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Does Prednisone Cause Hair Loss?

Does Prednisone Cause Hair Loss?

Does Prednisone Cause Hair Loss?

Yes, prednisone does cause hair loss. It happened to me and many others. In this article, find out what to expect with steroid-induced hair fall and what you can do about it.

Is Hair Loss a Side Effect of Steroids?

If you’re wondering, “do steroids cause hair loss?” the answer is yes. Steroids like prednisone can cause hair loss. There are lots of kinds of steroids though. Prednisone is a glucocorticoid-type of steroid. That’s different than body builder androgenic steroids used to grow muscle, which is not what this article is about. This article focuses on the steroids used for inflammation.

Evidence for Prednisone Hair Loss

According to the most respected and comprehensive drug database on the market, Clinical Pharmacology, “alopecia” is a listed side effect of prednisone. Alopecia is the medical term for hair loss or balding. But of the top 5 sources of prednisone side effect data, only Clinical Pharmacology listed hair loss. So it’s not a well-known or common side effect. At the end of this article you can see the seven scientific articles I cite related to this topic.

My hair! Will it ever grow back after prednisone?

I received this message from a Prednisone Warrior:

I took prednisone 20 mg for a week… but a couple days after I started noticing significant hair fall when I shower and brushing. I’ve been shedding for 8 months now. My hair is so thin, it may have slowed down these past couple of weeks but I’m still shedding really.

Is there any way this could be reversed?

Dr. Megan’s Perspective: After I stopped taking prednisone, I personally lost 1/3 of my hair. I stopped taking prednisone in the beginning of June. By the end of July, every time I brushed my hair, my brush would fill up completely. Entire brushfuls of hair, gone. The shower drain would clog. It was a mess. That lasted for about two months.

Does Hair Grow Back After Steroids Like Prednisone?

Time passed. I waited about six months. I couldn’t tell for sure, but it seemed like by February I had little shoots.

About a year and a half after I first noticed my hair fall, by March, there is a noticeable difference between the top and bottom of my braid. It’s a lot thicker. You can kind of see it in the video, below, that I’ve got thicker hair until about my shoulders, then it thins out below that.

My hair is super thick normally, so I was actually relieved to not have to deal with so much hair. It was months of falling out and then it stopped being so heavy slowly. Then several months later I noticed it thickening again.

Is Hair Loss from Steroids Like Prednisone Permanent?

Eventually I chopped off the thin hair from the prednisone hair loss days and donated it to Locks of Love. The short hair in my chin-length hair was as thick as it had ever been.

So yes, your hair will grow back after prednisone! The hair loss is NOT permanent.

Watch this video about Prednisone Hair Loss: 👱‍♀️ to 👩‍🦲 (Side Effect)

Watch now!

Why Do Steroids Cause Hair Loss?

Steroids like prednisone cause hair loss because they are a burst of anti-inflammatory action in your body. This level of change in inflammation can affect many body systems, resetting them.

One prednisone warrior told me her doctor diagnosed her with Telogen Effluvium, a medical diagnosis to explain the temporary loss of hair 3-6 months after a stressful event.

Hair Cycle depicted by Natarelli, et al. Credit

Prednisone and other steroids are mimicking our stress hormone, cortisol, and making our body’s cortisol level extra high. Cortisol can affect hair growth. One scientific article, Stress and the Hair Growth Cycle: Cortisol-Induced Hair Growth Disruption, stated:

“When cortisol is present at high levels it has been demonstrated to reduce the synthesis and accelerate the degradation of important skin elements, namely hyaluronan and proteoglycans by approximately 40%. …Specifically, high concentrations of cortisol in the body are known to have a damaging effect on proteoglycans in and around the hair follicle.”

Check these Tests for Other Hair Loss Causes

While prednisone itself could be the culprit, prednisone affects other systems in the body that could be out of whack, causing hair loss. It’s a good idea to check with your doctor that all of these blood tests are normal:

  • Thyroid: prednisone can cause both hypothyroidism and hyperthyroidism, high and low thyroid. Both ends of the thyroid spectrum can affect your hair.
  • Hormone panel: prednisone can affect female and male sex hormones. Sex hormones have many varied effects on the hair cycle.
  • Iron & anemia: prednisone can change blood levels or cause internal bleeding that can lead to anemia. Hair loss is also a symptom of anemia.

When does Prednisone Cause Hair Loss?

Prednisone hair loss usually happens after taking prednisone. Hair loss can also happen while still taking it. I hear from people telling me their hair loss didn’t happen until they were tapering to lower doses.

Does Prednisone Cause Other Hair Changes?

