Does Lisinopril Actually Cause Hair Loss?

/by William Rassman, M.D./21 /,

My Dr. told me that lisinopril doesn’t cause hair loss. You say it does. It is not listed as a side effect, so are you sure it does? I freaking out cuz my hair is falling out. I am 53 years old and had all blood work done and all came back fine. I always had thick thick hair and so does everyone in my family. I am wondering is it menapausual? I have no other syptoms and my periods are still very regular. Will it grow back in or what should I do??? Im so confused because everyone tells you somthing different.

Many drugs can potentially cause hair loss. Most of the times scientists cannot find the exact mechanism of why this happens. Likewise, scientists cannot find the exact cause of hair loss either, because there are so many different factors involved.

I have three important points to make with regards to medications causing hair loss:

  1. Before identifying a drug as a possible cause of hair loss, you should find other medical causes.
  2. People take medications for a health problem. You should not stop taking a medication just because you think it may be causing hair loss. Your health should come before your hair (especially if you are not certain that the medication is causing the hair loss).
  3. Most importantly, you should follow up with your doctor for medication changes and concerns.

If you are taking Lisinopril, you likely have high blood pressure. You should NOT stop taking Lisinopril just because it has a rare side effect that you may or may not be experiencing. Stopping high blood pressure medications puts you at risk for strokes and other serious medical complications. There are other drugs that work just as well for controlling blood pressure as lisinopril. Recent studies suggested some relationship between lisinopril and lung cancer increasing its risk by 14%.

Some women who have genetic hair loss have it appear at about your age. The best way to make this diagnosis is to have your scalp mapped out for miniaturization. If you have genetic female hair loss, then there will be miniaturization over the thinning areas and miniaturization in the ‘rim’ of hair around the side and back of your head. Mapping out your scalp is the key to this diagnosis.

Cymbalta, Atenolol, and Female Hair Loss

/by William Rassman, M.D./0 /, ,

Hi I’m a 24 yr old female, with some questions I would like to ask you about my hair that is thinning. About 10 months ago I was getting a haircut and the stylist had mentioned to me that my hair was thinning a lil at the crown of my head…It wasn’t very noticable, so I didnt think anything of it, and just went on with my life…I had started taking an Anti-depresent called Cymbalta, and a high blood pressure medicine called Atenolol, at around that time as well. Well in january of 2006 I noticed that my front part of my scalp, maybe from my hairline & back 2 inches was very thin. I couldn’t understand why, because it was an over nite thing, I would have noticed if my hair was thin, and i even look back at christmas pics from the month before and my hair was like usual, so I know it was a very immidiate thing. I had disconntinued my anti-depressent and blood pressure meds, like 1-2 months earlier, because I could no longer afford health insurance, so I had been med free for about a month when I noticed the thinning frontline. its now almost 3 months later and im starting to think the thinning is getting worse in this reigion only…i started to take folic acid and a prenatal pill, because I read folic acid helps with re-growth, but I dont know what to do..I cant see a Dr, for another month untill govt health insurance kicks in, but in the meantime what should I do??..i know I had blood test run before about 8 months ago checking for throid disease, but it came back normal, so could something medical cause this..because no one in my family has a balding problem, my mom is 47 and just started to thin, and thats only because she used many products in her hair for so many years. do you think my hair will grow back or get worse?…I heard it takes about 3 months for the hair growing process to start showing, but its been about that much time and i dont see any improvments…Ive looked through the internet and read some scary stuff that can cause hairloss…but im so down about this, becuase i am soooo young, and I dont know why my hair is falling out…please help me if you could, thanks alot and have a wonderful day.

You are in need of a good doctor and there is no substitute for what the doctor does. Problems like yours can not be managed well by a doctor through the internet, nor can you manage depression and high blood pressure combined with hair loss by yourself. Look through the many posts in this blog on female hair loss to educate yourself and then get a good doctor.

