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FDA approved for more than 25 years
Isotretinoin (formerly Accutane) helps control sebum production — your body’s natural oils — to reduce breakouts and acne.
Some people who take it may notice signs of hair thinning, a lack of new hair growth, or more hair fallout than usual. Can Accutane cause hair loss? And if so, is Accutane hair thinning reversible?
Unfortunately, the hair loss accutane connection isn’t a fluke. Hair loss is a potential side effect of Accutane. But do you really have to choose between clear skin and good hair?
Thankfully, the answer’s no. There are treatment options for those dealing with isotretinoin-related hair loss.
Here’s what to know about oral isotretinoin’s possible effects on hair, including why it might happen, who’s most likely to experience it, how long it may last, and what you can do about it.
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Isotretinoin (once known as the brand-name Accutane, which is now discontinued) is a prescription medication used to treat severe nodular acne—the inflammatory type with deep, painful pimples. It comes in a capsule and is usually taken twice a day.
As a retinoid treatment, the oral medication is a derivative of vitamin A. It works by lowering sebum production and preventing dead skin cells from building up and blocking your pores.
Potential side effects of isotretinoin treatment can be aggravating, to say the least.
According to the FDA (U.S. Food and Drug Administration), they include:
Peeling skin on the hands
Nosebleeds
Cracked, sore lips
Sweating
Dry skin near the eyes, mouth, or nose
Tiredness
Sweating
Flushing
More serious side effects include blurred vision, dizziness, nausea, and vomiting. If you experience any of these, contact a healthcare provider right away.
Isotretinoin can’t be taken by people who are pregnant or might become pregnant, as it can cause birth defects. As such, various forms of birth control may be prescribed during acne treatment.
It’s also suggested that people be careful when taking isotretinoin because it appears to have varying effects on semen characteristics, like size and shape.
So, there are definitely some dermatology and health risks to taking this medication, but what about your hair?
Yes, there is such a thing as isotretinoin-induced hair loss (sometimes called Accutane-related hair loss). Unfortunately, it’s one of the potential adverse side effects of this prescription drug.
The American Osteopathic College of Dermatology estimates that about 10 percent of people who take oral isotretinoin experience temporary hair thinning.
A 2013 study found that the acne-fighting drug is connected to temporary hair loss. The researchers also concluded that hair thinning may continue after people stop taking the medication — but that doesn’t mean it’ll last forever.
A study from 2018 suggests that only people who take high doses of an isotretinoin treatment notice a negative impact on hair growth.
Another 2022 study had a similar conclusion, suggesting that while it’s still unclear why it causes hair loss, it seems to be related to the dosage, duration of use, and possibly age.
Furthermore, in a 2019 study, isotretinoin at 0.5 mg/kg per day was provided to participants with moderate to severe acne vulgaris. Their hair growth parameters were measured before treatment and after three months of use.
The authors found no statistically significant changes in hair parameters, concluding that isotretinoin doesn’t cause hair loss when used in the short term and at lower doses.
Finally, a 2022 study looked at how often it causes hair loss, depending on the dose. The researchers found that people taking lower doses (<0.5 mg/kg/day) had hair loss about three percent of the time, while those on higher doses (≥0.5 mg/kg/day) had hair loss about six percent of the time.
Hair loss experienced while taking Accutane is thought to be connected to telogen effluvium, a form of temporary hair loss often caused by stress or hormonal factors.
With telogen effluvium, you’ll likely notice hair loss all over rather than concentrated in one area of your scalp.
Telogen effluvium occurs when a large number of hairs in the growth phase (also called the anagen phase) of the hair cycle suddenly go into the resting phase (aka the telogen phase).
New growth can stop for up to six months. Then, when hair reenters the growth phase, the hairs that were in the resting phase are pushed out from the hair follicles, and hair shedding occurs.
According to the above-mentioned studies, hair loss associated with taking isotretinoin is temporary. And there’s currently no research showing it may be permanent.
For participants in most of the studies, it seems the post-accutane hair loss eventually resolved itself. So if you experience hair loss after accutane, it most likely won’t be a forever problem, as long as you’re otherwise taking good care of your hair and scalp.
It may take a few months after stopping Accutane to notice your hair loss subsiding. Accutane pushes your hair from its anagen phase into its telogen phase, causing it to fall out — which can take three months or more to complete. Still, it’s not forever.
What could cause permanent hair loss are factors that damage your hair follicles, ultimately preventing strands from growing back.
One common condition that leads to permanent hair loss is traction alopecia. This happens when hair is continuously pulled on (like from too-tight hairstyles). For guys with longer locks, know that tight ponytails, small braids, and even rubber bands can make traction alopecia worse.
Scarring alopecia (when scar tissue builds up and prevents new growth) and alopecia areata (an autoimmune disease that causes thinning) are other forms of permanent hair loss.
Thankfully, taking isotretinoin doesn’t cause these conditions.
As noted, research shows that higher doses tend to result in hair loss, while acne patients on lower Accutane doses may not experience this side effect.
If you’re concerned about how isotretinoin may affect your hair, you might consider talking to your dermatologist about lowering your dose to help prevent hair loss.
Experiencing temporary hair loss while taking isotretinoin is undoubtedly frustrating, but you have options. Reversing hair loss from this medication is totally possible.
Here are some potential remedies for temporary hair loss or disappearing hairline caused by Accutane.
Hair loss medications can be effective. For temporary hair loss, a healthcare provider may suggest a hair loss medication that has been FDA-approved for male pattern baldness (androgenetic alopecia).
