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Does Xolair cause hair loss?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Feb 21, 2024.

Official Answer by Drugs.com

Hair loss (alopecia) has been reported in Xolair clinical studies in at least 2% of people with chronic hives. Hair loss has also been noted in several case reports with Xolair. The hair loss effect appears to be transient, lasting from 3 to 4 months. Due to limited data, the exact cause of hair loss or how often it occurs is not known.

Xolair is approved to treat asthma triggered by allergies, nasal polyps chronic hives (also called chronic spontaneous urticaria) and to help reduce serious allergic reactions due to accidental exposure to certain foods (along with avoiding foods to which you are allergic). It is not used for the emergency treatment of allergic reactions, including anaphylaxis.

Xolair is a subcutaneous (under the skin) injection and is typically used when other treatments have not been effective to control your symptoms. It works by inhibiting the binding of the IgE antibody (or immunoglobulin) to IgE receptors on mast cells and basophils.

Is alopecia reported with Xolair?

In two separate case reports, alopecia (hair loss) was reported with Xolair treatment.

Three women, 38, 62 and 70 years of age, with chronic spontaneous urticaria received treatment with omalizumab (Xolair) 300 mg. They had failed treatment with non-sedating antihistamines, ranitidine and montelukast. One patient reported having Hashimoto’s thyroiditis, which has been associated with hair loss, but was not in this case report.

In another case report, a 27-year woman was admitted to the hospital with chronic spontaneous urticaria for 3 weeks. She previously had no effect with non-sedating antihistamines, prednisolone, and montelukast (Singulair) treatment for her hives.

Related questions

Does Xolair cause alopecia areata?

Alopecia areata has also been reported with the use of Xolair for chronic hives.

Alopecia areata, an autoimmune disorder, leads to hair loss with circular patches and can occur when the immune system attacks the hair follicles.

Bottom Line

This is not all the information you need to know about Xolair (omalizumab) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other healthcare provider.

References
  • Ghazanfar MN, Thomsen SF. Transient hair loss in patients with chronic spontaneous urticaria treated with omalizumab. Eur Ann Allergy Clin Immunol. 2017;49(6):284-285. doi:10.23822/EurAnnACI.1764-1489.08
  • Konstantinou GN, Chioti AG, Daniilidis M. Self-reported hair loss in patients with chronic spontaneous urticaria treated with omalizumab: an under-reported, transient side effect? Eur Ann Allergy Clin Immunol. 2016 Sep;48(5):205-7. PMID: 27608479.
  • Magen Eli. ​​Alopecia Areata after Omalizumab Treatment for Chronic Spontaneous Urticaria. Acta Derm Venereol 2019; 99: 919–920. doi: 10.2340/00015555-3244
  • Xolair (omalizumab) prescribing information. 2/2024. Genentech. South San Francisco, CA. Accessed Feb. 21, 2024 at https://www.gene.com/download/pdf/xolair_prescribing.pdf

Read next

How long before Xolair starts working?

Free serum IgE levels are decreased within an hour of Xolair administration. However it may take several months for the full effects of Xolair to be seen, although some symptom improvement may be noted after a few weeks. Significant improvements were noted after 4 months in those with allergic asthma, after 3 months in those with chronic urticaria, and after 16 to 20 weeks in those with Ig-E-mediated food allergies. Continue reading

How does Xolair affect IgA and IgE levels?

Xolair demonstrates a highly selective effect on immunoglobulin levels in the body, with significant impacts on IgE but no meaningful effect on IgA or other immunoglobulin classes. This selective action is central to omalizumab's therapeutic value in treating IgE-mediated allergic conditions while minimizing broader immune system disruption.

Continue reading

Does Xolair cause cancer?

Xolair is associated with a slightly higher risk of cancer, but cancer specialists have determined that this does not mean that Xolair causes cancer. Research has shown that cancer occurred in 20 out of 4127 trial participants (0.5% of Xolair-treated study volunteers) and 5 out of 2236 (0.2%) of people who were assigned an inactive treatment. Continue reading

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