Acitrom Does Not Cause Hair Graying
Acitrom (acenocoumarol) is not associated with causing gray hair; in fact, recent research suggests it may actually prevent melanin production and could theoretically reduce pigmentation rather than cause graying.
Evidence Against Graying as a Side Effect
The available evidence does not support acenocoumarol causing hair graying:
Acenocoumarol has anti-melanogenic properties: A 2023 laboratory study demonstrated that acenocoumarol actually inhibits melanin synthesis in melanoma cells by downregulating tyrosinase and other melanogenic enzymes through multiple signaling pathways (PKA, MAPKs, PI3K/Akt/GSK-3β, and β-catenin) 1. This mechanism would theoretically reduce pigmentation, not cause graying.
Hair loss, not graying, is the documented concern: The British Journal of Dermatology reports that retinoids like acitretin can cause hair loss in up to 75% of patients, particularly women at doses exceeding 17.5 mg daily, presenting as diffuse, non-scarring alopecia that is reversible upon drug withdrawal 2. Acenocoumarol belongs to a different drug class (anticoagulants, not retinoids).
What Actually Causes Drug-Induced Hair Color Changes
When medications do cause hair color changes, the culprits are typically:
- Chloroquine and cancer chemotherapeutic agents have the strongest evidence for causing hair color changes 3
- Approximately 65% of patients report changes in hair color and texture following chemotherapy completion, with regrowth occurring 2-3 months after treatment ends 4
- Other implicated drugs include p-aminobenzoic acid, calcium pantothenate, anthralin, minoxidil, propofol, valproic acid, and verapamil, though confirmatory data is lacking 3
Clinical Pitfall to Avoid
Do not confuse acenocoumarol with acitretin: These are completely different medications with different side effect profiles. Acitretin (a retinoid) causes hair loss, while acenocoumarol (an anticoagulant) has no documented association with either hair loss or graying 2.
If a patient on acenocoumarol presents with premature graying, evaluate for: