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QUESTION OF THE WEEK


Hair Loss from Methotrexate

Methotrexate: Several Mechanisms of Hair Loss

Methotrexate is a medication which is widely used in to areas - as a cancer treatment and as a treatment for a wide variety of autoimmune conditions. 

Hair loss from methotrexate can occur but is not common. This side effect is estimated to occur in 5-10 % of users. There are two means by which hair loss can occur: hair shedding and hair breakage. 

Hair breakage from methotrexate. Trichorrhexis nodosa is shown in one hair. 

Hair breakage from methotrexate. Trichorrhexis nodosa is shown in one hair. 

Hair shedding occurs within the first 4-7 weeks and hair comes out by the root. This type of hair loss can range from mild to marked and depends on the dose of the drug used. 

Hair breakage occurs within the first 2-3 months. Rather than breaking off at the root, affected patients notice pieces of hair falling everywhere. A close up examination of hairs shows a phenomenon known as trichorrhexis nodosa. This is shown in the photo to the right. 

 

 


This article was written by Dr. Jeff Donovan, a Canadian and US board certified dermatologist specializing exclusively in hair loss.



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