From the Guidelines
The next recommended step for a patient experiencing hair loss while on accutane (isotretinoin) is to consult their dermatologist or prescribing physician immediately. The doctor may adjust the dosage of accutane or temporarily pause treatment to see if hair loss improves. Hair loss (telogen effluvium) is a known but uncommon side effect of isotretinoin that typically resolves after discontinuation of the medication 1. The physician might recommend supportive measures such as using gentle, sulfate-free shampoos, avoiding harsh hair treatments, and ensuring adequate nutrition with sufficient protein, iron, zinc, and biotin. In some cases, topical minoxidil 5% solution may be suggested as a temporary measure to help with regrowth, applied twice daily to affected areas.
Some key points to consider when managing hair loss in patients on accutane include:
- The medication alters the hair growth cycle, pushing more hairs into the resting (telogen) phase prematurely, but this effect is usually reversible once the medication is completed or adjusted 1.
- Patients should not discontinue accutane without medical guidance, as abrupt cessation can affect treatment outcomes for their skin condition.
- The guidelines for the management of acne vulgaris recommend routine monitoring of patients for any indication of side effects, including hair loss, and adjusting treatment as necessary 1.
- Other treatments for hair loss, such as contact immunotherapy, may be considered in severe cases, but are not widely available and have limited efficacy 1.
Overall, the management of hair loss in patients on accutane requires close monitoring and collaboration between the patient and their dermatologist or prescribing physician to minimize the risk of adverse effects and optimize treatment outcomes.
From the Research
Hair Loss on Accutane: Next Steps
- If a patient is experiencing hair loss while on Accutane, the next recommended step would be to consult their doctor about the potential side effects of the medication 2, 3.
- The doctor may consider adjusting the dosage or discontinuing the treatment if the hair loss is severe 4.
- Adding a biotin supplement to the treatment may help prevent or reduce hair loss, as it has been shown to increase the anagen hair ratio and decrease the telogen hair ratio 5.
- It is essential to note that the exact mechanism of how retinoids affect hair loss is still unclear, but dosage or duration of usage may be associated with an increased risk of hair loss 3.
- Patients who experience hair loss from isotretinoin are often older, have greater cumulative isotretinoin doses, and have longer durations of treatment 3.
- Regular monitoring for potential toxicity and routine check-ups with the doctor can help prevent and manage most adverse effects associated with isotretinoin, including hair loss 4.