Alopecia Possibly Secondary to Topical Ophthalmic Beta-Blockers

The document reported the first cases of alopecia potentially caused by topical ophthalmic β-blockers, commonly used for glaucoma treatment. The National Registry of Drug-Induced Ocular Side Effects received 56 reports of alopecia in patients using timolol (48 cases), betaxolol (5 cases), or levobunolol (3 cases). The patients, mostly female and aged 33-86, experienced asymptomatic, diffuse, non-scarring hair loss on the scalp, eyelashes, and/or eyebrows, with 4 cases identified as alopecia areata. The alopecia typically resolved within 4-8 months after discontinuing the β-blockers. This suggested that physicians should consider topical ophthalmic β-blockers as a potential cause of alopecia in their differential diagnosis.