Hair Loss Induced by Tumor Necrosis Factor Alpha Inhibitors

A decade ago, Lindsey and Tosti conducted a study that found Tumor Necrosis Factor alpha (TNF-α) inhibitors, drugs used to treat immune-mediated conditions, could cause various types of hair loss. They identified 62 cases of hair loss during therapy with TNF-α inhibitors from January 1998 to August 2013. The types of hair loss included alopecia areata, psoriatic alopecia, lichen planopilaris, drug-induced lupus erythematosus, androgenetic alopecia, and telogen effluvium. Alopecia was also mentioned as a side effect in three clinical trials and in FDA postmarketing surveillance. The researchers concluded that TNF-α inhibitors could cause severe alopecia areata and scarring alopecia, but noted a lack of controlled trials studying this condition. They recommended switching medication in patients with alopecia areata or psoriatic alopecia occurring during anti TNF-α therapy and suggested the application of topical steroids under occlusion.