Isotretinoin and Hair Loss

/by William Rassman, M.D./5 /,

Hello! I am a 24 year old female who is experiencing hair loss from isotretinoin, and was wondering what I can possibly do to help my hair stop falling out. I’ve been of the medication for a month now, and my hair started falling out about 2 months ago. I’ve now lost about half of my hair, and I’m really worried because it hasn’t slowed! My dermatoligist said there’s nothing that can be done except wait it out. I also know how freakish it’s going to look when it starts coming back in. I had long, blond, thick hair and now it’s so thin and starting to be noticeable. I tried Rogaine- used 4 bottles in 3 weeks and it didn’t seem to help. I just bought Nioxin shampoo/conditioner to try- I am desperate! Is there anything I can do- vitamins I can take, treatments, shampoo- that will help? Thank you so much!

Oh, I was on a very high dose, over 3 mg/kg of body weight; I figure that’s why I’m having this side effect.

Unfortunately, some people do experience temporary hair loss from isotretinoin. Taking a multi-vitamin may help. I agree with your dermatologist that there is not much that you can do right now and that you must wait it out. However, you might want to have blood work done to rule out other causes of hair loss for women like hypothyroidism, anemia, crash diet, contraceptive pills, and dermatitis.

DHEA Supplementation and Hair Loss

/by William Rassman, M.D./0 /,

Dear Sir,

I know you have touched on the efect of hormone supplementation in some earlier messages.

There are mixed views on whether DHEA supplmentation (say 25mg per day) in men leads to increased hair loss. While it certainly has made improvements to overall wellbeing, I always detect (or believe I do) increased hair loss while I am on DHEA and topical testosterone.

In your view, do these supplements increase risk of male hair loss and can this risk be minimised while using them? Thank you.

DHEA and steroids do make hair loss worse. Propecia may minimize the impact and it is doubtful that it would hurt. Check this out with the doctor who is prescribing your medications.

Topronil and Hair Loss

/by William Rassman, M.D./0 /,

i am a 50 yr old women and i have just recently started loosing quite abit of hair like in groups of like 10 hairs at each stroke of comb or brush and i was wondering if it would be caused by the drug topronil? not sure if i am spelling it right. it seems that this just started about 1 month into using this drug i cant believe how much i have lost could you please help?

If you saw an increase in hair loss upon starting a medication and there is no ‘need’ for that medication, you should consult with your doctor about stopping it. Topronil, however, does not show hair loss as one of its side effects.

D-BOL (Steroid) and Hair Loss

/by William Rassman, M.D./3 /,

took steriod called D-BOL four months ago.I only took five of the thirty month cycle.I noticed three weeks later my hair was reciding a little bit.I do have family history but not in there twenties.I used to have very thick hair only five months ago.Took D-BOL only five pills like i said.Thats only over two week period,can only five steriod pills cause this.I am very depressed to see my hair keeps getting wourse by the day.Wake up see minertrized hairs more by the day.Five months ago and still thinning.Is this a permedent thing now.My main question is will my hair regrow with time,or is it gone for good.And will my hair stop thinning and go back.I mean I thought steriods leave the body in four weeks also given the fact I only took five pills.Will my body correct itself or is the steriod effects ganna stay and mess with my hair forever.please your answer would be a big help.I am 22 male.I am getting upset to the point were im ganna take 6 avodart a day plus 3 saw p pills and laser comb for an hour on the hairline.My hair loss is in the front only.Very thick hair five months ago,now thinning over five pills I took five months ago.It should be long gone uot of my hair by now.

Steroids are strange in that they theoretically can kick-start a balding process. It is possible that a short course of steroids might start what may have otherwise taken years to start. Once started, anything goes. Your question should be: Do I have active genetic hair loss? The answer is get yourself examined; have your scalp mapped out for miniaturization to find out if you have genetic balding. With that knowledge, you can make intelligent decisions on what to do. Also, it might be worthwhile to read previous blog entries relating to steroids and hair loss.

