Medication and hair loss in women

The hair loss caused by medical treatments have become increasingly common over the last 50 years. Chemical substances arrive directly via the bloodstream at the level of the hair follicle, where the hair's keratin is manufactured.

When these substances have a negative effect on normal hair renewal, the extent of the damage caused depends on the duration of the treatment and the doses prescribed, as well as the patient's sensitivity to hair problems. In women, certain contraceptives are the most common cause of medicated hair loss.

THREE TYPES OF DRUG-INDUCED ALOPECIA

1. Telogen effluvium, the most common type

In medical terms, telogen effluvium means that a larger quantity of hair than usual enters the renewal phase. In other words, the lifespan of this hair will be shortened under the harmful effect of the drug. Hair will begin to fall out within 2 to 4 months of starting to take the drug. Hair loss will be diffuse, covering the entire scalp, and will be reversible when treatment is stopped, but will recur if treatment is resumed.

2. The anagen effluvium

It generally leads to faster and more severe alopecia. In this case, the drug abruptly stops the development of the hair at a time when it is in its growth phase. Anagen effluvium mainly concerns products prescribed for cancer chemotherapy. As in the previous case, hair loss is reversible when treatment is stopped, but recurs if treatment is resumed.

3. Androgenetic hair loss

A third category concerns 'androgenising' substances, contained in certain corticosteroid or hormonal treatments (such as 1st or 2nd generation contraceptives). In predisposed individuals, these substances can trigger or aggravate a androgenetic alopecia.
This type of alopecia is characterised by a shrinking of the hair follicles sensitive to androgens, a thinning and a localised and very gradual loss of hair.

THE IMPORTANCE OF DIAGNOSIS

Before accusing a medicinal product, it is important to ensure that :

  • That the hair loss coincides in time with that of the medication.
  • That it is not the disease itself, or the stress it causes, that is the cause of hair loss, but the treatment itself. In this case, you should ask your doctor if it is possible to replace this treatment (it sometimes is) with another molecule that has no effect on hair loss.
  • That the substance in question is duly listed as harmful to hair health. Some molecules have an undeniable and almost systematic negative effect, while others have a definite but less systematic effect, in terms of the number of cases reported. Others are controversial, having only been the subject of isolated cases. A in-depth diagnosis of your hair is recommended when in doubt.

TREATMENT FAMILIES INVOLVED

The table below lists the main drug families, some of which are likely to trigger drug-induced alopecia.

THERAPEUTIC FAMILIESTYPE OF ALOPECIA
Anticoagulants: to make blood more fluidtelogen effluvium
Antidepressantstelogen effluvium
Antiepileptics/anticonvulsants: reduce the activity of the central nervous systemtelogen effluvium
Anti-estrogens: blocking the action of estrogens on the breasts and uterustelogen effluvium
Antihypertensives Hypertension and androgenetic hair losstelogen effluvium
Colchicine anti-inflammatories: to combat gout attackstelogen effluvium
Anti-inflammatory steroids (AIS): synthetic corticosteroidsandrogenetic
Non-steroidal anti-inflammatory drugs (NSAIDs): for pain and rheumatismtelogen effluvium
Antimitotics: cancer chemotherapy Chemotherapy and hair lossanagen effluvium
Antithyroid drugs: regulating the thyroid gland Hair loss and thyroid problemstelogen effluvium
Beta-blockers: blocking the action of adrenalinetelogen effluvium
Hormonal contraceptives Hair and homonal contraceptionandrogenetic
Hypocholesterolemics-Hypolipidemics Cholesterol and hair losstelogen effluvium
Alpha interferons: regulating the immune systemtelogen effluvium
Lithium: mood regulatortelogen effluvium
Retinoids: treating severe forms of acne, seborrhoea and psoriasistelogen effluvium
Gold salts: anti-rheumastimal: treating polyarthritistelogen effluvium
Hormone replacement therapy (HRT) Menopause and hair lossandrogenetic

Other families in which molecules that promote alopecia (hair loss) may be found: certain antiarrhythmics, antibiotics, antifungals, antigonadotropics, antihelminthics, antimigraine drugs, antineoplastics, antimalarials, antiparkinsonian drugs, antirheumatic drugs, antiulcer drugs, antivirals, thyroid hormones, immunomodulators, immunosupressants, ACE inhibitors, neuroleptics, etc.

RED LIST OF MEDICINES

To find out whether the specific medication you are taking can cause hair loss, refer to the alphabetical list. This list is not exhaustive, but includes most medicines sold in pharmacies that are likely to cause hair loss. cause alopecia (it does not include treatments reserved for hospital use).

