Examination of Fluconazole-Induced Alopecia in an Animal Model and Human Cohort

February 2019 in “ Antimicrobial agents and chemotherapy (Print) ”

George R. Thompson, Charles R. Krois, Verena K. Affolter, Angela Everett, Eeva Varjonen, Victoria R. Sharon, Anil Singapuri, Michael Dennis, Ian Howard Mchardy, Hong Sik Yoo, Dawn M. Fedor, Nathan P. Wiederhold, Phylicia Aaron, Angela C Gelli, Joseph L. Napoli, Stephen D. White

fluconazole alopecia telogen effluvium retinoic acid triazole retinoid responsive gene expression

TLDR Fluconazole can cause hair loss, but the exact cause is unknown.

In the 2019 study, 12 male Wistar rats were used to investigate fluconazole-induced alopecia, showing a significant increase in the number of hairs in the telogen phase, indicative of telogen effluvium, but no significant changes in retinoic acid levels or retinoid responsive gene expression. In the human cohort, 5 patients with chronic coccidioidomycosis treated with fluconazole experienced alopecia, which abated for most after switching to an alternative triazole, except for one whose alopecia persisted. The study concluded that fluconazole can induce telogen effluvium, but the mechanism is not related to retinoic acid metabolism. The exact molecular mechanisms remain unknown.

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research Hair Pull Test: Evidence-Based Update and Revision of Guidelines

36 citations , March 2017 in “Journal of The American Academy of Dermatology”

The normal range for the hair pull test is 2 hairs or fewer, and washing or brushing hair before the test does not affect the results.

research Endogenous Retinoids in the Hair Follicle and Sebaceous Gland

50 citations , January 2012 in “Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biology of Lipids”

Maintaining the right amount of retinoic acid is crucial for healthy hair and skin.

research Towards Dissecting the Pathogenesis of Retinoid-Induced Hair Loss: All-Trans Retinoic Acid Induces Premature Hair Follicle Regression by Upregulation of Transforming Growth Factor-β2 in the Dermal Papilla

92 citations , June 2005 in “Journal of Investigative Dermatology”

All-trans retinoic acid causes hair loss by increasing TGF-β2 in hair follicle cells.

research Alopecia Associated with Fluconazole Therapy

4 citations , July 1996 in “Annals of Internal Medicine”

High doses of fluconazole can cause reversible hair loss.

research Alopecia Associated with Fluconazole Therapy

2 citations , July 1996 in “Annals of Internal Medicine”

Taking fluconazole for fungal infections might cause hair loss after about 3 months.

research Alopecia Associated with Fluconazole Therapy

63 citations , September 1995 in “Annals of internal medicine”

Fluconazole can cause temporary hair loss, which stops after reducing or stopping the drug.