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VERIFIED CONTENTAuthor: Katarzyna Wieczorek-Szukała, MD, PhD, medical biotechnologist, Medical University of Lodz

Drug-induced hair loss can have various causes. Hair loss or dullness indicates an improper diet and intake of micronutrients. Also, many medications taken routinely can stimulate excessive hair loss. What groups of preparations have such side effects? Is it possible to stop baldness despite the use of drug therapy?

Why do we need hair?

Animal hair has a very important protective function, protecting sensitive skin against UV radiation, low and high temperatures, abrasions and pollution.

In humans, the evolutionary decline in body hair has minimized its role. The hair on the head plays a rather aesthetic role, and its good condition determines the he alth, attractiveness and vitality of its owner. Shiny, long hair is a dream of women who devote time and considerable financial resources to care for it.

Many people forget, however, that for proper growth, hair - as a product of the epidermis - needs support from "inside" - a number of minerals and vitamins, including:

  • iron,
  • zinc,
  • selenium,
  • B vitamins,
  • vitamin H (biotin).

An adequately high supply and maintaining the proportion of unsaturated fatty acids (EFAs) - e.g. from the omega-3 and omega-6 group, is also important.

In the case of a shortage of the above-mentioned ingredients in the body, the necessary amount of them will not reach the hair follicles, which may result in impaired growth, excessive dryness and hair loss. This type of effect (usually temporary) may also appear after illness, malnutrition, pregnancy or weakness.

Hair plays an indirectly important diagnostic role, which indicates the way we eat, but also exposure to harmful substances and environmental pollutants.

What drugs affect hair loss?

Unfortunately, medications taken for a number of ailments, depending on the strength and duration of their action, can also often show side effects in the form of hair loss. As a result of the metabolism of the active substance, many specificsthe natural phases of hair growth are shortened. Properly growing hair has three stages:

  • Anagen - this is the phase of "young" hair growth, usually lasting between 3 and 6 years. If the body is he althy, more than 80% of all hair on the head should be in this growth phase.
  • Katagen - this phase is also called transitional and lasts up to about 2 weeks. During this period, the hair growth is inhibited, which gradually moves towards the surface of the skin and detaches from the nipple in the hair follicle. Usually only about 1% of hair is at this stage.
  • Telogen - it is a resting phase that may last
  • 2 to 4 months. The hair at this stage is already calloused and ready to be replaced by new hair (called anagen) growing in the hair follicle. On average, about 15% of hair in a he althy person is in this phase of the cycle.

As you can see, an imbalance in a hair's life cycle can dramatically affect the proportions of specific growth phases. The action of substances considered by the body to be potentially toxic causes more hair to remain in the final telogen phase. Gradually, as a result of brushing and moving, older hair will fall out, but new hair will not replace it quickly enough.

The drugs most often causing excessive hair loss can be, for example :

  • cytostatics used in chemotherapy,
  • certain contraceptives,
  • retinoids used in dermatology,
  • anticoagulants,
  • lipid lowering agents,
  • immunosuppressants - used in autoimmune diseases or organ transplants,
  • beta-blockers used in cardiological diseases.

Hair loss usually begins with a certain delay - even after several months - from the action of a harmful factor. This is why people who undergo long-term therapy or permanently take a given substance are the most exposed to drug-induced hair loss.

Hair loss after chemotherapy

Chemotherapy is one of the most commonly used methods of fighting cancer. The cytostatic substances used in it block the process of cell division, thus causing the death of rapidly dividing cancer cells.

Unfortunately, these drugs have a non-specific effect, which means they also affect all tissues of the body, the cells of which are rapidly dividing - including cells in the bone marrow, gastrointestinal tract and epithelium.

It works in many casesis a broad spectrum of side effects of chemotherapy - including alopecia or, at best, significant thinning of the hair. The global action of cytostatics - by inhibiting cell division in the hair follicles - causes loss not only of the hair on the head, but also of the eyebrows, eyelashes and body hair.

