Drugs That Can Induce Hair Loss

Which drugs can cause temporary hair loss?

Just as many pharmaceutical and herbal agents can be used to treat hair loss by stimulating hair growth, drugs may cause hair loss, hirsutism, or textural and color changes. Those that cause alopecia are mostly due to toxic effects on the hair matrix, which are usually reversible. Many different types of drugs can cause telogen effluvium (loss of hair in the resting phase). Cytotoxic drugs, such as chemotherapy agents, cause anagen effluvium (loss of hair in the growing phase).⁽³²⁾

Interestingly, many of the drugs used to treat hair loss (both anti-androgens and topical hair growth promoters) report that they may also induce temporary hair loss (typically in high doses).⁽²⁹⁾

Some types of drugs that may cause telogen effluvium include:

Drugs Reported to Cause Hair Loss
DRUGS THAT CAN CAUSE TEMPORARY HAIR LOSS
AGENT	WHAT IT DOES
ANABOLIC STEROIDS (e.g., stanozolol)⁽³²⁾	Question: How can anabolic steroids cause thinning hair? Answer: Steroids have hormonal effects that can damage hair follicles.⁽³²⁾
ANDROGEN MEDICATIONS (e.g., mesterolone and testosterone)⁽³²⁾	Question: How can androgen drugs cause thinning hair? Answer: Androgen drugs can cause androgen hormone imbalances.⁽³²⁾
ANGIOTENSIN-CONVERTING ENZYME (ACE) INHIBITORS (e.g., captopril and enalapril)⁽²⁹⁾	Question: How can ACE inhibitors cause thinning hair? Answer: ACE inhibitors bind zinc, an essential mineral for hair growth.⁽²⁹⁾
ANTIBIOTICS⁽³²⁾	Question: How can antibiotics cause thinning hair? Answer: The exact mechanism linking antibiotics to hair loss is unknown. However, antibiotic treatments that kill intestinal bacteria that synthesize biotin can cause biotin deficiency and hair loss.⁽³²⁾
ANTICONVULSANTS (e.g., carbamazepine and valproic acid)⁽²⁹⁾	Question: How can drugs that help prevent seizures cause thinning hair? Answer: Anticonvulsant drugs are thought to reduce selenium and zinc levels, minerals essential for hair growth.⁽²⁹⁾ Also known to reduce biotin levels by competitively binding to molecules that transport biotin from the intestines into the circulatory system and by accelerating the biotin breakdown, possibly causing biotin deficiency.⁽³³⁾
ANTICOAGULANTS (e.g., coumadin, heparin, and warfarin)^(29, 32)	Question: How can drugs that help prevent blood clots cause thinning hair? Answer: Blood thinners can affect blood flow in dermal papilla, harming hair follicles.⁽³²⁾
ANTIDEPRESSANTS (e.g., lithium)⁽²⁹⁾	Question: How can antidepressants cause thinning hair? Answer: Lithium can cause hypothyroidism, a cause of hair loss.⁽²⁹⁾
AROMATASE INHIBITORS (e.g., formestane and letrozole)⁽³²⁾	Question: How can aromatase inhibitors (often used to treat certain types of cancer) cause thinning hair? Answer: Aromatase inhibitors block the enzyme that converts testosterone to estrogen. This hormone imbalance can damage hair follicles.⁽³⁰⁾
BETA BLOCKERS (e.g., acebutolol, betaxolol, nadolol, propranolol, and timolol)⁽²⁹⁾	Question: Can beta blockers (used to treat high blood pressure and glaucoma) cause thinning hair? Answer: Although the exact mechanism is unknown, beta blockers are commonly linked with telogen effluvium type of hair loss.⁽³²⁾
ESTROGEN ANTAGONISTS (e.g.,tamoxifen)⁽²⁹⁾	Question: How can estrogen antagonists (used to treat certain types of cancer) cause thinning hair? Answer: Estrogen antagonists such as tamoxifen can cause telogen effluvium type of thinning hair by inhibiting the pro-growth effect of estrogen on hair follicles.⁽²⁹⁾
FIBRATES AND STATINS (e.g., clofibrate, cholestyramine, lovastatin, and triparanol)^(29, 32)	Question: How can fibrates and statins (used to treat heart disease) cause thinning hair? Answer: Fibrate and statin drugs interfere with the synthesis of cholesterol, a substance that is part of hair. The thinning hair effects are possibly dose-dependent.^{(14, 29, 32)}
GOUT MEDICATIONS (e.g., allopurinol)⁽³²⁾	Question: Can drugs for gout cause thinning hair? Answer: Although how gout medications cause thinning hair is unknown, gout drugs are commonly associated with hair loss.⁽²⁾
IMMUNOMODULATING DRUGS (e.g., alpha interferon and gamma interferon)⁽³²⁾	Question: Can immunomodulating drugs cause thinning hair? Answer: Drugs that help suppress the immune system have been linked to hair loss. In fact, thinning hair occurs in about 20% of hepatitis C patients undergoing interferon treatment.^(32, 34) If hair loss occurs, it typically begins in the third or fourth month of therapy, and may continue for another 3 months after interferon treatments end. However, medical experts state that even if there is hair loss it is often minimal and is temporary in nature.⁽³⁵⁾
PROGESTINS (e.g., levonorgestrel, norethisterone, and tibolone)⁽³²⁾	Question: Can progestins cause thinning hair? Answer: Certain progestins have androgenic effects. These hormonal changes can damage hair follicles.⁽³²⁾
RETINOIDS (e.g., excessive vitamin A, acitretin, and isotretinoin)⁽³²⁾	Question: Can retinoids cause thinning hair? Answer: Excessive vitamin A (retinoid compounds) interferes with the necessary buildup of keratin in hair follicle.⁽³²⁾
THYROID MEDICATIONS (e.g., levothyroxine and propylthiouracil)^(2, 32)	Question: Can drugs for thyroid disease cause thinning hair? Answer: Drugs used to treat thyroid conditions can interfere with thyroid hormone metabolism and affect hair growth.⁽³²⁾

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Excess hair growth in areas atypical for females (e.g., face, chest, and back).

Drugs to lower cholesterol (e.g., fenofibrate).

Vitamin A derivatives, such as acitretin and isotretinoin.

Synthroid®, used to replace thyroid hormone in treating hypothyroidism.

Used to treat hyperthyroidism.

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Drugs That Can Induce Hair Loss

DRUGS THAT CAN CAUSE TEMPORARY HAIR LOSS