Arthritis Medications and Hair Loss

Hair loss is a common side effect of some arthritis medications, including Rheumatrex, Trexall (methotrexate), Arava (leflunomide), Enbrel (etanercept), and Humira (adalimumab).

While symptoms may gradually resolve with a lower dosage, there is no true treatment for medication-related hair loss other than discontinuing the drug. However, don’t stop taking your medication until you consult with your healthcare provider.

How to Stop Hair Loss Associated With Medication

If hair loss is affecting your appearance and self-confidence, your healthcare provider may try to lower your dosage or switch you to another medication to see if that solves the issue.

If the medication is effectively treating your arthritis, your practitioner may discuss with you the benefits and side effects before taking such measures.

When altering the dose or switching medications isn’t possible, your practitioner may refer you to a dermatologist for other options.

Methotrexate Can Cause Hair Loss

Methotrexate is the most commonly prescribed disease-modifying antirheumatic drug (DMARD) for rheumatoid arthritis. It causes hair loss in about 1% to 3% of patients.

Methotrexate works by stopping the cells that cause inflammation from growing and, as a result, can stop hair follicles from growing too.

A folic acid supplement, commonly co-prescribed with methotrexate, can help keep your hair healthy, but does not encourage hair growth.

Leflunomide Can Cause Hair Loss

Leflunomide is another commonly prescribed DMARD for rheumatoid arthritis patients. The cause of the hair loss is similar to methotrexate and occurs in about 10% of users. 

Etanercept and Adalimumab Can Cause Hair Loss

Etanercept and adalimumab have hair loss as a side effect too. Exactly how these biologics cause hair loss isn’t known, but clinicians suspect it’s because these drugs change your body’s natural balance of messenger molecules called cytokines.

NSAIDs Can Cause Hair Loss

Hair loss from nonsteroidal anti-inflammatory drugs (NSAIDs), including Motrin (ibuprofen), is a rare side effect and is typically secondary to what the medical community calls telogen effluvium.

“This type of hair loss occurs when some stress, such as a medication, causes hair roots to be pushed prematurely into a resting state, called telogen,” according to rheumatologist Scott J. Zashin, MD, clinical assistant professor at University of Texas Southwestern Medical School.

“Abrupt diffuse hair loss will typically be noticed after two or more months from the time the stress occurred—for example, the time the medication was started,” he says.

Genetic Pattern Baldness and Arthritis Medications

If you have already inherited male or female pattern baldness, a form of permanent hair loss, taking drugs for arthritis might trigger or accelerate it.

Other Reasons for Hair Loss

Contact your rheumatologist immediately if you experience sudden or patchy hair loss, including:

• Excessive amounts of hair loss when you brush or wash your hair
• Regularly finding hair in your food
• Seeing lots of hair on your pillow

These are not common side effects of arthritis medication.

A consultation with your healthcare provider or a dermatologist can help to discover if there is some other reason for the hair loss, such as:

• Iron deficiency
• Lupus
• Thyroid disease