DRUGSHAIR LOSSALOPECISING SUBSTANCE
Activelle®often, if androgenetic predispositionnorethisterone
Adépal®often, if androgenetic predispositionlevonorgestrel
Adrexan®rarelypropranolol
Advil®very rarelyibuprofen
Aldomet®rarelymethyldopa
Alève®very rarelynaproxen
Allochrysine®rarelygold salts
Amlor®sometimescalcic inhibitor
Amlodipine Gésometimescalcic inhibitor
Anafranil®sometimesclomipramine
Apegmone®sometimestioclomarol
Apranax®rarelynaproxen
Arava®sometimesleflunomide
Arimidex®oftenanastrozole
Arthrocine®very rarelysulindac
Atenolol Gérarelyatenolol
Avlocardyl®rarelypropranolol
Azantac®very rarelyranitidine
Azathioprine Gérarelyazathioprine
Basdène®sometimes, if overdosedbenzylthiouracil
Béfisal®rarelybezafibrate
Betnésolsometimesbetamethasone
Bisoprolol Gésometimesbisoprolol
Brufen®very rarelyibuprofen
Calciparin®often, especially in high dosesheparin
Captea®very rarelycaptopril
Captirex®very rarelycaptopril
Captolane®very rarelycaptopril
Captopril Gévery rarelycaptopril
Carbamazepinesometimescarbamazepine
Catapressan®sometimesclonidine
Celestamine®sometimesbetamethasone
Célestène®sometimesbetamethasone
Cellcept®rarelymycophenolate mofetil
Cérazette® (and its generics)often, if androgenetic predispositiondesogestrel
Chrono-Indocid®very rarelyindometacin
Cimetidine Gévery rarelycimetidine
Clomidvery rarelyclomiphene
Colchicine H. ®often, especially in high dosescolchicine
Colchimax®often, especially in high dosescolchicine
Contracné Géquite oftenisotretinoin
Cordarone®rarelyamiodarone
Corgard®rarelynadolol
Co-Renitec®rarelyenalapril
Cortancyl®sometimes, in such large doses, for a long timeprednisolone
Coumadinsometimeswarfarin
Crestor®sometimesrosuvastatin
Crixivan®very rarelyindinavir
Curacné Géquite oftenisotretinoin
Cynomel®sometimes, if the dosage is incorrectly balancedLiothyronine sodium
Daily Gé®often, if androgenetic predispositionlevonorgestrel
Danatrol®oftendanazol
Dectancyl®sometimes, in such large doses, for a long timedexamethasone
Defanyl®sometimesamoxapine
Depakine®oftenvalproic acid
Depakote®oftenvalproic acid
Depamideoftenvalpromide
Depo-Medrolsometimes, in such large doses, for a long timemethylprednisolone
Depo-Provera®often, if androgenetic predispositionmedroxyprogestone
Deroxat®rarelyparoxetine
Désernil®rarelymethysergide
Detentiel®sometimes sometimesbisoprolol
Dexambutol®rarelyethambutol
Di-Hydan®sometimesphenytoin
Diprostene®sometimes in such high doses for so longbetamethasone
Divarius®rarelyparoxetine
Divina®often, if androgenetic predispositionmedroxyprogestone
Dolcidium®very rarelyindometacin
Duova®often, if androgenetic predispositionmedroxyprogestone
Ecazide®very rarelycaptopril
Effexor®very rarelyvenlafaxine
Elavil®sometimesamitriptyline
Epivir®sometimeslamivudine
Euthyral®often, if the dosage is incorrectly balancedLevothyroxine
Exluton®often, if androgenetic predispositionlynestrenol
Feldène®very rarelypiroxicam
Fémara®oftenletrozole
Fenofibrate Gérarelyfenofibrate
Fivasa®rarelymesalazine
Floxyfral®rarelyfluvoxamine
Fluoxetine Gésometimesfluoxetine
Fluvoxamine Gérarelyfluvoxamine
Furadantine®sometimesnitrofurantoin
Furadoinsometimesnitrofurantoin
Gentalline®rarelygentamicin
Glucophage®rarelymetformin
Haldol®very rarelyhaloperidol
Hemiprlalon®rarelypropranolol
Heparin C.®often, in such large doses, for a long timeheparin
Hydrocortancyl®sometimes, in such large doses, for a long timeprednisolone
Hydrocortisone®sometimes, in such large doses, for a long timeHydrocortisone
Ibuprofen Gevery rarelyibuprofen
Implanon®often, if androgenetic predispositionetonogestrel
Imurel®rarelyazathioprine
Indocid®very rarelyindometacin
Intrinsa®oftentestosterone 8.4 mg
Introna®ofteninterferon a 2b
Isoptine®very rarelyverapamil
Keratyl®quite oftennandrolone
Kessar Géoftentamoxifen
Kliogest®often, if androgenetic predispositionnorethisterone
Laroxyl®sometimesamitriptyline
Ledertrexate®oftenmethotrexate
Levothyrox®often, if the dosage is incorrectly balancedLevothyroxine
Lipanor®rarelyciprofibrate
Lipanthyl®rarelyfenofibrate