Synthroid and Female Hair Loss

/by William Rassman, M.D./4 /,

I had thick and fast growing hair until I started taking syntrhoid for an underactive thyroid. The doctor says the medicine is not to blame but it just seems too coincidental to me. But, I am losing most of my hair in the front part of my scalp and I feel these tiny pimple like bumps on my scalp. I do not have dandruff but am wondering if this could be something else. I take no other medications and I am 56 years old, female. MY Mother and Grandmother both had and have thinning hair but it is in the back and they were both on all sorts of heart and blood pressure medicine. My 58 year old sister and brother are having no hair problems. Any suggestions would be appreciated.

Patients with hypothyroidism tends to have hair loss, and hair loss is a known side effect of Synthroid. I would certainly take this up with your doctor. There are many other causes for female hair loss as well, such as stress, crash diets, oral contraceptive pills, beta blockers, coumadin, psoriasis, and inflammatory diseases.

Hair Loss from Accutane

/by William Rassman, M.D./0 /,

Hi Dr. Rassman,
First off, thanks for the helpful site. My question is regarding accucate-induced hairloss. I am a male and started losing my hair in a diffuse pattern, all over the head but more severe on the top, after a course of accutane when I was 15. It has been a very slow, gradual loss but now at age 21 it is extremely prononunced. I probably have a little less than 50% of my original density. I wasn’t sure that the hair loss was a direct result of accutane until I had a scal biopsy done by a dermatologist recently and she confirmed that it was accuate-induced (not sure how she knew that from the biopsy but that’s what she told me – I think it was something about the “properties” of the follicle). I’ve attached 2 pictures – these were from about 8 months ago and the hair loss is considerably more now than it was then.

My first question is whether there are any clinics/hospitals/studies you are aware of that are studying the side effects of accutane – either in order to test treatments or just to track users that are experiencing side effects. I’m pretty sure that my condition is untreatable and I’m just going to have to live with it, but I would be open to trying experimental treatments in order to help others out. Second, do you think there is any use in using propecia/minoxidil to try to slow the loss, or would they be useless since this loss is probably acting by a totally different mechanism? I have used both in the past without evident results, but it’s hard to tell if they were slowing the loss or doing nothing at all.

Thanks very much for your advice.

Unfortunately, there are no solutions to your Accutane problem, other than to stay away from that drug. If you have genetic balding on top of the Accutane problem, then you should get your hair analysis for miniaturization to be sure one way or the other, the status of genetic balding compounding the problem you already have. I do not have any people to recommend who are experimenting with problems like yours. Also, please see previous Accutane related posts.

Hair Loss from Pills for Menstrual Cycle?

/by William Rassman, M.D./0 /,

hi! i’m already 25 years old. but then, i never had a normal menstrual cycle. when i had my consultation with an ob-gyne, he/she (since i’ve seen two doctors already) told me that all the tests given to me was normal and they prescribed me with provera pills. but then, as i started to use it for a long period of time, i suddenly felt that i’m starting to lose some of my hairs.i never thought that it can be a side effect of using pills. i went to my dermatologist and told me that my hairs will still grow back. Up to now, i’m having second thoughts on taking any pills that would help me regulate my menstruation since it seems that i’m going to have problems with my hair. can other pills like diane-35 can also cause hair loss? i’m planning to make another appointment with my ob-gyne for provera intake since my last menstruation was last october and then afterwards take diane-35 for my pimples. it’s just that i’m sick and worried of losing my hair. what can i do to prevent hair loss? is it also okay to use a horse shampoo for my hair and minoxidil regroe? they say that it can also make your hair thick. it’s just that i don’t want to lose any more hairs. thank you.

It sounds like you may have a genetic or hormonal cause of your hair loss. The absence of a normal menstrual cycle, which cause you to go on regulatory hormones, can cause hair loss. All of these hormonal supplements will have this as a potential side effect. You need to work with your OB/Gyn doctor to find the right hormones that meet all of your needs with the least risk to your hair.

Many people do use horse shampoos, and minoxidil may work to address some of the hair loss issues. Good luck.

