28-Year-Old Female with Diffuse Thinning of the Scalp After Isotretinoin and Oral Contraceptives

January 2022 in “ Clinical Cases in Dermatology ”

Gabriel Mirhaidari, Richard Boyd, Suchita Sampath, Shannon C. Trotter

drug-induced alopecia telogen effluvium chemotherapy-induced alopecia scalp cooling topical minoxidil oral minoxidil VEGF keratinocyte growth factor Rogaine

TLDR Some hair loss from medication may reverse after stopping the drug, but treatment options are limited and ongoing research is needed.

The document discusses the challenges in diagnosing drug-induced alopecia due to the need for a detailed patient history and understanding of hair growth cycling. It highlights that while drug-induced alopecia is often reversible upon stopping the offending drug, this isn't always a viable option for life-saving and long-term use drugs. The emotional and psychological impact of hair loss also poses serious risks to patient well-being and drug regimen compliance. For chemotherapy-induced alopecia, several targeted therapies exist with promising results such as scalp cooling. Topical and oral minoxidil may be used in those experiencing a drug-induced cause of telogen effluvium. More recent therapies focus on the use of growth factors such as VEGF and keratinocyte growth factor. Despite limited evidence-based therapies for the treatment of drug-induced alopecia, there is a high degree of interest in the field for continued investigations into new treatments.

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Research cited in this study

18 / 18 results

research Prevention and Treatment of Chemotherapy-Induced Alopecia

25 citations, June 2020 in “Dermatology practical & conceptual”

Scalp cooling can help prevent hair loss from chemotherapy, but treatment should be tailored to the individual and more research is needed.

research Scalp Cooling to Prevent Chemotherapy-Induced Alopecia

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Scalp cooling is an effective way to prevent hair loss from chemotherapy.

research Minoxidil And Its Use In Hair Disorders: A Review

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Minoxidil effectively treats hair loss, but use cautiously and monitor side effects.

research Treatment of Chronic Telogen Effluvium with Oral Minoxidil: A Retrospective Study

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Oral minoxidil effectively reduces hair shedding in women with CTE, with no major side effects.

Promotion of Anagen, Increased Hair Density, and Reduction of Hair Fall in a Clinical Setting Following Identification of FGF5-Inhibiting Compounds via a Novel 2-Stage Process

research Promotion of Anagen, Increased Hair Density, and Reduction of Hair Fall in a Clinical Setting Following Identification of FGF5-Inhibiting Compounds via a Novel 2-Stage Process

27 citations, February 2017 in “Clinical, Cosmetic and Investigational Dermatology”

New compounds were found to help increase hair growth and decrease hair loss.

research Traditional Anticoagulants and Hair Loss: A Role for Direct Oral Anticoagulants? A Review of the Literature

31 citations, January 2016 in “Drugs - Real World Outcomes”

Some new oral anticoagulants may also cause hair loss and might not be better than traditional ones for preventing hair loss.

research Diffuse Hair Loss Induced by Sertraline Use

3 citations, January 2015 in “Case reports in psychiatry”

Sertraline can cause hair loss, which stops after stopping the drug.

research Efficacy of Interventions for Prevention of Chemotherapy-Induced Alopecia: A Systematic Review and Meta-Analysis

110 citations, August 2014 in “International journal of cancer”

Scalp cooling significantly reduces chemotherapy-induced hair loss.

research Alopecia Caused by Isoniazid

4 citations, April 2014 in “Journal of Pharmacology and Pharmacotherapeutics”

The boy's hair loss was caused by the tuberculosis drug isoniazid but grew back after stopping the medication.

research Drugs and Hair Loss: Mechanisms and Clinical Implications

54 citations, September 2012 in “Dermatologic Clinics”

Some medications can cause hair loss, but stopping the drug usually leads to recovery within 3 months.

research Isoniazid-Induced Alopecia

13 citations, January 2011 in “Lung India”

Stopping isoniazid can reverse hair loss caused by the drug.

research Chemotherapy-Induced Alopecia: Emotional Distress and Mitigation Strategies

155 citations, March 2009 in “Seminars in Cutaneous Medicine and Surgery”

Scalp cooling might reduce hair loss from chemotherapy, but evidence is weak and other treatments are being tested.

