Alopecia Associated with Fluconazole Therapy

    July 1996 in “ Annals of Internal Medicine ”
    Lowell A. Goldsmith
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    TLDR High doses of fluconazole can cause reversible hair loss.
    The document discussed reversible alopecia associated with high-dose fluconazole therapy, suggesting that it might increase endogenous retinoid levels, leading to hair loss, dry skin, and dry lips, similar to retinoid toxicity. The authors disagreed with the notion that the hair loss was due to telogen effluvium and believed it was directly related to fluconazole exposure, supported by observations from multiple investigators. Clinical observations indicated that patients on fluconazole for more than 3 months at doses of 400 mg/day or higher experienced significant hair loss, which resolved upon cessation of the drug. Further investigation into the interaction between fluconazole and retinoid metabolism was recommended.
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