Does Dupixent cause hair loss?

Although hair loss is not reported in the product information as a side effect of Dupixent, there have been rare reports of hair loss published since the drug was approved. It is possible that Dupixent can cause hair loss in a very small number of people (also called drug-induced alopecia). Conversely, there have also been case reports of people with pre-existing alopecia experiencing significant hair regrowth with Dupixent. Doctors and their patients should consider the potential for hair loss or hair regrowth when prescribing Dupixent.

One case report describes a 27-year-old Hispanic man who reported significant patchy hair loss (alopecia areata) 18 weeks after starting Dupixent. The hair loss was noted throughout the entire scalp but was accentuated on the vertex and crown. The hair loss did not subside with daily clobetasol 0.05% foam and 3-times weekly ketoconazole 2% shampoo use and laboratory investigations revealed an alopecia areata-like hair loss pattern with hair miniaturization, inflammation of the hair root, and severe shrinkage (atrophy) of the sebaceous glands. Dupixent was discontinued and the man was administered topical triamcinolone acetonide 0.1% ointment to the scalp alternating weekly with tacrolimus 0.1% ointment, and one round of intralesional triamcinolone acetonide injections to approximately 30 sites. Within 8 weeks the hair had started to grow back with no remaining areas of alopecia, scale, or redness noted.

Another report describes a 42-year-old woman with longstanding atopic dermatitis (AD) that had not responded to systemic treatments and a history of alopecia areata that had occurred 5 years ago, which responded to intralesional triamcinolone. She was started on Dupixent which improved her AD but, 4 months later, she started rapidly losing her hair on the top and back of her scalp and above her ears. She received intramuscular triamcinolone and chose to continue dupilumab. After 2 months, she had nearly complete hair regrowth without further need for triamcinolone treatment.

There have been at least seven cases of alopecia areata caused by Dupixent published, but all but one of these patients were able to be continued on dupilumab.

Conversely, there have been case reports of significant hair regrowth in some people prescribed Dupixent, for example, a 34‐year‐old woman with severe recalcitrant AD since early childhood, exercise‐induced asthma, and alopecia universalis; and a 4-year-old girl with severe atopic dermatitis with concomitant alopecia areata (AA).

The most commonly reported side effects of Dupixent include injection site reactions, eye and eyelid inflammation, and nasopharyngitis.

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