What Is The Science Behind Accutane Induced Hairloss?

[CuckedByChad]

I’m 99% sure that all of my hair related issues stem from my use of Accutane about 5 years ago. About 2 months into my first (and only) Accutane cycle for horrible cystic acne I had the worst hair shedding I have ever experienced. I’d go through my hair in the shower and without exaggerating I’d have about 100/200 hairs in my hand when shampooing them. I figured this was telogen effluvium from the Accutane and thought my hair would bounce back after some time.

Except it never did. It didn’t really effect my hairline itself since I’m still only about a Norwood 1.5/2 after all these years, but it gave me horrible ruined diffuse thinning in a NW6 pattern. Needless to say it completely ruined my hair. I’ve been battling against disease ever since although without much avail.

It really left me wondering what the f*** actually caused this in the first place? Can Accutane actually induce male pattern baldness? Perhaps it started the male pattern baldness cascade and then my natural hairloss took over since it never recovered. I really would like to know the science behind it.

I’m now left with pathetic, thin and fragile hair that needs covering up with Toppik, otherwise it just looks too disgusting. Dutasteride isn’t even working for me either, and my hair continues to fall out.

It is fair to say that this sh*t ruined my life completely. I traded in acne for a ruined hairline, just lol.

 

[Trichosan]

I don't think Accutane touched off male pattern baldness and then it went wild on you. Rather, it had a coincidental compounding effect that interrupted proper growth phase and nourishment to the follicles. Biggest impact with that drug is on the liver which produces over three hundred critical enzymes. But I don't know which or in what pathways it would impact hair. Also, Accutane could affect different people differently. My son took it, cystic acne also, it had zero impact on his hair but he did not inherit baldness genes either. Cured his skin completely, fortunately before any permanent damage occured to it.

 

[Dontwannabeabetabob]

I took accutane as a teenager and it did nothing for my acne. I don't remember it causing hair fall, though I do remember it being a side effect. Looking back I literally tried everything for my acne, it was so stubborn nothing worked except with age it improved. Now I'm cursed with male pattern baldness, gotta love genetics.

BTW, nice username OP haha.

 

[UberBaldaten]

Isotretinoin's exact mechanism of action is unknown, but several studies have shown that isotretinoin induces apoptosis (programmatic cell death) in various cells in the body. Cell death may be instigated in the meibomian glands,[29][54] hypothalamic cells,[55]hippocampus cells[56][57] and—important for treatment of acne—in sebaceous gland cells.[58][59] Isotretinoin has a low affinity for retinoic acid receptors (RAR) and retinoid X receptors (RXR), but may be converted intracellularly to metabolites that act as agonists of RAR and RXR nuclear receptors.[4]

One study suggests the drug amplifies production of neutrophil gelatinase-associated lipocalin (NGAL) in the skin, which has been shown to reduce sebum production by inducing apoptosis in sebaceous gland cells, while exhibiting an antimicrobial effect on Propionibacterium acnes.[60][61][62] The drug decreases the size and sebum output of the sebaceous glands.[63] Isotretinoin is the only available acne drug that affects all four major pathogenic processes in acne, which distinguishes it from alternative treatments (such as antibiotics) and accounts for its efficacy in severe, nodulocystic cases.[64] The effect of Isotretinoin on sebum production can be temporary,[6] or remission of the disease can be "complete and prolonged."[63][65][66]

Isotretinoin has been speculated to down-regulate the telomerase enzyme and hTERT, inhibiting "cellular immortalization and tumorigenesis."[67] In a 2007 study, Isotretinoin was proven to inhibit the action of the metalloprotease MMP-9 (gelatinase) in sebum without any influence in the action of TIMP1 and TIMP2 (the tissue inhibitors of metalloproteases).[68] It is already known that metalloproteases play an important role in the pathogenesis of acne.[69]

Pharmacokinetics
Oral Isotretinoin is best absorbed when taken with a high-fat meal, because it has a high level of lipophilicity.[70] The efficacy of isotretinoin doubles when taken after a high-fat meal compared to when taken without food.[71] Due to Isotretinoin's molecular relationship to Vitamin A, it should not be taken with Vitamin A supplements due to the danger of toxicity through cumulative overdosing.[72] Accutane also negatively interacts with tetracycline, another class of acne drug, and with micro-dosed ('mini-pill') progesterone preparations, norethisterone/ethinylestradiol ('OrthoNovum 7/7/7'), St. John's Wort, phenytoin, and systemic corticosteroids.

Isotretinoin is primarily (99.9%) bound to plasma proteins, mostly albumin. Three metabolites of Isotretinoin are detectable in human plasma after oral administration: 4-oxo-isotretinoin, retinoid acid (tretinoin), and 4-oxo-retinoic acid (4-oxo-tretinoin). Isotretinoin also oxidizes, irreversibly, to 4-oxo-isotretinoin—which forms its geometric isomer 4-oxo-tretinoin. After an orally-administered, 80 mg dose of liquid suspension 14C-isotretinoin, 14C-activity in blood declines with a half-life of 90 hours.[70] The metabolites of isotretinoin and its conjugates are then excreted in the subject's urine and faeces in relatively equal amounts.[70] After a single, 80 mg oral dose of Isotretinoin to 74 healthy adult subjects under fed conditions, the mean ±SD elimination half-life (t1/2) of isotretinoin and 4-oxo-isotretinoin were 21.0 ± 8.2 hours and 24.0 ± 5.3 hours, respectively.[70] After both single and multiple doses, the observed accumulation ratios of isotretinoin ranged from 0.90 to 5.43 in patients with cystic acne.[70]

 

[Afro_Vacancy]

@shookwun

 

[dr75]

Accutane induces telogen effluvium at very high doses. It has nothing to do with androgenetic alopecia.

 

[michel sapin]

for me accutane was a great drug ! perfect skin an no sides !
But i started worrying about my hair at this time ( 16-17) after reading the leaflet , then was convincend accutane caused my male pattern baldness , but it was the genetic

 

[1knox1]

So, is it safe to say that the majority of your hair issues are not due to male pattern baldness? But damage due to other factors - i.e accutane? I'm sure you've already looked at this but maybe minoxidil could help? It's been shown to help in chemically damaged hair and other fragile hair disorders.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835892/

'Abnormal morphogenesis of sebaceous glands often results in degeneration of hair follicle structures'.

Can accutane effect the sebaceous gland attached to the hair follicle? A lot of broscience I know.

 

[Native]

OP any updates? Legendary bump but keep in mind I am trying to figure out if I’m male pattern baldness diffuse thinning right now or it’s telogen effluvium on the top of my scalp due to accutane. Scary scary sh*t man.

 

[Brendan452]

I'm also searching for this

 

[BetaBoy]

OP any updates? Legendary bump but keep in mind I am trying to figure out if I’m male pattern baldness diffuse thinning right now or it’s telogen effluvium on the top of my scalp due to accutane. Scary scary sh*t man.

is your thinning across the entire scalp or just localised to the Norwood area?

 

[JaneyElizabeth]

I hate when threads from years back get resurrected because it becomes disjointed but first things first. Acne is highly correlated with hair loss. They are both DHT artifacts so we would assume that many people who need treatment for acne might have hair loss occur fairly soon afterwards. It seems strange since we associate acne with youth and baldness with being an adult but they likely begin together even though expression of hair loss might not be apparent for several years.