Drugs and Hair Loss: Mechanisms and Clinical Implications

The 2013 document outlines how certain medications can lead to hair loss through mechanisms such as anagen arrest, telogen effluvium, and the worsening of androgenetic alopecia, with drug-induced scarring alopecia being rare. It stresses the importance of ruling out other causes before attributing hair loss to drugs and notes that recovery usually occurs within 3 months of stopping the medication. The paper lists various drug classes associated with hair loss, including psychotropics, anticoagulants, cardiovascular drugs, oral contraceptives, retinoids, antimicrobials, antiretroviral agents, androgen hormones, and drugs linked to scarring hair loss. Specific drugs mentioned include enoxaparin, metoprolol, propranolol, captopril, and certain retinoids, with a note that some oral contraceptives and androgen hormones can lead to hair loss, and biologics like etanercept and infliximab, as well as epidermal growth factor receptor inhibitors, have been associated with scarring alopecia. Clinicians are advised to be vigilant for drug-induced hair loss to prevent noncompliance with treatment.