Clonazepam and Hair Loss

/by William Rassman, M.D./0 /,

I currently take a medication called clonazepam (0.5 mg) once or twice daily as a muscle relaxer. I have been taking this medication since I was 19 or 20 (I am now 28). Could this be a cause in my thinning hair? I do not have a history of men or women balding in my family. My father has a full head (really full) along with both my grandfathers. My hairline is moving back more each year and my hair is all around is thinning and i am extremly worried. I do have a large amount of stress in my life and always have…but is it possible that hair from stress can grow back? I am extremly frusturated and baffled as to why my hair is thinning…If it is the medication, I am willing to get off of it with the consent of my doctor.
Thank you for your time.

Many drugs can cause hair loss, including Clonazepam. Before considering a drug as the source of your hair loss, you should also consider other medical causes. You should see your primary care doctor for a good examination and possible blood work to find a possible medical cause.

In address to the relationship between stress and hair loss, it is well known that stress can accelerate genetic hair loss as it unfolds over time. You discuss the movement of your hairline higher on your head, so I would wonder if this is the normal recession of maturing found in most men (the hairline goes up about 2/3rd inch in the middle and 1 or 1-1/2 inches in the corners). Sounds like you need an expert to evaluate the hair loss as well as your family doctor to assess your medication routine. The question an expert will is address is if you have a genetic component adding to the other factors causing hair loss or are you just seeing a maturing hairline in development. As you indicated you are in Los Angeles, you are invited to visit my LA office for a free consultation. You can call 800-NEW-HAIR to make an appointment, or request additional info via the NHI site.

Wellbutrin, Xanax, and Hair Loss

/by William Rassman, M.D./1 /,

I am 49 years old, female. I take both Wellbutrin and Xanax. My hair has thinned in the front and top. It could be from either of the drugs or hormonal. If I stop taking the drugs, will my hair grow back? How long might it take?

Many drugs are known to cause hair loss, including the ones you just mentioned. Before thinking it may be drug related, it is my opinion that you should see your primary care doctor to find out if your hair loss may be health related. Health related causes of hair loss (such as hypothyroidism) can be treated and must be properly evaluated.

Medicines and Hair Loss

/by William Rassman, M.D./0 /,

Can my high blood pressure medicine (Triamt/HCTZ tab 37.5–25) cause my hair to have breakage?

Yes. Blood pressure medicines (and many other medicines) can cause hair loss. However, you should consider other sources of hair loss before focusing on a medication.

You should first be evaluated by your primary care doctor, because hair loss may be a symptom of an underlying medical problem.

A less than exclusive list of medications that cause hair loss are: allopurinol, arsenic, apirin, l-asparaginase, bismuth, bleomycin, boric acid, bromocriptine, carbamazepine, carbon monoxide, chlorambucil, chloramphenicol, cimetidine, colchicine, clofibrate, clomiphene citrate, coumarin anticoagulant, cyclophosphamide, cyproterone acetate, dactinomycin, danazol, diethyl carbamazepine, dipyridamole, doxorubicin, ethionamide, etoposide, etretinate, fenifibrate, gentamycin sulphate, guanethidine, heparin (telogen effluvium after 6-16 weeks ), hydroxychloroquine, ibuprofen, idoxuridine, indandione, indomethacin, interferon, iodine, isophosphamide, levamisole, levodopa, lithium, mepacrine, mercury, mesalazine, methisazone, methotrexate, methyl CCNU, methysurgide, metoprolol, mitomycin, mitrexantrone, morphine, nadolol, nafoxidine, nicotinic acid, nicotinyl alcohol, nitrofurantoin sodium, norethisterone, estrogens, oral contraceptives, para aminosalicylate, phenindione, phenprocoumon, potassium thiocyanate, procainamide, propanolol, selenium sulphide, sodium aurothiomalate, sodium valproate, spironolactone, sulphasalazine, tamoxifen, thalium acetate, thiamphenicol, terfenadine, trimethadione, troxidone, vasopressin, vincristine, vindesine, vitamin A, warfarin.

Sometimes I wonder if the hair loss side effect really occurs or if it is just verbiage that the drug companies put into their warnings to cover their legal ‘derriere’ in the event that it occurs. I so rarely see most of these drugs in action, so I am not really in a position to agree or disagree with what is published in the warnings posted on these medications.

