It is common to shed around 50 to 100 strands of hair daily, but extreme shedding can lead to excessive hair loss which can be upsetting. There are treatments available depending on the cause.
When starting a new treatment, there may be some side effects that you were not anticipating such as drug-induced hair loss or hair thinning. It is vital that you understand how the medication is working, why it may be causing hair loss and if this is a known side effect. So what medications cause hair loss? You can discuss this with your healthcare provider when you are being prescribed a new medication. The patient information leaflet is also a good source of information for this.
One of the causes of hair loss may be that you have started a medication and this is a side effect of the drug (drug-induced alopecia). Starting chemotherapy is known to induce hair loss depending upon which medication is used. Stress, illness and iron deficiency are also causes which can be reversed with appropriate treatment of the root cause.
Hair loss can affect a patient's mental well-being and self-esteem as its effects are visible. Below we will take a look at drug induced hair loss, the different stages of the cycle at which growth is affected, ways in which to prevent further hair loss as well as how to encourage new hair growth.
Common Medications That Can Cause Hair Loss
Chemotherapy Drugs
Chemotherapy drugs are used to treat various types of cancers including breast cancer. These drugs are cytotoxic (toxic to living cells) and can disrupt the way in which cancer cells grow and divide. In the process, they also affect normal cells such as the hair follicles. Once treatment has ended, these cells usually recover and hair growth resumes.
The types of chemotherapy drugs that are being used, the dose and the way in which your body reacts can all affect the level of hair loss or hair thinning. It is common with medications such as doxorubicin, which stops damaged cancer cells from growing, and cyclophosphamide which stops cancer cells from reproducing.
Anagen effluvium refers to hair loss or shedding that occurs during the anagen phase or the growth stage of the hair cycle. The main causes of this are an infection, medication, a toxin, radiation or autoimmune disease.
Telogen effluvium, sometimes called diffuse hair loss, is hair shedding that arises during the telogen phase or the resting phase of the hair cycle.
Acne Medications
Patients treated with retinoids for acne can suffer from hair loss as a result of the medications prescribed. Taking retinoids such as isotretinoin can lead to excessive build-up of Vitamin A in the body which can lead to a dry scalp and weaker hair. Isotretinoin can also slow down the growing phase of hair follicles, resulting in telogen effluvium.
There are certain steps you can take to help manage any hair loss from your treatment. Consider other medications such as salicylic acid. If this isn't an option there are other preventative measures, such as reducing stress, increasing B Vitamins, protecting your scalp from the sun and a few other steps.
Blood Thinners
Anticoagulants are medicines used to prevent blood clots. They are given to patients who are at an increased risk of clots, to reduce their chances of developing serious conditions such as heart attacks or strokes. Hair loss is a common side effect of treatment with anticoagulants such as warfarin and enoxaparin and is thought to occur through telogen effluvium.
It is important to continue treatment with anticoagulant medications even if you are experiencing hair loss. This is so that you are protected from the possibility of any major cardiac events. Seek medical advice from a healthcare professional so that you can weigh up risks and benefits of your treatment. There may be other medications available or ways in which drug-induced alopecia, can be managed. A family of drugs known as NOACs may serve as an alternative blood thinning treatment for those who can take these safely alongside existing medication.
You can monitor your symptoms of hair loss or shedding by keeping a lookout for any thinning which is more common than hair falling out in patches. You may notice that you are losing more hair from the top of the scalp. You can check in the mirror or take photographs of your scalp regularly to monitor the rate and pattern of hair loss.
Cholesterol-Lowering Drugs
Statins are medications which are used to lower the levels of low-density lipoprotein (LDL) cholesterol in the blood. High levels of LDL cholesterol can lead to hardening and narrowing of the arteries which progresses to become cardiovascular disease. It is listed in the product literature that statins such as atorvastatin and simvastatin may cause hair loss although this is an uncommon side effect.
Risk factors include:
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Male/female pattern hair loss on either your mother's or father's side.
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Age.
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Medical conditions such as diabetes and lupus.
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Poor nutrition.
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Stress.
You can prevent the likelihood of hair loss or pattern baldness whilst taking statins by consuming a diet rich in vitamins A and B with foods such as carrots, broccoli and bananas. Follow a focused hair care regimen, using treatments such as Regaine which can be used by both men and women in varying strengths for each. Oral medications such as finasteride and dutasteride can encourage hair growth in men.
Other measures such as reducing stress, protecting your head from the sun and avoiding chemical treatments or heat styling can reduce the risk of hair loss.
Mood Stabilizers and Antidepressants
Mood stabilisers and antidepressants are used to treat conditions such as depression and mood disorders. Lithium is often prescribed as a mood stabiliser and up to 10% of patients who take lithium suffer with drug-induced hair loss.
Lithium seems to result in a poorer absorption of zinc and selenium so supplementing these minerals may slow hair loss that is caused by the treatment. It may also impact thyroid function which again can result in hair loss.
Valproic acid can also lead to hair loss and may cause a biotin deficiency, so consider supplementation.
If you notice any alopecia (the medical term for hair loss) you can speak to your healthcare provider. They may recommend lowering the dosage, as high doses are more likely to result in side effects. However, you will need to make sure you're aware of the risks involved in changing your medication.
