Quiz: Discover the Cause of Your Hair Loss

Medications That Can Affect Hair

Medications are chemical substances developed to treat diseases, relieve symptoms, or improve health conditions.

Although they are extremely important and often necessary tools in modern medicine, virtually all medications can cause side effects beyond those intended.

These unintended effects are called side effects, and hair loss is a relatively common side effect of various types of medication.

Understanding whether any medication you are taking may be contributing to the hair loss is an important piece of the diagnostic puzzle.

There are different mechanisms by which medications can cause hair loss.

Some medications induce telogen effluvium, causing a greater number of follicles to prematurely enter the resting phase.

Two to three months after starting the medication, these follicles simultaneously enter the shedding phase, causing a noticeable increase in hair loss.

Other medications cause anagen effluvium, affecting the follicles during the active growth phase.

This is rarer and usually associated with very potent medications such as chemotherapy drugs used in cancer treatment.

Some medications alter hormone levels in the body, and these hormonal changes can secondarily affect the hair.

Others can cause nutritional deficiencies that indirectly impair hair growth.

Let's understand the most common categories of medications that can affect hair.

Hormonal contraceptives, popularly known as birth control pills, contain synthetic versions of the female hormones estrogen and progesterone.

These synthetic hormones suppress ovulation and regulate the menstrual cycle.

The relationship between birth control pills and hair loss is complex and can go in two opposite directions.

Some pill formulations can improve hair, especially in women with polycystic ovary syndrome or other conditions with excess androgens.

Pills containing progestogens with antiandrogenic properties help reduce the effect of androgens on hair follicles, and may even improve androgenetic alopecia.

On the other hand, pills containing progestogens with androgenic activity may worsen hair loss in genetically predisposed women.

Furthermore, both starting and stopping birth control pills represent a significant hormonal change for the body.

This change can trigger temporary telogen effluvium, with increased hair loss two to three months after the change.

This is particularly common when a woman stops taking the pill after years of use.

While using the pill, the synthetic hormones kept more hair strands in the growth phase.

When the pill is discontinued and natural hormones return, many hairs simultaneously enter the resting phase and fall out months later.

This post-pill hair loss is usually temporary and resolves on its own within six to twelve months.

Hormone replacement therapies used by menopausal women can also affect hair in varying ways depending on the specific formulation.

Antidepressants and anxiolytics are medications used to treat depression, anxiety, and other mental health conditions.

Although extremely important and often necessary, some of these medications can cause hair loss as a side effect in a percentage of people.

The class of antidepressants called selective serotonin reuptake inhibitors, known by the acronym SSRIs, which includes medications such as fluoxetine, sertraline, and escitalopram, can cause falls in some people.

Tricyclic antidepressants, an older class, also have hair loss listed as a possible side effect.

Mood stabilizers used to treat bipolar disorder, such as lithium and some anticonvulsants, can also affect hair.

It is important to emphasize that not everyone who takes these medications develops hair loss.

The incidence varies depending on the specific medication and individual susceptibility.

For many people, the benefits of properly treating their mental health condition far outweigh the potential side effects on their hair.

Never stop taking psychiatric medication without medical advice, as this can be dangerous.

If you suspect your antidepressant is causing hair loss, talk to your psychiatrist about alternatives.

It is often possible to switch to another medication in the same class or a different class that does not cause this effect in you.

Medications for high blood pressure, especially a class called beta-blockers, can cause falls in some people.

Anticoagulants, medications that thin the blood to prevent clots, also have drops listed as a possible side effect.

Medications to lower cholesterol, especially statins, occasionally cause a drop, although this is relatively rare.

Some medications for thyroid problems, both for hyperthyroidism and hypothyroidism, can paradoxically cause a temporary drop in blood pressure at the beginning of treatment.

This usually improves as thyroid hormone levels return to normal.

Acne medications, especially those containing isotretinoin, can cause hair loss and thinning during treatment.

This effect usually reverses after stopping the medication.

Supplements and vitamins, while generally considered harmless, can also cause problems when taken in excess.

Excess vitamin A is a known cause of hair loss.

Taking multiple supplements simultaneously without medical guidance can lead to inadvertent overdoses.

Anabolic steroids, used illegally by some people for muscle gain, are synthetic derivatives of testosterone.

They dramatically increase androgen levels in the body and can cause accelerated androgenetic alopecia in genetically predisposed individuals.

In women, anabolic steroids often cause hair loss on the scalp while stimulating the growth of facial and body hair.

Immunosuppressant medications used after organ transplants or in the treatment of autoimmune diseases can have varying effects on hair.

Corticosteroids, depending on the dose and duration of use, can both cause hair loss and, paradoxically, be used in the treatment of certain forms of alopecia.

Chemotherapy drugs used in cancer treatment are perhaps the most well-known medications for causing hair loss.

These medications attack rapidly dividing cells, including cancer cells but also cells in hair follicles.

Most chemotherapy drugs cause diffuse and often complete hair loss during treatment, but hair usually grows back after chemotherapy ends.

If you are taking any medication regularly and have started noticing hair loss after starting that medication, it is important to make the temporal connection.

Make a note of when you started taking the medication and when you first noticed the hair loss.

Remember that for drug-induced telogen effluvium, hair loss appears two to three months after starting the medication.

Talk to the doctor who prescribed the medication about this possible connection.

Never stop taking prescribed medications on your own, especially medications for serious conditions such as high blood pressure, diabetes, heart problems, or psychiatric conditions.

Abrupt interruption can be dangerous and cause serious health problems.

The doctor can assess whether there is a viable alternative that does not cause this effect, or whether the benefits of the medication still outweigh the side effect.

Sometimes simply adjusting the dose can make a difference.

In other cases, it may be necessary to accept the side effect if the medication is absolutely necessary for your health.

Fortunately, in most cases, drug-induced hair loss is temporary and reversible.

When the offending medication is discontinued or changed, normal hair growth tends to return within a few months.