Hair loss, both temporary and permanent, diffuse or localised, sudden or gradual, is a frequent cause for complaint. It can sometimes have a profound psychological impact. Hair loss is observed in a number of situations: hormonal disorders, dietary deficiency, auto-immune diseases, infections, inflammation, psychological or emotional trauma, tumours and exposure to toxic substances or drugs.

Drug-related hair loss can be early or late, sudden or gradual, diffuse or localised. It is generally reversible once the treatment is halted.

Anti-cancer treatments are very often implicated in sudden and massive hair loss, but a number of other drugs also cause hair loss: interferons in particular expose patients to moderate but reversible loss causing diffuse loss or round patches. Some antifungal treatments expose patients to reversible hair loss, especially in the case of lengthy, high-dose treatment. Many immunosuppressants as well as lithium also expose patients to hair loss.

Other drugs can also be implicated, but to a lesser extent: hormonal treatments, vitamin A and retinoids, various cardiovascular drugs, antidepressants, anti-infectives, anticoagulants, etc.

All hair loss should be taken into account due to its sometimes profound psychological effects. When a drug is known to expose patients to hair loss, it is better to help prepare the patient for this adverse effect, which is generally reversible once treatment stops.

©Prescrire 1 May 2016

"Drug-induced hair loss" Prescrire Int 2016; 25 (171): 127-129. (Pdf, subscribers only).