The GP appointment
The medications that thin hair: a checklist for the bathroom cabinet
If a shed began two to four months after a new prescription or a dose change, the prescription is a suspect. It is not usually the whole story, and it is almost never a reason to stop on your own, but it is worth knowing which ones do it, because the fix is often a swap rather than a struggle.
How medication sheds hair
Most drug-related hair loss is telogen effluvium: the drug pushes a cohort of follicles into rest, and they release two to four months later. It is diffuse, not patterned, and it usually settles within six months even if the drug continues, as the follicles adapt. A smaller group of drugs act on hormones and produce a patterned thinning at the temples and crown that does not settle. And a few, mainly chemotherapy and high-dose retinoids, stop the growing follicle directly.
The list
Hormonal contraception — starting, stopping or switching, and the more androgenic progestogens in particular (levonorgestrel, norethisterone; the injection and the hormonal coil). Its own article.
Antidepressants — SSRIs, SNRIs, bupropion, mirtazapine. Uncommon, temporary, dose-related. Its own article.
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Start the quiz →Beta blockers (propranolol, atenolol, bisoprolol) — commonly prescribed for anxiety, migraine and blood pressure; hair loss is a recognised side effect, usually reversible.
Anticoagulants (warfarin, heparin, and less often the newer ones) — a well-documented diffuse shed in a proportion of users.
Isotretinoin and high-dose vitamin A — the acne treatment causes thinning and dryness while it is taken; recovers after.
Anticonvulsants and mood stabilisers (valproate especially, also carbamazepine, lamotrigine) — valproate causes hair loss in a significant minority and can change texture to curly.
Statins — occasional, reported, reversible.
Thyroid medication at the wrong dose — both too little and too much levothyroxine cause shedding; a dose adjustment after pregnancy is often needed.
Steroid tablets at high doses or for long periods; also some steroid inhalers at high dose.
Methotrexate and other immunosuppressants for arthritis, psoriasis or Crohn’s.
GLP-1 injections — indirectly, via the weight loss. Its own article.
Testosterone or DHEA, prescribed or otherwise — patterned thinning in women with sensitive follicles.
Some anti-fungals, gout medications, and older blood-pressure drugs — less common; ask the pharmacist.
What to do
Do the calendar. Date the shed started; look two to four months back for a prescription or dose change. If nothing lines up, the medication is probably not it.
Rule out the rest. Ferritin, thyroid and vitamin D, because a drug-related shed is worse on a low store and because low thyroid is itself the commonest medication-related hair problem (wrong dose).
Give it six months. Most drug sheds settle without any change.
Then talk to the prescriber — not about stopping, about alternatives. Most drug classes have members with lower reported rates. A beta blocker can often be swapped; a progestogen can be changed; an SSRI can be switched. The pharmacist is a good first stop and is free.
Treat the follicle locally in the meantime. A shed is a shed; the follicle still responds to the things that shorten rest and lengthen growth, and a leave-on scalp treatment does not interact with any of the above.
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Twelve questions. We tell you what we think is going on for you, and we say so if it is something a GP should see first.
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