Medications that cause hair loss, and what to do about it

It sheds differently from pattern loss

Drug-induced shedding is usually telogen effluvium: hair across the whole scalp, including the back and sides, moves into the resting phase and falls out two to four months after a drug is started or a dose changed. It comes out in handfuls in the shower instead of thinning quietly at the temples. Chemotherapy causes a different and much faster process, with loss appearing within one to three weeks.

The medicines that most often do it

The recurring names are isotretinoin for acne, beta-blockers, anticoagulants, lithium and valproate, some antidepressants, interferon, high-dose vitamin A and hormonal contraceptives when they are started or stopped. Chemotherapy agents sit in a category of their own. None of this means the drug is wrong for you. It means the shedding has an explanation, and an explanation changes what you should do next.

Why we will not operate on this

A transplant moves hair from one part of the scalp to another. If the entire scalp is shedding because of a medication, there is nothing stable to move and nothing stable to move it into. Drug-induced effluvium usually reverses within three to six months of stopping or switching the drug, and the hair returns without help. Operating in the middle of that spends irreplaceable grafts on a problem that was going to resolve.

What to do instead, and what never to do

Never stop a prescribed medicine because of your hair; speak to whoever prescribed it about alternatives. Have ferritin, a thyroid panel, vitamin B12 and vitamin D checked, because deficiency and drug effects frequently travel together. Photograph the same three views every month and reassess at nine to twelve months. If genuine pattern loss is underneath, it will still be there, and surgery becomes a real conversation.

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