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This study found that pediatric patients on valproic acid may experience hair loss due to reduced zinc and biotinidase levels within the first 3 months, with zinc depletion continuing to contribute by the 6th month.

In this study, valproic acid treatment did not significantly affect serum biotinidase enzyme activity in children, but was associated with hair loss in some patients, which resolved with biotin supplementation.

In this study on rats, valproic acid was associated with reduced biotinidase enzyme activity and higher alopecia rates, but biotin supplementation did not significantly affect alopecia occurrence.

In this study, valproic acid treatment was associated with reduced biotinidase activity and improved skin lesions after biotin supplementation in children with seizures.

The authors concluded that administering biotin may help prevent alopecia caused by reduced biotinidase activity during valproic acid therapy in rats.