From the Guidelines
Acitretin is the GI drug most likely to cause hair loss, with up to 75% of patients experiencing increased hair loss, although frank alopecia is observed in less than 10% of treated patients. This medication, used to treat various skin conditions, can cause a range of mucocutaneous side effects, including dryness of the lips, cheilitis, and nail fragility, in addition to hair loss 1. The severity of these side effects is often dose-related, with higher doses (50-75 mg daily) resulting in a higher incidence of mucocutaneous reactions. If severe side effects occur, dose reduction should be attempted before discontinuing the drug. Other GI medications may also cause hair loss, but acitretin is the most notable example due to its high incidence of hair loss as a side effect. Key points to consider include:
- Hair loss is a common side effect of acitretin, affecting up to 75% of patients
- Frank alopecia is less common, occurring in less than 10% of treated patients
- The severity of mucocutaneous side effects, including hair loss, is often dose-related
- Dose reduction should be attempted if severe side effects occur, rather than discontinuing the drug immediately 1
From the FDA Drug Label
In one completed study... Additional side effects of low frequency have been reported These include skin rashes, alopecia, fever, arthralgias, diarrhea, steatorrhea, negative nitrogen balance, reversible interstitial pneumonitis, hepatosplenic T-cell lymphoma (see Warnings - Malignancy), and Sweet's Syndrome (acute febrile neutrophilic dermatosis). If the patient survives, recovery of multiorgan injury may be accompanied by rebound leukocytosis and alopecia starting about one week after the initial ingestion.
The GI drugs that may cause alopecia (baldness) are azathioprine (PO) and colchicine (PO) 2 3.
From the Research
GI Drugs and Hair Loss
There is no direct evidence in the provided studies that links a specific GI drug to hair loss. However, some studies mention colchicine, a drug used to treat gout and other inflammatory conditions, which may be related to GI issues.
Colchicine and Hair Loss
- There is no mention of hair loss as a side effect of colchicine in the studies 4, 5, 6, 7.
- However, a study on drug-induced hair loss 8 mentions that various drugs can cause hair loss, but it does not specifically mention colchicine or any other GI drug.