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Study Finds Thiopurine Treatment for IBD Causes Severe Hair Loss


Inflammatory bowel disease sufferers undergoing thiopurine treatment may experience ‘severe hair loss according to a new study published in The Pharmacogenomics Journal.

Conditions that affect the digestive system, including Crohn’s disease and ulcerative colitis, come under the ‘inflammatory bowel disease’ (IBD) term.

New Hair Loss StudyIBD patients likely to decline thiopurine treatment

Although thiopurines, including azathioprine (AZA) and 6-mercaptopurine (6MP), have proved beneficial for IBD conditions, there are concerning side-effects. Most commonly, the severe side effects from treatment with thiopurines altered by doctors include leukopenia and severe hair loss.

The ‘cosmetic problem’ this thiopurine-induced hairloss causes has been cited in this latest study as a ‘critical reason for patients to decline thiopurine treatment’.

Investigating thiopurine-related hair loss

Researchers found that a specific genotype, NUDT15 R139C, was ‘strongly associated’ with thiopurine-induced leukopenia in Caucasians and people from Korea. Following on from this discovery, a new ‘association study’ was carried out, investigating the links between R139C and thiopurines side-effects in Japanese patients.

This involved examining 142 Japanese IBD patients with a history of thiopurine treatment, and trying to recreate its side-effects. Each test subject’s IL28B gene sub-type, also known as a genotype, was recorded. This gene is involved in the immune response and has three genotypes, CC, CT, and TT. People with the CC genotype generally have a stronger immune response than the other two.

Researchers reported five instances of test subjects developing severe hair loss, all of which were in patients with the TT genotype. Conversely, no ‘early severe hair loss’ was observed in CT or CC genotype subjects.

Some interesting patterns emerged in relation to how long each subject continued treatment. The study revealed ‘Patients with the CT genotype discontinued treatment or required thiopurine dose reduction significantly earlier than patients with the CC genotype. However, on manipulating the doses, there was no significant difference in the thiopurine continuation rates between the groups’. Furthermore, when looking at the maintenance period, findings showed that ‘the frequencies of 6MP usage were higher, and the doses of thiopurines were significantly lower in patients with the CT genotype than in those with the CC genotype’.

As per these results, it was recommended that IBD patients with the TT genotype should avoid treatment with thiopurines and that low doses of 6MP could be given to CT genotype IBD patients instead of AZA.

Treating hair loss caused by medication side effects

Persistent shedding caused as a side effect of medication generally indicates a condition known as Chronic Telogen Effluvium. This lasts for a minimum of 12 months and presents as diffuse thinning all over the scalp, as well as sometimes making the hair more brittle than usual.

Although the hair should regrow naturally once the source of the problem has been addressed, there are Chronic Telogen Effluvium treatment options to spur this on.

Topical applications of the hair loss treatment minoxidil combined with appropriate use of hair growth boosters, have produced notable regrowth results for many Belgravia clients with this condition.

Patients with chronic illnesses, or those experiencing hair loss from medication can benefit from working with both their doctor and a hair loss specialist. Taking this kind of holistic approach to caring for both your health and your hair can help to provide balance when managing both conditions, as well as giving you a strong support network.

The Belgravia Centre Hair Loss ClinicThe Belgravia Centre

The Belgravia Centre is the leader in hair loss treatment in the UK, with two clinics based in Central London. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the UK or the rest of the world. View our Hair Loss Success Stories, which are the largest collection of such success stories in the world and demonstrate the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time for our hair loss helpline or to arrange a free consultation.

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