  10. Unravelling the collateral damage of antibiotics on gut bacteria
  11. Chemotherapy-induced hair loss
  12. Alopecia and nail changes associated with voriconazole therapy
  13. Do statins cause hair loss?
  14. Hair loss with levetiracetam in five patients with epilepsy
  15. Traditional Anticoagulants and Hair Loss: A Role for Direct Oral Anticoagulants? A Review of the Literature
  16. Tremor Drugs in the Crosshairs
  17. Risk of hair loss with different antidepressants: a comparative retrospective cohort study
  18. Diffuse Alopecia Areata Associated with Weight-Loss Pills
  19. Hair loss in chemotherapy: Can chemotherapy-related hair loss be prevented?
  20. Alternate-day versus daily energy restriction diets: which is more effective for weight loss? A systematic review and meta-analysis
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