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

The 2016 review explored the link between traditional anticoagulants such as heparin and warfarin and hair loss, and assessed if direct oral anticoagulants (DOACs) might be a preferable option for patients suffering from alopecia due to these medications. It was found that hair loss is a recognized side effect of traditional anticoagulants, likely caused by telogen effluvium. The review cited 405 reports of hair loss associated with DOACs in the World Health Organization's VigiBase® and noted an incidence rate of 4.4 alopecia cases per 100 patient years for those on rivaroxaban and dabigatran. The conclusion was that DOACs might also cause hair loss and may not be a better alternative for those affected by hair loss from traditional anticoagulants. The review called for more clinical reporting to understand the prevalence of anticoagulant-related alopecia, as the current understanding might be limited due to underreporting.