The two common options include:
Topical minoxidil, which comes as minoxidil foam or minoxidil liquid solution.
Oral finasteride, which can be taken in tablet form.
Topical finasteride, while not FDA-approved for hair loss in men, may be prescribed “off-label” by some healthcare providers.
For example, many find that combining the two medications above yields the best results, such as with our topical finasteride & minoxidil spray. This product sends a signal to your blood vessels to open, allowing more nutrients and oxygen to reach the hair, which makes it healthier and stronger.
This topical spray also prolongs the growth period, meaning more follicles will form to replace strands that have fallen out.
While not a direct treatment for hair loss, certain supplements may also help with hair fallout — particularly if your diet is lacking in them.
Biotin is often associated with supporting healthy hair growth. But does it deserve this reputation? Actually, it does.
A study found that taking biotin produces quicker hair growth in those with thinning hair. That said, the study used a marine protein containing biotin with other vitamins and minerals — so it’s hard to pinpoint this B vitamin as a singular driving factor.
Biotin is found naturally in some foods (like eggs, milk, and bananas). If you don’t have a vitamin B or biotin deficiency, you don’t need a supplement. But if you don’t get enough biotin from food, vitamin B supplements could help.
Hims has a biotin gummy that also has vitamin D in it. Why? Low levels of vitamin D are thought to increase hair shedding.
Another popular supplement thought to help with hair health is collagen, which you can get as gummies, capsules, and powders. However, research is limited when it comes to the connection between collagen and hair health.
So, why do people think collagen can help? Hair is mostly made up of a protein called keratin. Amino acids in your body help build keratin. One of these amino acids is proline.
Proline contributes to collagen. Because of this, some people think consuming collagen could help boost the keratin in your hair, making it stronger and healthier.
Studies show that having a deficiency in iron and zinc could negatively impact hair health. For instance, some research has observed that when people increased their intake of these minerals, they saw an improvement in hair growth.
Crab, cashews, and oatmeal are all solid sources of zinc. Leafy greens, red meat, legumes, and seafood can help boost your iron levels.
To enhance your iron absorption further, especially from plant-based sources, pair iron foods with vitamin C foods — like citrus fruits, strawberries, bell peppers, tomatoes, or broccoli.
There are also some lifestyle habits you can change or incorporate to help with thinning hair caused by isotretinoin.
One thing you might want to give up? Smoking. This habit affects hair loss — among other things — and hair regrowth can benefit from quitting.
Not only is the actual smoke a pollutant that damages hair, but cigarettes can also wreak havoc on the DNA of your hair follicles.
These things can increase hair loss — something you definitely don’t want if you’re already shedding from taking isotretinoin.
Stress can lead to hair loss, and hair loss can be very stressful, creating a bit of a vicious cycle. We all know dealing with severe acne can be stressful, too.
To sidestep this stress cycle and (hopefully) keep hair loss at a minimum, try stress management techniques. These can include:
Exercising regularly
Finding time to relax
Getting enough sleep
Spending time with friends or loved ones
Meditation
How does stress affect the body? Read our blog for insight.
One of the common side effects of taking isotretinoin is dryness all over — even in the hair on your head. Dry, brittle strands are more likely to break. When your hair breaks, it looks thinner.
Add moisture back to your hair care routine by using hair products packed with hydration. Hims offers thickening shampoo and conditioner that moisturize while promoting growth.
You may also want to avoid too much sun exposure (wear a hat!) to prevent UV light from drying out your strands.
Beyond that, be careful when brushing or combing your hair. A wide-toothed comb is usually best, especially when your hair’s wet, as that’s when it’s the weakest.
Does Accutane cause hair loss? Potentially.
Isotretinoin is used as a treatment for acne. While it can be a miracle drug for cystic acne and other types of severe acne, one of the potential undesirable side effects is hair loss.
Here’s what to keep in mind about Accutane hair loss:
Hair loss is a possible side effect of Accutane. Though not all patients with acne treated with isotretinoin will notice hair thinning or loss, some will.
Accutane hair loss probably isn’t permanent. If it happens to you, the good news is this side effect doesn’t tend to be permanent, especially if you’re taking good care of your hair, scalp, and overall health needs.
A lower dose might help. Your healthcare provider may be able to adjust your dosage of isotretinoin to prevent more hair loss.
Treatments are available. Treatments for this type of hair loss include supplements, lifestyle tweaks, and prescription medication, like topical minoxidil or oral finasteride.
If you notice abnormal shedding, hair loss, or thinning, it’s best to speak with a healthcare professional for personalized medical advice. They’ll be able to assess what’s going on and go over your treatment options.
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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.
Dr. Knox Beasley is a board certified dermatologist specializing in hair loss. He completed his undergraduate studies at the United States Military Academy at West Point, NY, and subsequently attended medical school at Tulane University School of Medicine in New Orleans, LA.
Dr. Beasley first began doing telemedicine during his dermatology residency in 2013 with the military, helping to diagnose dermatologic conditions in soldiers all over the world.
Dr. Beasley is board certified by the American Board of Dermatology, and is a Fellow of the American Academy of Dermatology.
Originally from Nashville, TN, Dr. Beasley currently lives in North Carolina and enjoys spending time outdoors (with sunscreen of course) with his wife and two children in his spare time.
Bachelor of Science, Life Sciences. United States Military Academy.
Doctor of Medicine. Tulane University School of Medicine
Dermatology Residency. San Antonio Uniformed Services Health Education Consortium
Board Certified. American Board of Dermatology
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