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Alopecia associated with fluconazole therapy

P G Pappas1, C A Kauffman, J Perfect

  • 1University of Alabama, Birmingham, USA.

Annals of Internal Medicine
|September 1, 1995
PubMed
Summary

Fluconazole can cause significant hair loss, especially at higher doses (400 mg/d) for extended periods. This reversible alopecia typically resolves after stopping or reducing the fluconazole dose.

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Area of Science:

  • Mycology
  • Dermatology
  • Pharmacology

Background:

  • Fluconazole is a widely used antifungal medication.
  • Alopecia is a potential side effect of various medications.
  • The association between fluconazole and alopecia requires further investigation.

Purpose of the Study:

  • To investigate the relationship between fluconazole use and the occurrence of reversible alopecia.
  • To characterize the incidence and clinical presentation of fluconazole-induced alopecia.

Main Methods:

  • A retrospective survey of patients treated with fluconazole by Mycoses Study Group (MSG) investigators.
  • Analysis of data from 33 patients who developed alopecia during fluconazole therapy.
  • Review of treatment protocols and patient outcomes.

Main Results:

  • 33 patients experienced substantial alopecia while on fluconazole therapy.
  • Alopecia occurred in patients with various deep and superficial mycoses.
  • Higher doses (≥400 mg/d) for longer durations (≥2 months) were associated with increased risk.
  • Hair loss resolved within 6 months of fluconazole discontinuation or dose reduction.

Conclusions:

  • Alopecia is a common, albeit reversible, adverse effect of high-dose, long-term fluconazole treatment.
  • Dose reduction or discontinuation of fluconazole leads to hair regrowth.
  • Clinicians should monitor for alopecia in patients receiving prolonged fluconazole therapy.