Pumpkins, Squash and Hair Loss: A bitter tale

A Bitter Tale

Pumpkins and squash, together with zucchini and some gourds are members of the cucurbita family (formally Cucurbitaceae). A new interesting report suggests that “cucurbit poisoning” is something all hair loss physicians need to know a thing or two about. Fortunately, it’s not common and provided we never eat “bitter” pumpkin or squash we’ll all be fine and can continue to enjoy these foods.

Dr Assouly (Paris) reported two women who developed severe illness and hair loss after eating members of this cucurbit family. The first patient developed nausea, vomiting and diarrhea within hours of eating some “bitter tasting” pumpkin soup. Although her stomach issues quickly cleared up, one week later she developed hair loss. Her family (who also ate the soup) also got sick but didn’t lose hair - presumably because they ate less pumpkin soup.

The second patient also developed severe vomiting within 1 hour of eating “bitter tasting” squash. Three weeks later she developed hair loss.

This case is interesting as the type of hair loss found to be present was best in keeping with a true “anagen effluvium” - similar to what one might experience after chemotherapy. Numerous broken hairs and hair breakage characterized the loss. The toxic compound in this case is known as “cucurbitacin” and this is what gave these otherwise delicious foods the bitter taste. It’s thought to be rare that squash and pumpkins would have high levels of these toxins. However, cross pollination with wild growing cucurbita can cause occasional ones to have high cucurbitacin and a bitter taste. One should never eat squash and pumpkin that tastes bitter. Fortunately, both patients experienced regrowth of their hair.

Reference

Assouly P et al. Hair Loss Associated With Cucurbit Poisoning. JAMA Dermatol. 2018