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 FAMILIES | TYPE OF ALOPECIA |
|---|---|
| Anticoagulants: to make blood more fluid | telogen effluvium |
| Antidepressants | telogen effluvium |
| Antiepileptics/anticonvulsants: reduce the activity of the central nervous system | telogen effluvium |
| Anti-estrogens: blocking the action of estrogens on the breasts and uterus | telogen effluvium |
| Antihypertensives Hypertension and androgenetic hair loss | telogen effluvium |
| Colchicine anti-inflammatories: to combat gout attacks | telogen effluvium |
| Anti-inflammatory steroids (AIS): synthetic corticosteroids | androgenetic |
| Non-steroidal anti-inflammatory drugs (NSAIDs): for pain and rheumatism | telogen effluvium |
| Antimitotics: cancer chemotherapy Chemotherapy and hair loss | anagen effluvium |
| Antithyroid drugs: regulating the thyroid gland Hair loss and thyroid problems | telogen effluvium |
| Beta-blockers: blocking the action of adrenaline | telogen effluvium |
| Hormonal contraceptives Hair and homonal contraception | androgenetic |
| Hypocholesterolemics-Hypolipidemics Cholesterol and hair loss | telogen effluvium |
| Alpha interferons: regulating the immune system | telogen effluvium |
| Lithium: mood regulator | telogen effluvium |
| Retinoids: treating severe forms of acne, seborrhoea and psoriasis | telogen effluvium |
| Gold salts: anti-rheumastimal: treating polyarthritis | telogen effluvium |
| Hormone replacement therapy (HRT) Menopause and hair loss | androgenetic |
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).
| DRUGS | HAIR LOSS | ALOPECISING SUBSTANCE |
|---|---|---|
| Activelle® | often, if androgenetic predisposition | norethisterone |
| Adépal® | often, if androgenetic predisposition | levonorgestrel |
| Adrexan® | rarely | propranolol |
| Advil® | very rarely | ibuprofen |
| Aldomet® | rarely | methyldopa |
| Alève® | very rarely | naproxen |
| Allochrysine® | rarely | gold salts |
| Amlor® | sometimes | calcic inhibitor |
| Amlodipine Gé | sometimes | calcic inhibitor |
| Anafranil® | sometimes | clomipramine |
| Apegmone® | sometimes | tioclomarol |
| Apranax® | rarely | naproxen |
| Arava® | sometimes | leflunomide |
| Arimidex® | often | anastrozole |
| Arthrocine® | very rarely | sulindac |
| Atenolol Gé | rarely | atenolol |
| Avlocardyl® | rarely | propranolol |
| Azantac® | very rarely | ranitidine |
| Azathioprine Gé | rarely | azathioprine |
| Basdène® | sometimes, if overdosed | benzylthiouracil |
| Béfisal® | rarely | bezafibrate |
| Betnésol | sometimes | betamethasone |
| Bisoprolol Gé | sometimes | bisoprolol |
| Brufen® | very rarely | ibuprofen |
| Calciparin® | often, especially in high doses | heparin |
| Captea® | very rarely | captopril |
| Captirex® | very rarely | captopril |
| Captolane® | very rarely | captopril |
| Captopril Gé | very rarely | captopril |
| Carbamazepine | sometimes | carbamazepine |
| Catapressan® | sometimes | clonidine |
| Celestamine® | sometimes | betamethasone |
| Célestène® | sometimes | betamethasone |
| Cellcept® | rarely | mycophenolate mofetil |
| Cérazette® (and its generics) | often, if androgenetic predisposition | desogestrel |
| Chrono-Indocid® | very rarely | indometacin |
| Cimetidine Gé | very rarely | cimetidine |
| Clomid | very rarely | clomiphene |
| Colchicine H. ® | often, especially in high doses | colchicine |
| Colchimax® | often, especially in high doses | colchicine |
| Contracné Gé | quite often | isotretinoin |
| Cordarone® | rarely | amiodarone |
| Corgard® | rarely | nadolol |
| Co-Renitec® | rarely | enalapril |
| Cortancyl® | sometimes, in such large doses, for a long time | prednisolone |
| Coumadin | sometimes | warfarin |
| Crestor® | sometimes | rosuvastatin |
| Crixivan® | very rarely | indinavir |
| Curacné Gé | quite often | isotretinoin |
