Drug-induced alopecia - Hair and Scalp
Alerts and Notices
Synopsis
The degree of anagen effluvium from cytotoxic drugs is dependent upon the dosage, schedule, and route of administration. The risk for alopecia is higher with high-dose, intermittent, intravenous, and/or combination therapies. Topical therapies such as topical timolol solution and topical diclofenac 3% gel can induce hair loss as well. Although drug-induced alopecia is usually reversible upon discontinuation of the culprit medication, permanent alopecia from chemotherapy (taxane and adjuvant hormonal therapy) has been reported. Changes in the hair color, quality, or texture are also possible from chemotherapy.
Localized alopecia has been reported as an adverse effect in men at the site of deoxycholic acid injections for submental adiposity.
See articles on telogen effluvium and anagen effluvium for more information on implicated medications.
Codes
ICD10CM:L65.8 – Other specified nonscarring hair loss
SNOMEDCT:
73383004 – Drug-related alopecia
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
Other causes of diffuse, nonscarring hair loss:- Telogen effluvium (after high fever, childbirth, seasonal loss, age, iron deficiency, thyroid disease)
- Hair shaft breakage from hair treatments (see traumatic alopecia)
- Alopecia areata
- Androgenetic alopecia (male and female pattern alopecia)
- Secondary syphilis
- Traction alopecia
- Anagen effluvium (secondary to infection, autoimmune diseases, radiation)
- Tinea capitis
- Trichotillomania
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:05/20/2018
Last Updated:09/22/2019
Last Updated:09/22/2019
Drug-induced alopecia - Hair and Scalp