Cosmetic Adverse Effects of Antiseizure Medications: A Systematic Review

October 2021 in “ Seizure ”

Ali A. Asadi‐Pooya, Marzieh Rostaminejad, Zahra Zeraatpisheh, Nafiseh Mirzaei Damabi

hair loss hirsutism acne gingival hyperplasia phenytoin valproate

TLDR Some antiseizure medications can cause cosmetic problems like hair loss, excessive hair growth, acne, and gum overgrowth.

This systematic review examined the cosmetic adverse effects of antiseizure medications (ASMs), focusing on hair loss, hirsutism, acne, and gingival hyperplasia. The review included 127 studies from an initial pool of 3,938. The most robust evidence pointed to phenytoin causing gingival hyperplasia, hirsutism, and acne, and valproate causing hair loss and hirsutism. However, other ASMs were also implicated in these adverse effects. The findings highlight the need for physicians to consider these significant cosmetic side effects, which can impact patients' facial attractiveness, quality of life, and emotional state.

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research Short-Term Side Effects of Low Dose Valproate Monotherapy in Epileptic Children: A Prospective Study

4 citations , January 2019 in “PubMed”

Low dose valproate in epileptic children mainly causes weight gain and other non-life-threatening side effects.

research Valproate: Its Effects on Hair

11 citations , January 2018 in “International journal of trichology”

Valproate can cause hair loss and changes in hair appearance, but may help regrow hair when applied topically.

research Sodium Valproate Induced Alopecia: A Case Series

1 citations , January 2017 in “Journal of Clinical and Diagnostic Research”

Sodium valproate can cause reversible hair loss in some patients.

$Behavioral Effects and Somnolence Due to Levetiracetam Versus Oxcarbazepine: A Retrospective Comparison Study of North Indian Patients with Refractory Epilepsy$

research Behavioral Effects and Somnolence Due to Levetiracetam Versus Oxcarbazepine: A Retrospective Comparison Study of North Indian Patients with Refractory Epilepsy

10 citations , November 2016 in “Epilepsy & behavior”

Levetiracetam often causes behavioral issues, while oxcarbazepine is more likely to cause sleepiness in epilepsy patients.

research Cosmetic Side Effects of Antiepileptic Drugs in Adults With Epilepsy

46 citations , January 2015 in “Epilepsy & behavior”

Some antiepileptic drugs can cause weight gain and hair loss, especially in women.

research Hair Loss with Levetiracetam in Five Patients with Epilepsy

13 citations , February 2014 in “Seizure: European Journal of Epilepsy”

Levetiracetam may cause hair loss, which can potentially reverse with lower doses or stopping the drug.

research Serum Drug Level-Related Sodium Valproate-Induced Hair Loss

17 citations , January 2013 in “Indian Journal of Pharmacology”

High levels of the seizure medication sodium valproate can cause hair loss.

research The Influence of Valproic Acid and Carbamazepine Treatment on Serum Biotin and Zinc Levels and on Biotinidase Activity

21 citations , June 2011 in “Journal of child neurology”

Valproic acid and carbamazepine do not change biotin or biotinidase levels but may lower zinc levels, still within normal range.

research The Influence of Valproic Acid Treatment on Hair and Serum Zinc Levels and Serum Biotinidase Activity

36 citations , September 2009 in “European journal of paediatric neurology”

Valproic acid treatment may cause temporary hair loss due to reduced zinc and biotinidase levels, which tend to normalize after 6 months.

research Serum Biotinidase Activity in Children Treated With Valproic Acid and Carbamazepine

16 citations , May 2009 in “Journal of child neurology”

Valproic acid does not change biotinidase enzyme activity in children's blood.

research Side Effects of Sodium Valproate During Long-Term Treatment in Epilepsy

18 citations , January 2009 in “Acta neurologica Scandinavica”

Long-term sodium valproate treatment for epilepsy generally caused mild and temporary side effects.

research Short-Term Efficacy and Safety of Valproate Sustained-Release Formulation in Newly Diagnosed Partial Epilepsy: VIPe Study. A Multicenter Observational Open-Label Study

7 citations , September 2007

Valproate sustained-release is effective and generally safe for short-term treatment of new partial epilepsy.

research A Case of Hair Loss Induced by Carbamazepine

2 citations , June 2004 in “PubMed”

Carbamazepine caused hair loss in a man, which stopped after he stopped taking the drug.

research Topiramate-Induced Hair Loss: Case Report

2 citations , January 2002 in “Dermatology + psychosomatics”

Topiramate may cause reversible hair loss.

research Low Serum Biotinidase Activity in Children with Valproic Acid Monotherapy

73 citations , October 2001 in “Epilepsia”

Children taking higher doses of valproic acid had lower biotinidase activity, which may lead to biotin deficiency, but biotin supplements could help.

research Carbamazepine-Induced Hair Loss

12 citations , December 1985 in “Dicp-The annals of pharmacotherapy”

Carbamazepine can cause hair loss, which may reverse when the medication is stopped.