| Cynomel® | sometimes, if the dosage is incorrectly balanced | Liothyronine sodium |
| Daily Gé® | often, if androgenetic predisposition | levonorgestrel |
| Danatrol® | often | danazol |
| Dectancyl® | sometimes, in such large doses, for a long time | dexamethasone |
| Defanyl® | sometimes | amoxapine |
| Depakine® | often | valproic acid |
| Depakote® | often | valproic acid |
| Depamide | often | valpromide |
| Depo-Medrol | sometimes, in such large doses, for a long time | methylprednisolone |
| Depo-Provera® | often, if androgenetic predisposition | medroxyprogestone |
| Deroxat® | rarely | paroxetine |
| Désernil® | rarely | methysergide |
| Detentiel® | sometimes sometimes | bisoprolol |
| Dexambutol® | rarely | ethambutol |
| Di-Hydan® | sometimes | phenytoin |
| Diprostene® | sometimes in such high doses for so long | betamethasone |
| Divarius® | rarely | paroxetine |
| Divina® | often, if androgenetic predisposition | medroxyprogestone |
| Dolcidium® | very rarely | indometacin |
| Duova® | often, if androgenetic predisposition | medroxyprogestone |
| Ecazide® | very rarely | captopril |
| Effexor® | very rarely | venlafaxine |
| Elavil® | sometimes | amitriptyline |
| Epivir® | sometimes | lamivudine |
| Euthyral® | often, if the dosage is incorrectly balanced | Levothyroxine |
| Exluton® | often, if androgenetic predisposition | lynestrenol |
| Feldène® | very rarely | piroxicam |
| Fémara® | often | letrozole |
| Fenofibrate Gé | rarely | fenofibrate |
| Fivasa® | rarely | mesalazine |
| Floxyfral® | rarely | fluvoxamine |
| Fluoxetine Gé | sometimes | fluoxetine |
| Fluvoxamine Gé | rarely | fluvoxamine |
| Furadantine® | sometimes | nitrofurantoin |
| Furadoin | sometimes | nitrofurantoin |
| Gentalline® | rarely | gentamicin |
| Glucophage® | rarely | metformin |
| Haldol® | very rarely | haloperidol |
| Hemiprlalon® | rarely | propranolol |
| Heparin C.® | often, in such large doses, for a long time | heparin |
| Hydrocortancyl® | sometimes, in such large doses, for a long time | prednisolone |
| Hydrocortisone® | sometimes, in such large doses, for a long time | Hydrocortisone |
| Ibuprofen Ge | very rarely | ibuprofen |
| Implanon® | often, if androgenetic predisposition | etonogestrel |
| Imurel® | rarely | azathioprine |
| Indocid® | very rarely | indometacin |
| Intrinsa® | often | testosterone 8.4 mg |
| Introna® | often | interferon a 2b |
| Isoptine® | very rarely | verapamil |
| Keratyl® | quite often | nandrolone |
| Kessar Gé | often | tamoxifen |
| Kliogest® | often, if androgenetic predisposition | norethisterone |
| Laroxyl® | sometimes | amitriptyline |
| Ledertrexate® | often | methotrexate |
| Levothyrox® | often, if the dosage is incorrectly balanced | Levothyroxine |
| Lipanor® | rarely | ciprofibrate |
| Lipanthyl® | rarely | fenofibrate |
| Lipur® | rarely | gemfibrozil |
| Livial® | often, if androgenetic predisposition | tibolone |
| Lodalès® | sometimes | simvastatin |
| Lodoz® | sometimes | bisoprolol |
| Lopressor® | rarely | metoprolol |
| Lopril® | very rarely | captopril |
| L-Thyroxine® | often if the dosage is incorrectly balanced | Levothyroxine |
| Ludéal Gé® | often, if androgenetic predisposition | levonorgestrel |
| Ludiomil® | sometimes | maprotiline |
| Lutenyl® | often, if androgenetic predisposition | nomgestrol |
| Malarone® | very rarely | proguanil |
| Mediator | rarely | benfluorex |
| Médrol® | sometimes in such high doses for so long | methylprednisolone |
| Metformin Gé | rarely | metformin |
| Methotrexate | often | methotrexate |
| Microdoin® | sometimes | nitrofurantoin |
| Microval® | often, if androgenetic predisposition | levonorgestrel |
| Minidril® | often, if androgenetic predisposition | levonorgestrel |
| Miniphase® | often, if androgenetic predisposition | norethisterone |
