Biotinidase Deficiency from Accutane Causing Hair Loss?

Hi Dr Rassman,

firstly I would like to thank you for your website, I’ve been a keen reader for many months. Well about me, i’m 23 years old and ever since I stopped a nine month course of Accutane at the age of 19 I suddenly began to lose my hair rapidly in a diffuse pattern on the whole scalp area. This is very depressing as I used to have long thick hair. My hairline is relatively intact but I would say i’ve lost 60% volume at least, so you can see my scalp through it. There is some balding on my mothers side but they didn’t start balding till age 40+ and not in a agressive diffuse pattern like me. I strongly believe this is from the Accutane, maybe it has accelerated my mapped out MPB that I would get later in life. But also I’ve heard of people suffering Biotinidase Deficiency after a strong course of Accutane that can last for years and cause severe hair loss. Do you think biotin or any other vitamins could benefit post accutane treatment? I’ve been on 1mg propecia for 1 year with no regrowth or noticable benefits and Rogaine also with very slight regrowth, so these seem to not be helping my hair loss at my tender”ish” age.

Also i’ve was diagnosed with arthritis a few months ago and i’m on 4x 500mg paracetamol/30mg codeine tablets a day to help with the pain, but i’ve read that paracetamol reduces the effectiveness of rogaine do you know anything about this?

thanks for your time.

Marc P DiFazio, MD authored a good source for botinidase deficiency information, available at eMedicine.

I don’t know enough about the connections other than what I have learned via the web (researched briefly after your question was received). I am sure that you know the information on Accutane (isotretinoin) and hair loss seems to be a real problem for many people, but the solution to this problem is not evident. I did write to an email group of experts on the subject and there was no real insight into the connections you are looking at. I do not know if there is reaction between minoxidil and paracetamol, so I’d discuss this further with your prescribing physician.