Understanding Drug-Induced Alopecia
Drug-induced alopecia is usually reversible and occurs within days to weeks of starting a new treatment or changing your dose.
Two types of hair loss due to medicines can occur:
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Telogen effluvium - occurs when the hair is in its “resting phase”. Loss in this phase is usually short-term and tends to occur 2-4 months after starting a drug.
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Anagen effluvium - occurs when the hair is in its growing phase and may be long-term. This may be more concerning as it can be permanent in some cases and tends to occur 1-2 weeks after starting a drug.
Other types of hair disorders include:
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Androgenetic alopecia - a genetic disorder due to an excessive response to specific hormones. It is characterised by progressive loss of terminal hair of the scalp after puberty.
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Alopecia areata - a disease that occurs when the immune system attacks a hair follicle leading to hair loss. Alopecia areata usually affects the head and face.
How Do Medications Cause Hair Loss?
Some medications can disrupt the normal hair growth cycle, sending hair follicles into the resting phase early. This is usually temporary and reversed after stopping medications.
Hair follicles can be impacted by topical medications, such as those used to treat acne, which can result in dry and brittle hair that is prone to shedding as well as an itchy scalp. Consider alternative treatments where possible or try some natural remedies such as rosemary oil to treat this.
Certain drugs can also interfere with the normal absorption and metabolism of nutrients. Mood stabilisers and antidepressants are examples of this. You may need to supplement your diet if this becomes a problem. Speak to your healthcare provider for more information.
Risk Factors for Medication-Induced Hair Loss
The longer you are on medications which can cause hair loss and the higher the dose you are on, the greater your risk.
Taking multiple medications that have hair loss listed as a potential side effect can raise your overall risk. This is because the combined effects of the drugs can magnify the impact, potentially causing you to lose hair through different pathways.
Your own unique genetic factors and circumstances will also make up part of your risk factors. Some people are genetically more susceptible to medication-induced hair loss than others. This means they may be more likely to experience symptoms even with lower doses or shorter treatment durations.
Certain medical conditions can make you more vulnerable to hair loss caused by medications. For instance, individuals with pre-existing hair conditions might see their hair loss worsen when combined with certain medications.
Managing and Treating Hair Loss from Medications
It is important to discuss any concerns with a healthcare professional. Stopping certain medications altogether due to their side effects may present critical health risks. Your healthcare provider may suggest a reduction in dose if hair loss is causing distress. Alternatively, the medication may be changed to one which does not share the same side effect profile. Another option that may be the use of certain supplements to offset any vitamin deficiencies.
Supportive treatments such as topical minoxidil which can stimulate hair growth can be used to offset hair loss from medications. You can also consider hair supplements containing vitamins and minerals essential for hair health but their effectiveness can vary.
Managing stress levels, improving your diet, taking regular exercise and sleeping well can all improve your hair health and help to slow any hair loss you may experience.
Remember to speak to a healthcare professional when making any changes to your medication, supplements or diet to ensure they are appropriate for you.
Can Hair Grow Back After Stopping the Medication?
Yes, typically after stopping medication most patients will begin to regrow hair. It can take up to six months after stopping treatment to see new hair growth. This will depend on your circumstances and medications. If you don't see any regrowth after this period speak to a medical professional.
Summary
Several medications can cause hair loss. If you notice an increase in the amount of hair that you are losing when starting a new course of medication, speak to your doctor. Your doctor may lower the dose of your medicine or prescribe an appropriate alternative.
Usually, drug-induced alopecia is reversible. A person’s hair usually starts growing back a few months after they stop taking the medication.
FAQs
Are there any over-the-counter medications that can cause hair loss?
Yes, along with the above-mentioned medications, nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen which are used to treat pain, inflammation and fever can cause hair loss in some cases.
Can medications for chronic conditions like diabetes or hypertension lead to hair loss?
Yes, drugs like metformin for diabetes or metoprolol for hypertension can potentially lead to hair loss. Specific beta blockers and many anti-diabetic drugs can also cause hair loss as a side effect, although this is reported in rare cases.
How can I tell if my hair loss is medication-induced or due to other factors?
As far as possible you can try to rule out other factors, such as stress, poor diet or a lack of exercise or sleep. You can also speak to your doctor about potentially stopping/switching your medication to see if you have drug-induced alopecia. However, they will need to weigh up the benefits vs potential risks. The effects of drug-induced alopecia usually appear within a few months of an individual starting treatment with the new medication. You will notice hair thinning as opposed to patchy hair loss and this may be more common at the top of the scalp. A scalp biopsy can be taken to rule out any other factors.
Are there preventive measures I can take to reduce the risk of medication-induced hair loss?
Yes, monitor your dosages with your doctor to find the right balance between effectiveness and side effects. To reduce the risk of hair loss due to medication, consume a diet high in vitamins A and B, avoid stress or the use of chemical and heat treatments and try not to expose the scalp to the sun.
Can supplements or natural remedies help with hair regrowth after drug-induced alopecia?
Some supplements and natural remedies, such as saw palmetto, rosemary oil and pumpkin seed oil have been shown to reduce hair loss, promote growth and lead to more hair coverage when used correctly. In order to regrow hair, measures such as massages to stimulate the scalp, hair oiling with rosemary oil and taking fish oil supplements may help. It may take a few months to see noticeable results.