What is the association between Hydroxychloroquine (Plaquenil) and alopecia (hair loss)?

From the Research

Hydroxychloroquine can be considered as a treatment option for certain types of alopecia, including lichen planopilaris, frontal fibrosing alopecia, and alopecia areata, as it has shown variable efficacy in slowing or halting the progression of hair loss in these conditions. According to a recent study published in 2023 1, hydroxychloroquine has been used to treat these hair disorders with underlying autoimmune components, and while there is no standardized treatment, incorporation of hydroxychloroquine should take into consideration individual patient characteristics, clinical judgment, and risks of side effects.

Some key points to consider when using hydroxychloroquine for alopecia include:

• The medication can interfere with the normal hair growth cycle, pushing more hair follicles into the telogen (resting) phase, resulting in increased shedding 2
• The condition is generally reversible once the medication is discontinued or the dosage is reduced
• Alternative treatments may be considered if hair loss significantly impacts the patient's quality of life
• Hydroxychloroquine has been reported as variably effective in inducing significant hair regrowth in adults with alopecia areata, and can be considered as a treatment option for alopecia areata in children 3

It's also important to note that hydroxychloroquine is associated with myriad adverse dermatologic effects, including hair loss, and that dermatologic adverse events and primary diagnoses related to the use of hydroxychloroquine may be under-reported 2. However, a recent study published in 2025 4 suggests that hydroxychloroquine may be beneficial as an adjuvant therapy for folliculitis decalvans, a chronic and recurrent neutrophilic scarring alopecia.

Overall, hydroxychloroquine should be considered as a treatment option for patients suffering from certain types of alopecia, but its use should be carefully evaluated and monitored due to the potential for adverse effects. If a patient experiences significant hair loss while taking hydroxychloroquine, they should consult their healthcare provider who may consider adjusting the dose or switching to an alternative medication.