Currently, there are no effective methods to protect against hair loss during chemotherapy. Most often, oncological patients are left with the purchase of a wig or the use of headgear until the end of therapy.

With the cessation of the use of strong drugs, he althy cells resume dividing, and thus, even after about 2 months, the hair will start to grow back. The proper rate of hair growth, especially after debilitating treatment, is an individual feature.

Sometimes the shade, shape and texture of the regrowth of the strands may differ from the original ones, which depends on the general condition of the body, genetic factors and the type of treatment used.

Contraceptives and hair loss

The preparations taken daily by millions of women in the world are contraceptive pills. Despite the undoubted convenience and effectiveness of this method of birth control, unfortunately it is not free from side effects, and many users notice, among others, excessive hair loss or weakening of its structure.

This is because most of the preparations used contain 2 hormonal components: estrogens and progestogens.

While the former are famous for their protective effect on the skin, hair and nails, improving their appearance, progestogens (also called gestagens for short) show androgenic activity.

This means that these compounds can act on hair follicles in the same way as male hormones - androgens - weaken natural hair regrowth and stimulate hair loss. Examples of gestagens found in two-component contraceptive pills are, for example :

  • lewonorgestrel,
  • noretisteron,
  • dezogestrel,
  • gestoden,
  • dienogest.

Especially people with genetic predisposition, taking preparations based on the action of progestagens, may, over time, observe the so-called androgenic alopecia. This type of hair loss is most visible on the top of the head - in the form of a "plaque" characteristic (especially for men) or a widening part of the hairstyle. Similar symptoms may be associated with severe stress in women and require a change of the used contraceptive to, for example, a single-component contraceptive.

Hair loss may also increase significantly after discontinuationcontraceptive drugs - permanently or when taking a break of several months. This side effect does not occur immediately, and is associated with a drop in estrogen levels a few weeks after stopping consumption.

These hormones - especially when taken in a synthetic form from tablets - show a much stronger effect than natural compounds produced in the body, stimulating hair growth. After discontinuation of this type of supplementation, a large part of the hair goes into the telogen phase and after some time it falls out naturally.

How to support hair during drug therapy?

If the patient knows in advance that they will be taking medications that will potentially cause increased hair loss or even alopecia (especially during strong chemotherapy), they can take the appropriate steps on their own.

Proper care implemented before and during the treatment can significantly minimize the side effects that worsen the quality of your hair. Since the hair will be exposed to negative factors "from the inside", you should definitely limit the treatments that potentially weaken and dry the curls, such as:

  • intensive drying,
  • using a straightener or curling iron,
  • regular coloring,
  • excessive exposure to sunlight.

For the daily care of weakened hair, we recommend gentler shampoos and cosmetics that will not burden the delicate scalp. The combing technique is also important - soft brushes with natural bristles will be much better than excessively jerky combs. A specially selected moisturizing treatment may be a good solution, which should be consulted with a specialist trichologist.

When will trichological diagnostics be useful?

Sometimes it is very difficult to determine the correct cause of hair loss on your own. If at a given moment we are not in the course of strong therapy (e.g. oncology), and we still notice visible hair loss, it is worth consulting the problem in a trichology office.

Unlike a dermatologist (who studies a number of skin conditions), a trichologist only deals with problems related to the scalp and hair. During the trichological diagnosis, special microscopic enlargement photos of the scalp and hair follicles are taken.

Rated is, among others, the correct phase of hair growth and their proportions, and even elemental analysis of the hair structure. Thanks to obtaining such insightful data, it is possible to determine the real cause of the problem of hair loss and to design a personalized

Unfortunately, when it comes to the action of certain groups of drugs - only their discontinuation will stop hair loss. Of course, you should not stop taking the prescribed medications without consulting a specialist doctor, but if the problem is serious - it is worth discussing the inclusion of other, alternative preparations.

If you have a problem with hair loss, don't underestimate it. The direct cause of baldness can also be the source of many other, seemingly unrelated diseases. The sooner you diagnose it, the sooner you can implement effective treatment.

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