Lipur®rarelygemfibrozil
Livial®often, if androgenetic predispositiontibolone
Lodalès®sometimessimvastatin
Lodoz®sometimesbisoprolol
Lopressor®rarelymetoprolol
Lopril®very rarelycaptopril
L-Thyroxine®often if the dosage is incorrectly balancedLevothyroxine
Ludéal Gé®often, if androgenetic predispositionlevonorgestrel
Ludiomil®sometimesmaprotiline
Lutenyl®often, if androgenetic predispositionnomgestrol
Malarone®very rarelyproguanil
Mediatorrarelybenfluorex
Médrol®sometimes in such high doses for so longmethylprednisolone
Metformin Gérarelymetformin
Methotrexateoftenmethotrexate
Microdoin®sometimesnitrofurantoin
Microval®often, if androgenetic predispositionlevonorgestrel
Minidril®often, if androgenetic predispositionlevonorgestrel
Miniphase®often, if androgenetic predispositionnorethisterone
Mini-Sintron®sometimesacenocoumarol
Miréna®often, if androgenetic predispositionlevonorgestrel
Modopar®rarelylevodopa,benserazide
Myanbutol®rarelyethambutol
Naémis®often, if androgenetic predispositionnomgestrol
Naprosyne®rarelynaproxen
Neo-Mercazolesometimes, if overdosedcarbimazole
Neoral®extremely rarecyclosporine
Nilevar®oftennorethandrolone
Nolvadex®oftentamoxifen
Noristerat®sometimes, if there is an androgenetic predispositionnorethisterone
Norplant®sometimes, if there is an androgenetic predispositionlevonorgestrel
Novafemme®sometimes, if there is an androgenetic predispositionnorethisterone
Novatrex®oftenmethotrexate
Nureflex®very rarelyibuprofen
Ocadrik®very rarelyverapamil
Oncotam Géoftentamoxifen
Orencia®sometimesabatacept
Orgametril®often, if androgenetic predispositionlynestrenol
Pacilia Géoften, if androgenetic predispositionlevonorgestrel
Paludrinevery rarelyproguanil
Parlodel®very rarelyBromocriptine
Paroxetine Gérarelyparoxetine
Pentasa®rarelymesalazine
Pepcidac®very rarelyfamotidine
Pergotime®very rarelyclomiphene
Pertofran®sometimesdesipramine
Pindione®rarelyphenindione
Piroxicam Gévery rarelypiroxicam
Prednisolone Gésometimes in such high doses for so longprednisolone
Préviscan®rarelyfluindione
Procuta Géquite oftenisotretinoin
Propranolol®rarelypropranolol
Propylex®sometimes, if overdosedpropylthiouracil
Prozac®sometimesfluoxetine
Quitaxon®sometimesdoxepin
Renitec®rarelyenalapril
Ridauran®rarelygold salts
Roaccutane®quite oftenisotretinoin
Roferon®ofteninterferon a 2a
Rowasa®rarelymesalazine
Salazopyrin®very rarelysulfasalazine
Savarine®very rarelyproguanil
Seloken®rarelymetoprolol
Sinemet®rarelycarbidopa, levodopa
Sintrom®sometimesacenocoumarol
Solumédrol®sometimes in such high doses for so longmethylprednisolone
Solupred®sometimes in such high doses for so longprednisolone
Soriatane®oftenacitretin
Sotalex®rarelysotalol
Sotalol Gérarelysotalol
Stédiril®often, if androgenetic predispositionnorgestrel
Stalevo®rarelycarbidopa, levodopa
Surmontil®sometimestrimipramine
Surgestone®often, if androgenetic predispositionpromégestone
Tagamet®very rarelycimetidine
Tamofen Géoftentamoxifen
Tamoxifen Géoftentamoxifen
Tegretol®sometimescarbamazepine
Tenormin®rarelyatenolol
Téralithe®oftenlithium
Thiophenicol®very rarelythiamphenicol
Thyrozol®sometimes so badly dosedthiamazole
Timacor®rarelytimolol
Timolol Gérarelytimolol
Timoptol®rarelytimolol
Tofranil®sometimesimipramine
Triella®often, if androgenetic predispositionnorethisterone
Triflucan®often in such high doses for so longfluconazole
Trinordiol®often, if androgenetic predispositionlevonorgestrel
Trisequens®often, if androgenetic predispositionnorethisterone
Trolovol®sometimespenicillamine
Viraferon®ofteninterferon a 2a
Vitamin Avery often, if overdosedretinol
Zeffix®very rarelylamivudine
Zentel®very rarelyalbendazole
Zocor®sometimessimvastatin
Zoloftrarelysertraline
Zyloric®very rarelyallopurinol
Jean-François Cabos

Jean-François Cabos is the creator of a unique hair care method based on the research he coordinated, which led to the publication of the book "Cheveux, Racines de Vie" with Hélène Clauderer by Robert Laffont (Collection "Réponses/ Santé").

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