Atrophic Telogen Effluvium from Cytotoxic Drugs and a Randomized Controlled Trial to Investigate the Possible Protective Effect of Pretreatment with a Topical Vitamin D3 Analogue in Humans

research Atrophic Telogen Effluvium from Cytotoxic Drugs and a Randomized Controlled Trial to Investigate the Possible Protective Effect of Pretreatment with a Topical Vitamin D3 Analogue in Humans

47 citations, July 2005 in “British Journal of Dermatology”

Topical vitamin D3 does not prevent hair loss from chemotherapy.

research Telogen Effluvium Caused by Magnesium Valproate and Lamotrigine

16 citations, October 2004 in “Acta dermato-venereologica”

Two people lost a lot of hair because of epilepsy drugs, but their hair grew back after changing medication.

research Hair Loss in Psychopharmacology

63 citations, March 2000 in “Annals of clinical psychiatry”

Some psychiatric medications can cause hair loss, but it usually grows back after adjusting the medication.

research Male Pattern Hair Loss: Current Understanding

59 citations, August 1998 in “International Journal of Dermatology”

Genetics and hormones cause hair loss; finasteride treats it safely.

research A Randomized Trial of Minoxidil in Chemotherapy-Induced Alopecia

127 citations, July 1996 in “Journal of The American Academy of Dermatology”

Minoxidil shortens baldness from chemotherapy by 50.2 days without significant side effects.

research Psychotropic Medication and Drug-Related Alopecia

30 citations, May 1991 in “Psychosomatics”

Some psychiatric medications can cause reversible hair loss.

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community 6 week update fellas, 5mg oral minoxidil. Pics are 2nd June – 10th July

in Progress Pictures 2 years ago

, you can find it online with a script This user was discussing their progress with hair loss treatments including 5mg oral Minoxidil and combining 3mg oral Minoxidil with MTF HRT. They also discussed side effects of increased body hair in other parts of the body.

community Lost density 60% all over scalp in 120 days (4months)

in Update 10 upvotes 6 months ago

A user lost 60% hair density in 4 months, started finasteride and microneedling, and has greasy, flaky, yellowish scalp. They are awaiting biopsy results, and another user suggested trying ketoconazole shampoo.

community FINASTRIDE and switch to DUTASTRIDE, my experience

in Progress Pictures 138 upvotes 3 months ago

The user shared their experience with Finasteride and Dutasteride for hair loss. They initially had success with Finasteride but switched to Dutasteride after experiencing shedding, which continued, and are now considering a hair transplant.

community Is this shedding or continued loss? 2 months of new dutasteride dose after two years of dutasteride

in Finasteride/Dutasteride 6 upvotes 6 months ago

A user increased their dutasteride dose to 3mg daily after two years but experienced significant hair loss. They also use RU58841 and minoxidil and are concerned about whether the loss is due to shedding or another issue like telogen effluvium.

community HLT Megathread on HMI-115 (key takeaways in comments)

in Research/Science 39 upvotes 1 year ago

HMI-115, a newly discovered hair loss treatment that could potentially be effective for those with diffuse thinning and telogen effluvium. It is based on prolactin receptor antagonist signaling and has already undergone Phase I trials in women, with potential commercialization by 2027.

community Diffuse hair loss and scalp biopsies

in Research 692 upvotes 4 months ago

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

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Various medicinal plants like Polygonum multiflorum, Red ginseng extract, and Zizyphus jujuba can potentially treat hair loss, offering benefits like low cost and multiple ways of working. Other effective natural substances include Pygeum africanum, Seneroa, Urtica dioica, and more.

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research Disorders of Hair

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