Drug-Induced Hair Loss: Analysis of the Food and Drug Administration's Adverse Events Reporting System Database

Introduction: Drug-induced hair loss is one of several causes of hair loss commonly seen in clinical practice, and it is often a daunting task to determine a potential culprit drug when a patient is taking numerous medications. Our objective was to identify drugs responsible for hair loss, using the Food and Drug Administration's Adverse Events Reporting System (FAERS) database, a compilation of drug-related adverse events (AEs). Methods: Using the FAERS database, we queried all domestic reports with the reaction term "alopecia" listed as an AE in patients >= 18 years old from April 1, 1968, to September 29, 2023. Using descriptive statistics, individual agents were grouped by drug class. Results: We analyzed a total of 39,346 hair loss AE reports related to a single agent. Immunomodulatory agents and monoclonal antibodies represented the highest proportion of AE reports for alopecia, followed by hair loss drugs, contraceptives, and antitumor necrosis factor (anti-TNF) biologics. Conclusion: In sum, we showed that immunomodulatory agents and monoclonal antibodies, hair loss drugs, including minoxidil and finasteride, contraceptives, kinase inhibitors, and anti-TNF drugs are most frequently associated with hair loss AEs in the FAERS database. Because many of these drugs are not prescribed primarily for dermatologic indications, our study provides guidance for dermatologists in identifying common medications associated with alopecia.