| Mini-Sintron® | sometimes | acenocoumarol |
| Miréna® | often, if androgenetic predisposition | levonorgestrel |
| Modopar® | rarely | levodopa,benserazide |
| Myanbutol® | rarely | ethambutol |
| Naémis® | often, if androgenetic predisposition | nomgestrol |
| Naprosyne® | rarely | naproxen |
| Neo-Mercazole | sometimes, if overdosed | carbimazole |
| Neoral® | extremely rare | cyclosporine |
| Nilevar® | often | norethandrolone |
| Nolvadex® | often | tamoxifen |
| Noristerat® | sometimes, if there is an androgenetic predisposition | norethisterone |
| Norplant® | sometimes, if there is an androgenetic predisposition | levonorgestrel |
| Novafemme® | sometimes, if there is an androgenetic predisposition | norethisterone |
| Novatrex® | often | methotrexate |
| Nureflex® | very rarely | ibuprofen |
| Ocadrik® | very rarely | verapamil |
| Oncotam Gé | often | tamoxifen |
| Orencia® | sometimes | abatacept |
| Orgametril® | often, if androgenetic predisposition | lynestrenol |
| Pacilia Gé | often, if androgenetic predisposition | levonorgestrel |
| Paludrine | very rarely | proguanil |
| Parlodel® | very rarely | Bromocriptine |
| Paroxetine Gé | rarely | paroxetine |
| Pentasa® | rarely | mesalazine |
| Pepcidac® | very rarely | famotidine |
| Pergotime® | very rarely | clomiphene |
| Pertofran® | sometimes | desipramine |
| Pindione® | rarely | phenindione |
| Piroxicam Gé | very rarely | piroxicam |
| Prednisolone Gé | sometimes in such high doses for so long | prednisolone |
| Préviscan® | rarely | fluindione |
| Procuta Gé | quite often | isotretinoin |
| Propranolol® | rarely | propranolol |
| Propylex® | sometimes, if overdosed | propylthiouracil |
| Prozac® | sometimes | fluoxetine |
| Quitaxon® | sometimes | doxepin |
| Renitec® | rarely | enalapril |
| Ridauran® | rarely | gold salts |
| Roaccutane® | quite often | isotretinoin |
| Roferon® | often | interferon a 2a |
| Rowasa® | rarely | mesalazine |
| Salazopyrin® | very rarely | sulfasalazine |
| Savarine® | very rarely | proguanil |
| Seloken® | rarely | metoprolol |
| Sinemet® | rarely | carbidopa, levodopa |
| Sintrom® | sometimes | acenocoumarol |
| Solumédrol® | sometimes in such high doses for so long | methylprednisolone |
| Solupred® | sometimes in such high doses for so long | prednisolone |
| Soriatane® | often | acitretin |
| Sotalex® | rarely | sotalol |
| Sotalol Gé | rarely | sotalol |
| Stédiril® | often, if androgenetic predisposition | norgestrel |
| Stalevo® | rarely | carbidopa, levodopa |
| Surmontil® | sometimes | trimipramine |
| Surgestone® | often, if androgenetic predisposition | promégestone |
| Tagamet® | very rarely | cimetidine |
| Tamofen Gé | often | tamoxifen |
| Tamoxifen Gé | often | tamoxifen |
| Tegretol® | sometimes | carbamazepine |
| Tenormin® | rarely | atenolol |
| Téralithe® | often | lithium |
| Thiophenicol® | very rarely | thiamphenicol |
| Thyrozol® | sometimes so badly dosed | thiamazole |
| Timacor® | rarely | timolol |
| Timolol Gé | rarely | timolol |
| Timoptol® | rarely | timolol |
| Tofranil® | sometimes | imipramine |
| Triella® | often, if androgenetic predisposition | norethisterone |
| Triflucan® | often in such high doses for so long | fluconazole |
| Trinordiol® | often, if androgenetic predisposition | levonorgestrel |
| Trisequens® | often, if androgenetic predisposition | norethisterone |
| Trolovol® | sometimes | penicillamine |
| Viraferon® | often | interferon a 2a |
| Vitamin A | very often, if overdosed | retinol |
| Zeffix® | very rarely | lamivudine |
| Zentel® | very rarely | albendazole |
| Zocor® | sometimes | simvastatin |
| Zoloft | rarely | sertraline |
| Zyloric® | very rarely | allopurinol |
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 Hair, Roots of Life with Hélène Clauderer published by Robert Laffont (Collection "Réponses/ Santé").
