From the Guidelines
Plaquenil (hydroxychloroquine) is not typically prescribed as a first-line treatment for hair loss, and its use should be limited to cases where hair loss is caused by certain autoimmune disorders. The primary use of Plaquenil is to treat autoimmune conditions like lupus and rheumatoid arthritis. However, in cases where hair loss is caused by certain autoimmune disorders such as lupus or lichen planopilaris (a type of scarring alopecia), Plaquenil may be prescribed as part of the treatment plan 1. The typical dosage for these conditions is 200-400 mg daily, often taken as a single or divided dose. Treatment duration varies but is usually long-term for autoimmune conditions, requiring regular monitoring. Plaquenil works by modulating the immune system and reducing inflammation, which may help control the underlying autoimmune process causing hair loss. Side effects can include stomach upset, headache, dizziness, and rarely, retinal toxicity, which requires regular eye exams during treatment. For most common types of hair loss like male or female pattern baldness, medications such as minoxidil, finasteride, or spironolactone are more appropriate first-line treatments. Some studies have shown that platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) may be effective in treating androgenetic alopecia (AGA), with PRF appearing to be a promising and safe treatment option 1. Anyone experiencing hair loss should consult with a dermatologist for proper diagnosis and treatment recommendations.
From the Research
Plaquenil and Hair Loss
- Plaquenil, also known as hydroxychloroquine (HCQ), has been used to treat various hair disorders, including those with autoimmune components such as lichen planopilaris (LPP), frontal fibrosing alopecia (FFA), and alopecia areata (AA) 2.
- Studies have shown that HCQ can be effective in slowing or halting the progression of hair loss in these conditions, although results have been variable, ranging from halted hair loss to no improvement 2, 3.
- In the case of alopecia areata, HCQ has been reported to induce significant hair regrowth in some patients, particularly in pediatric cases 3.
- However, other studies have found that HCQ may not be effective in treating certain types of hair loss, such as alopecia universalis, with only one out of six patients showing a response to treatment 4.
- The use of HCQ for hair loss is often considered in combination with other treatments, such as steroids, and individual patient characteristics and clinical judgment should be taken into account when deciding on treatment 2, 5.
Efficacy and Safety of HCQ for Hair Loss
- The efficacy and safety of HCQ for hair loss have been evaluated in several studies, with results indicating that it can be a useful treatment option for certain types of hair loss, particularly those with autoimmune components 2, 3, 5.
- However, the use of HCQ for hair loss is not without risks, and side effects such as gastrointestinal intolerance and headache have been reported 3.
- A comprehensive review of pharmacological strategies for alopecia found that HCQ, along with other systemic agents like corticosteroids, can be effective in managing scarring alopecias, including lichen planopilaris and discoid lupus erythematosus 5.