Yes, prednisone can cause hirsutism, which is male-pattern hair growth. In women it can cause facial hair. In men it can cause other hormonal changes as well.

Could Prednisone Improve Hair Growth?

Yes, doctors prescribe prednisone for a condition known as alopecia areata, an autoimmune condition in which the body’s immune system attacks the hair follicle. Since prednisone helps with many autoimmune conditions, in this situation, prednisone could help halt the inflammatory autoimmune condition which would cause hair re-growth.

Do Other Steroids Like Inhalers Cause Hair Loss?

A Prednisone Warrior asked if her Ciclovent inhaler could be contributing to her ongoing hair loss. I found a study from the Netherlands that showed that between 1984 and 2006, four people reported alopecia, the medical term for hair loss, from using inhalers. The steroid inhalers included those with fluticasone, budesonide, and beclomethasone (Ciclovent). The study showed that yes, steroid inhalers could be the culprit causing hair loss:

“Inhaled corticosteroids (ICS) are widely used in the treatment of asthma. We studied the suspected adverse drug reactions (sADRs) reported during the use of ICS in the Netherlands. There were…4 reports of alopecia…”

Watch this video to hear me explain the research about hair loss from corticosteroid inhalers:

How Did Your Hair Grow Back, Dr. Megan?

I’ve been asked what I did to make it grow back. Personally, I did nothing but wait, because my hair is quirky. It’s normally so thick that in elementary school other kids made fun of me for my “lion’s mane.” For the first time in my life, with this 1/3 hair loss, I felt like I had normally thick hair. I know this is unique, but I didn’t really want it to come back. Having 1/3 less hair was just right for me. But it did grow back, and that’s what matters.

What can You do?

  • Decrease inflammation
  • Drink lots of water
  • Eat foods

    Which Supplements do you Recommend for Hair Loss?

    • A high-quality prenatal vitamin
    • Biotin

    Other suggestions from functional medicine pharmacists include:

    1. Castor oil in scalp

    2. Hair massage
    3. Biotin up to 100 mg daily

    “Custom HTML” block:

    4. Michael’s Hair, Skin & Nails

    Prescription Medications that may help with hair loss

    There isn’t strong evidence that any of these work, but theoretically may help:

    These prescription medicines may help remove excess androgens (male hormones) or correct male hormone imbalances. It’s possible for women to take these medications off-label for this, but obviously requires a prescription medication. This is a last-resort option after trying all of the dietary and nutrition changes first.

    Bottom line: prednisone does cause hair loss. Many options can help but more research is needed to clarify the best strategy. Make sure you are getting the best nutrition possible to optimize your health while on prednisone.

    1. Prednisone. In: Clinical Pharmacology [database on the Internet]. Tampa (FL): Elsevier. 2018 [cited 2018 April 25]. Available from: www.clinicalpharmacology.com. Subscription required to view.
    2. Hughes EC, Saleh D. Telogen Effluvium. [Updated 2023 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430848/
    3. Thom E. Stress and the Hair Growth Cycle: Cortisol-Induced Hair Growth Disruption. J Drugs Dermatol. 2016 Aug 1;15(8):1001-4. PMID: 27538002.
    4. Fernando T, Goldman RD. Corticosteroids for alopecia areata in children. Can Fam Physician. 2020 Jul;66(7):499-501. PMID: 32675094; PMCID: PMC7365156.
    5. de Vries TW, de Langen-Wouterse JJ, van Puijenbroek E, et al. Reported adverse drug reactions during the use of inhaled steroids in children with asthma in the Netherlands. Eur J Clin Pharmacol. 2006 May;62(5):343-6. doi: 10.1007/s00228-006-0102-6. Epub 2006 Apr 1. PMID: 16583230.
    6. Sinclair RD. Female pattern hair loss: a pilot study investigating combination therapy with low-dose oral minoxidil and spironolactone. Int J Dermatol. 2018 Jan;57(1):104-109. doi: 10.1111/ijd.13838. Epub 2017 Dec 12. PMID: 29231239.
    7. Natarelli N, Gahoonia N, Sivamani RK. Integrative and Mechanistic Approach to the Hair Growth Cycle and Hair Loss. J Clin Med. 2023 Jan 23;12(3):893. doi: 10.3390/jcm12030893. PMID: 36769541; PMCID: PMC9917549.

Dr. Megan Milne, PharmD, BCACP

Dr. Megan Milne, PharmD, BCACP, is an award-winning clinical pharmacist board certified in the types of conditions people take prednisone for. Dr. Megan had to take prednisone herself for an autoimmune condition so understands what it feels like to suffer prednisone side effects and made it her mission to counteract them as the Prednisone Pharmacist.

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