Medication Related Hair Loss Treatment at The Birmingham Hair Revive Clinic

How Medications Cause Hair Loss

Your hair goes through a natural growth cycle with three distinct phases. The anagen phase is when hair actively grows, lasting two to seven years. The catagen phase is a brief transition period lasting a few weeks. Finally, the telogen phase is a resting stage lasting about three months, after which the hair falls out and new growth begins.

Medications can disrupt this cycle in two main ways, causing what the NHS recognises as drug-induced alopecia.

Telogen Effluvium

This is the most common type of medication-related hair loss. It occurs when drugs cause a large number of hair follicles to enter the resting (telogen) phase prematurely. About two to four months after starting the medication, you’ll notice increased shedding, typically losing 30% to 70% more hair than the usual 100 to 150 strands per day.

The hair loss is usually diffuse, meaning it affects the entire scalp rather than specific areas. While distressing, telogen effluvium is generally reversible once the medication is stopped or adjusted.

Anagen Effluvium

This more severe form of drug-induced hair loss occurs when medications interfere with the active growth phase of hair. It prevents the matrix cells that produce new hair from dividing normally. This type typically happens within days to weeks of starting the drug and is most commonly associated with chemotherapy.

Anagen effluvium can cause rapid and extensive hair loss, affecting not just scalp hair but also eyebrows, eyelashes, and body hair. The NHS acknowledges that while chemotherapy doesn’t always cause hair loss, certain cancer drugs do have this significant side effect.

Common Medications That Cause Hair Loss

Understanding which medications are most likely to cause hair loss can help you have informed conversations with your doctor. Here are the main categories:

Chemotherapy Drugs

Chemotherapy remains the most well-known cause of medication-induced hair loss. These powerful drugs target rapidly dividing cells throughout the body, which unfortunately includes hair follicles. Hair loss typically begins two to four weeks after starting treatment and can progress rapidly.

Not all chemotherapy drugs cause hair loss, and the severity varies depending on the specific medication, dosage, and combination of drugs. NHS hospitals offer scalp cooling systems that can help reduce hair loss during chemotherapy. These cold caps lower the temperature of the scalp, restricting blood flow to hair follicles and protecting them from the damaging effects of chemotherapy drugs.

Antidepressants

While the NHS lists many potential side effects of antidepressants, hair loss isn’t commonly mentioned, yet it does occur in some patients. SSRIs (selective serotonin reuptake inhibitors) like fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil) have been linked to hair thinning in certain individuals.

The mechanism isn’t entirely clear, but these medications may affect the hair growth cycle by altering hormone levels or neurotransmitter activity. The good news is that this type of hair loss is typically temporary and may resolve when switching to a different antidepressant or adjusting the dose.

Blood Pressure Medications

Several types of blood pressure medications can contribute to hair loss, including beta-blockers like atenolol and propranolol, and ACE inhibitors such as lisinopril and enalapril. These medications may reduce blood flow to hair follicles or interfere with the hair growth cycle, though the exact mechanism isn’t fully understood.

If you’re taking blood pressure medication and experiencing hair loss, never stop taking your medication without consulting your doctor. High blood pressure itself is dangerous, and your GP may be able to switch you to an alternative that doesn’t affect your hair.

Anticoagulants (Blood Thinners)

Blood thinning medications like warfarin, heparin, and newer anticoagulants can sometimes cause telogen effluvium. Hair loss can appear anywhere from weeks to years after starting the medication, and the exact cause remains unclear. These are essential medications for many people, so any concerns about hair loss should be discussed with your doctor rather than stopping the medication.

Cholesterol-Lowering Drugs

Statins, which are commonly prescribed to lower cholesterol, occasionally cause hair loss in some patients. The mechanism may involve changes in hormone levels or reduced blood flow to hair follicles. However, hair loss from statins is relatively uncommon, and the cardiovascular benefits usually outweigh this potential side effect.

Retinoids

Medications containing vitamin A derivatives, particularly isotretinoin (commonly known as Roaccutane in the UK) used to treat severe acne, can cause hair loss. These drugs may affect the hair growth cycle and can cause scalp dryness and irritation. High doses can also reduce the absorption of nutrients essential for healthy hair.

Hormone-Related Medications

Birth control pills, hormone replacement therapy, and testosterone can all potentially cause hair loss by altering hormone levels. Some contraceptives contain progestins with high androgenic activity, which can trigger hair thinning in sensitive individuals. Conversely, stopping hormonal contraception can also temporarily trigger increased shedding.

Other Medications

Additional drugs that may cause hair loss include gout medications like allopurinol, anticonvulsants used for epilepsy, antifungal drugs, and some arthritis medications. Even certain antibiotic treatments have been associated with hair thinning in rare cases.

Recognising Medication-Induced Hair Loss

Drug-induced hair loss typically presents with certain characteristics that can help you identify it. You might notice increased shedding when brushing or washing your hair, more hair on your pillow, or your shower drain clogging more frequently. The hair loss is usually diffuse rather than following a specific pattern like male or female pattern baldness.

Timing is an important clue. Telogen effluvium typically appears two to four months after starting a new medication, while anagen effluvium from chemotherapy can begin within days to weeks. If you’ve recently started a new medication or changed doses and then notice increased hair loss, the drug could be the cause.

What to Do If Your Medication Is Causing Hair Loss

If you suspect your medication is causing hair loss, the most important thing is not to stop taking it without medical advice. Many medications treat serious conditions, and suddenly stopping can be dangerous.

Talk to Your Doctor

Schedule an appointment with your GP to discuss your concerns. They can review your medications and determine whether any of them are likely culprits. Your doctor might:

• Reduce the dosage if appropriate
• Switch you to an alternative medication with a lower risk of hair loss
• Confirm that the benefits of the medication outweigh the temporary hair loss
• Rule out other potential causes of your hair loss

Give It Time

If you and your doctor decide to stop or change the medication, remember that hair regrowth takes time. Hair grows roughly half an inch per month, so it can take three to six months after stopping the medication before you notice significant improvement. Patience is essential during this recovery period.

Optimise Your Hair Health

While waiting for your hair to recover, focus on general hair health. Use gentle, sulphate-free shampoos, avoid excessive heat styling, eat a balanced diet rich in protein and essential nutrients, and be gentle when brushing or combing. These measures won’t reverse medication-induced hair loss, but they can prevent additional damage.

Consider Treatment Options

For some types of medication-induced hair loss, treatments may help. Minoxidil, available over the counter in the UK, can stimulate hair growth. However, it’s important to check with your doctor whether it’s suitable alongside your other medications.

At Hair Revive Clinic in Birmingham, we offer advanced treatment options for patients struggling with significant hair loss. For those whose hair hasn’t fully recovered after stopping medication, or for cases where the medication cannot be discontinued, treatments like Exosome Hair Therapy can help stimulate follicle activity and promote regrowth.