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Medication Induced Hair Loss

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Medication is designed to treat a variety of health conditions, but sometimes they can have unwanted side effects – including changes to your hair. Certain medicines can contribute to excess hair growth, changes in hair colour or texture, or even hair loss. Medication-induced hair loss, like any other type of hair loss, can have a real effect on your self-esteem. The good news is that in most cases, it’s reversible once you stop taking the medication.

Medications can lead to two types of hair loss:

Telogen effluvium is the most common form of medication-induced hair loss. It usually appears within two to four months after taking the medication. This condition causes the hair follicles to go into their resting phase (telogen) and fall out too early. People with telogen effluvium usually shed between 100 and 150 hairs a day.

Anagen effluvium is hair loss that occurs during the anagen phase of the hair cycle, when the hairs are actively growing. It prevents the matrix cells, which produce new hairs, from dividing normally. This type of hair loss usually occurs within a few days to weeks after taking the medication. It’s most common in people who are taking chemotherapy medications and is often severe, causing people to lose most or all of the hair on their head, as well as their eyebrows, eyelashes and other body hairs.

The severity of medication-induced hair loss depends on the type of medication and dosage, as well as your sensitivity to that medicine.

What types of medications cause hair loss?

Many different types of medicines are thought to cause hair loss, including some of the following types of medications:

Chemotherapy medications often lead to the anagen effluvium type of hair loss. As these kill cancercells throughout the body, they can also damage healthy cells, including hair matrix cells. The hair typically starts to fall out after the second cycle of chemotherapy. Hair loss is more common and severe in patients taking combinations of chemotherapy medications than in those who take just one medication.

How is medication-induced hair loss diagnosed?

If you are experiencing hair loss, your GP will ask you several questions, including:

  • When did the hair loss start?
  • How quickly has the hair been falling out?
  • What other symptoms do you have (scalp itching, burning or tingling)?
  • What medications were you taking in the four months leading up to the hair loss?
  • What other illnesses do you have?
  • Have you made any changes to your diet or hair-care routine?

The doctor also will examine your scalp to look at the pattern of hair loss.

Tests that may be done include:

  • Thyroid function tests – to test for thyroid disorders, which can sometimes cause hair thinning and hair loss
  • Full blood count – to test for iron deficiency anaemia, which can sometimes cause hair thinning
  • Hair shaft exam – to look at the shape, length and fragility of the hairs
  • Pull test – gently pulling on about 60 hairs to see how many come out
  • Biopsy – removing a piece of scalp tissue for examination
  • Hormone tests

It can be difficult to prove which medication is causing the hair loss, or even that one is to blame. Your doctor may ask you to stop taking one medication at a time and see whether your hair stops falling out, but it can take two to three months after stopping a medication for the hair loss to end.

How is medication-induced hair loss treated?

It’s important to review any medications you take and discuss their potential side effects with your GP and pharmacist. When hair loss does occur from a medication you’re taking, there is a good chance that the hair will grow back on its own after you stop taking it. If stopping the medications does not improve hair thinning, you may need to be treated with a medication that stops hair loss and can stimulate new hair growth.

One technique is available to prevent hair loss during chemotherapy. It’s called scalp hypothermia, and it involves placing ice packs on the scalp a few minutes before, and for about a half-hour after chemotherapy treatment. Cooling the scalp reduces blood flow to the hair follicles, making it harder for the chemotherapy medications to get into the follicular cells. Cooling also reduces biochemical activity, making the hair follicles less susceptible to damage from chemotherapy drugs.

After chemotherapy treatment, the hair usually grows back very quickly, but it may change in texture. In rare cases, the hair will stay thin even after treatment has been stopped. Hair growth medication may help re-grow hair that is slow to return. Some chemotherapy patients wear a wig or hat to cover their hair loss until their hair grows back. (http://www.webmd.boots.com/skin-problems-and-treatments/hair-loss/medication-induced-hair-loss)

Here is a more detailed list of prescription drugs that cause hair loss:

Acne

All drugs derived from vitamin A as treatments for acne or other conditions, including:

  • Accutane (isotretinoin)

Blood

Anticoagulants (blood thinners), including:

  • Panwarfin (warfarin sodium)
  • Sofarin (warfarin sodium)
  • Coumadin (warfarin sodium)
  • Heparin injections

Cholesterol

Cholesterol-lowering drugs, including:

  • Atronid-S (clofibrate)
  • Lopid (gemfibrozil)

Convulsions/ Epilepsy

  • Anticonvulsants, including:
  • Tridone (trimethadione)

Depression

  • Antidepression drugs, including:
  • Prozac (fluoxetine hydrochloride)
  • Zoloft (sertraline hydrochloride)
  • Paxil (paroxetine)
  • Anafranil (clomipramine)
  • Janimine (imipramine)
  • Tofranil (imipramine)
  • Tofranil PM (imipramine)
  • Adapin (doxepin)
  • Sinequan (doxepin)
  • Surmontil (trimipramine)
  • Pamelor (nortriptyline)
  • Ventyl (nortriptyline)
  • Elavin (amitriptyline)
  • Endep (amitriptyline)
  • Norpramin (desipramine)
  • Pertofrane (desipramine)
  • Vivactil (protriptyline hydrochloride)
  • Asendin (amoxapine)
  • Haldol ( haloperidol)

Diet

  • Amphetamines

Fungus

  • Antifungals

Glaucoma

The beta-blocker drugs, including:

  • Timoptic Eye Drops (timolol)
  • Timoptic Ocudose (timolol)
  • Timoptic XC (timolol)

Gout

  • Lopurin (allopurinol)
  • Zyloprim (allopurinol)

Heart

Many drugs prescribed for the heart, including those known as the beta blockers, which are also used to treat high blood pressure, and include:

  • Tenormin (atenolol)
  • Lopressor (metoprolol)
  • Corgard (nadolol)
  • Inderal and Inderal LA (propanolol)
  • Blocadren (timolol)

High Blood Pressure

See Above list of beta blockers under “Heart”

Hormonal Conditions

All hormone-containing drugs and drugs prescribed for hormone-related, reproductive, male-specific, and female-specific conditions and situations have the potential to cause hair loss, including:

  • Birth Control Pills
  • Hormone-replacement therapy (HRT) for women (estrogen or progesterone)
  • Male androgenic hormones and all forms of testosterone
  • Anabolic steriods
  • Prednisone and other steroids

Inflammation

Many anti-inflammatory drugs, including those prescribed for localized pain, swelling and injury.

  • Arthritis drugs
  • Nonsteroidal Anti-Inflammatory Drugs including:
  • Naprosyn (naproxen)
  • Anaprox (naproxen)
  • Anaprox DS (naproxen)
  • Indocin (indomethacin)
  • Indocin SR (indomethacin)
  • Clinoril (sulindac)

An anti-inflammatory that is also used as a chemotherapy drug:

  • Methotrexate (MTX)
  • Rheumatex (methotrexate)
  • Folex (methotrexate)

Parkinson’s Disease

  • Levadopa / L-dopa (dopar, larodopa)

Thyroid Disorders

  • Many of the drugs used to treat the thyroid

Ulcer

Many of the drugs used to treat indigestion, stomach difficulties, and ulcers, including over-the-counter dosages and prescription dosages.

  • Tagamet (cimetidine)
  • Zantac (ranitidine)
  • Pepcid (famotidine)

(http://www.americanhairloss.org/drug_induced_hair_loss/)

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