Methotrexate is a medication used to manage conditions like rheumatoid arthritis, psoriasis, and certain types of cancer. While effective, hair loss is a concern for some individuals undergoing this therapy.
How Often Methotrexate Causes Hair Loss
Hair thinning or loss can occur with methotrexate use. The Arthritis Foundation indicates that approximately 1% to 3% of people taking the medication may experience some degree of hair loss. Other studies have reported higher rates, such as 3% to 10% in psoriasis patients, and one study noted about 9.2% of individuals with early rheumatoid arthritis experienced hair loss over a year. This hair loss typically presents as a diffuse thinning across the scalp, rather than distinct bald patches, and tends to be a gradual process. The severity can sometimes correlate with the dosage, with higher doses potentially leading to more noticeable thinning.
Why Methotrexate Affects Hair Growth
Methotrexate is an antifolate, meaning it interferes with the body’s utilization of folic acid, a B-vitamin crucial for cell division and growth. Hair follicle cells are among the fastest-growing cells, making them particularly susceptible to the drug’s effects. By disrupting the folate pathway, methotrexate can impair normal cell division within hair follicles, prematurely shifting them from their active growth phase (anagen) into a resting or shedding phase (telogen effluvium). This disruption weakens hair strands and can lead to increased shedding and overall hair thinning.
Strategies for Managing Hair Loss
Individuals experiencing hair loss while on methotrexate can adopt several strategies. Gentle hair care practices are beneficial, such as avoiding harsh chemical treatments, excessive heat styling, and tight hairstyles that pull on the hair. Brushing and combing hair less frequently and with a soft touch can also help minimize breakage and shedding.
Maintaining a balanced diet that supports overall hair health is important. Ensuring adequate nutrient intake can contribute to healthier hair. Folic acid supplementation is often prescribed alongside methotrexate to help counteract some side effects, including hair loss, by replenishing the body’s folate stores. However, folic acid primarily helps maintain existing hair health and may not promote new hair growth.
When to Seek Medical Advice
Any concerns about hair loss while taking methotrexate should be discussed with a healthcare provider. A doctor can assess the extent of hair loss, determine if it is related to the medication, or rule out other potential causes. They can also evaluate its impact on a patient’s well-being.
In some cases, a doctor might consider adjusting the methotrexate dosage or exploring alternative treatment options. They may also advise on the proper dosage of folic acid supplementation, commonly co-prescribed to mitigate side effects. Patients should never alter their medication regimen or stop taking methotrexate without explicit medical guidance. Severe, sudden, or patchy hair loss, or the shedding of large clumps of hair, warrants immediate medical attention.