Warfarin and Hair Loss

/by William Rassman, M.D./0 /

will warfarin cause my hair to come out ?

Warfarin is one of many drugs that may cause hair loss. The important point is that you are most likely on warfarin for a very serious medical condition and you should not stop taking warfarin because of a possible hair loss. You should first seek out other causes of hair loss. Follow up with your doctor or follow up with a hair transplant surgeon to map your scalp hair for miniaturization and pattern of hair loss.

ScalpMed Causing Shedding?

/by William Rassman, M.D./14 /, ,

I am a 38 year old mail in good health and good physical condition, however like most men my hair has begun to thin. I saw the infomercial for “ScalpMed” and it looked promising, so I thought…what the heck, i’ll give it a try. Now, my question is this, it appears that I shed more hairs in the morning when I wash my hair (using a a ph balanced DHT reducing shampoo) after using this product. Can minoxidil cause one to shed more hair since I know this product contains this? If I don’t use scalpmed at night, the next morning when I wash my hair I have fewer hairs in the tub– about 14 without Scalpmed, and 20-40 with Scalpmed).

I also would like to make a comment to the medical industry. If one wants to try and find a cure for baldness, maybe they should research the italians or greek bloodline and see why the majority of those men have their hair way into their 40’s, 50’s, if not later years. Maybe they should research those genetics???

Thanks for your time and insight.

It is normal for one to lose 100 to 150 hairs a day. It is also normal for one to be concerned about hair loss and be proactive as you to try with products such as “ScalpMed”. Unfortunately there is no way to tell if these products actually work. That is why most are not sold as medications or FDA approved products. If ScalpMed is causing you to lose hair, I can not comment on it for there is no real information on the issues of safety or effectiveness.

Minoxidil has been studied as a topical treatment and shows good promise of hair growth in some individuals. To date, there are only two medically proven ways to treat male pattern baldness where it is not really ‘hit or miss’.

  1. Hair transplant, which works 99.9% of the time
  2. Propecia drug regimen (which may or may not work for you but it met strict FDA requirements) is more reliable, the earlier the hair loss is seen. In men under 30 with thinning and not recession, the reversal in my experience is significant. Reversal of a receding hairline, however, is highly unusual (even in the young man). The key to this drug is to start on it early if you have genetic balding and get to the hair while it is miniaturizing and before it falls out.

To more specifically answer your question, counting 14 vs 20 hairs lost per day seems insignificant (at least from a medical perspective). As stated, we normally lose on the average 100 to 150 hairs a day. ScalpMed may be contributing to the extra 6 hairs that you are losing, but there is no way to really tell.

Finally, the hair loss gene spans all races and cultures. The study of Italians and Greeks has already been done and there it still almost 50% of men in these ethnic patterns that have hair loss.

Hair Loss with Bald Spot Above Ear

/by William Rassman, M.D./0 /,

This is a follow-up to Hair Loss from Propecia:

Well i also moved a couple of months before this happened. Also about two months before i moved, i dyed my hair. So im wondering if this could be telogen effluvium? Ive dyed my hair alot in my lifetime and it has seemed to make it thinner but never any hairloss of the front. And if it did it grew back and I just didnt pay my hairline much atttention back then. My Mom’s dad was bald. But thats about it. My dad has a receding hairline but he is 57, and he still has plenty of hair and i dont think he will ever go complety bald. No one else in my family is bald. I also have an almost bald spot on the side of the right ear and my hair is thinner on the sides and the top than the back. I have no good hair doctor in my area so please help.

Please send me photographs. With a bald spot now above your ear, it is possible that you have other causes for your hair loss, rather than pure genetic causes with MPB. Singular bald spots may indicate a series of other etiologies, including infectious or autoimmune causes. Any good dermatologist can address this and even with pictures, there is no substitute for a direct examination by a doctor. Dermatologist are all over the US. See the American Academy of Dermatology to find a dermatologist in your area.