From the Guidelines
Retinoids are the class of medications that cause the most hair loss, with up to 75% of patients experiencing increased hair loss, particularly at higher doses 1.
Key Points to Consider
- Hair loss is a common side effect of retinoids, especially in women, and is dose-dependent, with higher doses exceeding 17.5 mg per day increasing the risk of hair loss 1.
- Other classes of medications, such as chemotherapeutic agents, antidepressants (e.g., SSRIs like Fluoxetine), blood pressure medications (e.g., Beta-blockers like Propranolol), anticonvulsants (e.g., Valproic acid), and immunosuppressants (e.g., Cyclosporine), can also contribute to hair loss.
- The likelihood and severity of hair loss vary depending on the specific medication, dose, and duration of treatment.
- It is essential to weigh the benefits and risks of retinoid therapy, particularly in women of childbearing potential, due to the potential for teratogenicity and other adverse effects 1. Some key medications that can cause hair loss include:
- Acitretin, a retinoid used to treat psoriasis, which can cause hair loss in up to 75% of patients 1.
- Doxorubicin, Paclitaxel, and Cyclophosphamide, chemotherapeutic agents used to treat cancer, which can cause hair loss due to their mechanism of action.
- Fluoxetine, an SSRI used to treat depression, which can cause hair loss as a side effect.
- Propranolol, a Beta-blocker used to treat high blood pressure, which can cause hair loss as a side effect.
- Valproic acid, an anticonvulsant used to treat epilepsy, which can cause hair loss as a side effect.
- Cyclosporine, an immunosuppressant used to treat autoimmune disorders, which can cause hair loss as a side effect.
From the FDA Drug Label
The following discussion refers to the overall safety database of 812 patients with solid tumors treated with single-agent paclitaxel in clinical studies Toxicities that occurred with greater severity or frequency in previously untreated patients with ovarian carcinoma or NSCLC who received paclitaxel in combination with cisplatin or in patients with breast cancer who received paclitaxel after doxorubicin/cyclophosphamide in the adjuvant setting and that occurred with a difference that was clinically significant in these populations are also described. During paclitaxel treatment, Grade IV neutropenia was reported for 15% of patients, Grade II/III neurosensory toxicity for 15%, Grade II/III myalgias for 23%, and alopecia for 46%.
The class of medications that causes the most hair loss is chemotherapy agents, specifically taxanes like paclitaxel, with alopecia reported in 46% of patients 2.
From the Research
Class of Medications Causing Hair Loss
- Chemotherapy is a widely recognized form of cancer treatment that uses cytotoxic drugs to treat varieties of cancer, and one of its common side effects is hair loss 3.
- Chemotherapeutic agents are divided into several categories, including anthracycline antibiotics, antimetabolites, alkylating agents, and plant alkaloids, all of which can cause hair loss 3.
- Targeted cancer therapies, which include monoclonal antibodies, small molecule inhibitors, antibody-drug conjugates, and immunotherapy, can also cause hair loss, although it is not listed as a common side effect in the provided studies 4, 5.
- Paclitaxel, a member of the taxane class of anticancer drugs, is a common chemotherapeutic agent used against many forms of cancer, and its use can lead to hair loss 6.
- Chemotherapeutic agents used for the treatment of metastatic breast cancer can also cause hair loss, highlighting the need for clinicians to identify more specific targets to increase the effectiveness of a drug and reduce side effects 7.
Common Chemotherapeutic Agents Causing Hair Loss
- Anthracycline antibiotics
- Antimetabolites
- Alkylating agents
- Plant alkaloids
- Taxane class of anticancer drugs (e.g. paclitaxel)
Side Effects of Chemotherapeutic Agents
- Fatigue
- Nausea
- Vomiting
- Mucositis
- Hair loss
- Dry skin
- Skin rash
- Bowel changes
- Anemia
- Increased risk of acquiring infection