Today I learned that chronic aspirin/ibuprofen/naproxen use causes hair loss

[Reyesuela]

Anything that is a COX 1 inhibitor stunts hair growth and causes androgenic-type alopecia because it lowers the level of prostaglandin E2, which upregulates hair production. And studies have confirmed that these NSAIDs can do this.


GAH.


Sucky part is, there are COX 2 selective inhibitors, but they tend to have a lot of side effects of their own. Curcumin is a selective COX 2/LOX 5 inhibitor without side effects, but it isn't that strong. Still, I'll try taking it for pain when tylenol isn't cutting it.

[lapushka]

I take regular ibuprofen (at least during the week of my cycle because of migraines, and sometimes a number of days outside of it too). I've never seen negative side-effects.

Maybe if you have to take them daily, *all of the time*, that might be different.

[Reyesuela]

Most likely daily or near daily use.

I totally wouldn't worry about 1-5, maybe 10 doses a month.

Low level aspirin therapy has been shown to cause hair loss, though.

I was already trying to avoid it at night. It's a melatonin antagonist. I need sleep aids when I have it at night, and chronic daily Benadryl use increases dementia risk by 50%. Now I am only going to take it when I'm desperate and will see if curcumin can handle lesser stuff with reasonable amounts of acetaminophen.

EDIT: To clarify, it would not cause hair fall/extra shedding that's really noticeable so much as more or increasing thinness.

[lapushka]

Aren't you kind of panicking about it a bit? I wonder.

I would like to see some scientific sources on this, if you don't mind?

[Groovy Granny]

I take NSAIDS daily and have seen no adverse effects re: my hair; my silver is fine :shrug:

[Dark40]

I take a baby St. Joseph aspirin daily 85mg daily. Will that cause any hair loss?

[truepeacenik]

I'd really like to see source material on this.

I'm betting that the 81 mg aspirin hair loss has many additional factors. Many
And likely a gender disparity.

Who funded the studies, etc?

[Reyesuela]

I'm not panicking--I just have chronic pain, so I sometimes use a LOT of cox1/cox2 inhibitors.

"The synthesis and metabolism of prostaglandins or eicosanoids is a very actively studied area, not only given its importance in skin biology such as inflammation(17). The cascade begins with membrane phospholipids which are metabolized by phospholipase into arachidonic acid. This lipid is the substrate for a host of different pathways including the leukotrienes, but also is a substrate for the cyclooxygenase enzymes (COX1/2 or PTGS ½). The cyclooxygenase enzymes produce PGH2 which is converted into selectively different prostaglandin species by specific synthases. Multiple isoforms of synthases can act to create each individual prostaglandin species. For example, PGD2 has at least 2 synthase enzymes using PGH2 as a substrate(18). PGF2a can also be synthesized from PGH2 also through the enzyme PGH 9-11-endoperoxide reductase, but also from PGE2 or PGD2 via the enzymes PGE 9-ketoreductase and PGD 11-ketoreductase(19, 20) respectively. Prostaglandin synthesis enzymes are expressed in the skin diffusely including hair follicles(20, 21) and sebaceous glands(22). Complicating understanding of these pathways is that minutely different lipid compound substrates with very similar chemical structures can often still be metabolized by these same enzymes leading to distinct products with undetermined biologic significance."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3982925/

PGE2 is what's needed for hair growth. In androgenic alopecia, PGH2 is converted into PGD2, which is involved in the whole DHT/hair follicle destruction cascade. PGE2 does the opposite.

More about the need for COX-1 for PGE2 for hair growth: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3762294/

Other studies showed that COX 1/2 non-selective inhibitors render minodixil ineffective, but I did not realize that this is because COX 1 is needed for all hair growth. No COX inhibitor is 100% effective, of course, so none of them can possibly make you totally bald, but this will be a dose-dependent stunting of hair growth.

Now I can't find the original article on Pubmed (I read it earlier, grrr), but here is a hair loss clinic basically trying to tell you why you should get a hair transplant because of the minoxidil/COX-1 inhibitor issue:

"Minoxidil, available by the brand name Rogaine, is one of the most widely used non-surgical treatments for hair loss. Though it is still unclear exactly how the topical foam suppresses hair loss, many studies indicate that Rogaine stimulates the production of a very special enzyme called cyclooxygenase1, or COX-1. As the production of COX-1 increases, so too does the production of prostaglandin E2, or PGE2.

"Increased levels of PGE2 has a very positive impact on the overall health and functionality of hair follicles, and in some cases may reverse the process of hair miniaturization. Hair miniaturization is characterized by the inability of hair follicles to sustain natural hair growth, a phenomenon that may eventually lead to pattern baldness, or androgenetic alopecia. In this way, Rogaine is thought to reverse the signs of hair loss by stabilizing hair follicles through increased production of PGE2."

http://www.miamihair.com/blog/hair-loss-research/take-rogaine-or-aspirin-never-both/

Without the spin, it is still accurate--aspirin DOES counteract Rogaine, but the problem is that it can stunt growth, period, through that pathway, whether or not you're using minoxidil.

COX-1 inhibitors will cause hair loss if it becomes the rate-limiting step for your hair growth. It's pretty much that simple. Is it the rate-limiting step for you? Depends on how much you take. Once or twice a week? No worries. It will do nothing. But the more you take, the higher your risk of hitting that mark.

A fluffier source: http://www.dailymail.co.uk/health/article-2214841/Bad-hair-day-Blame-medicine.html

And...what's worse? It increases hearing damage, too. Great: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3530351/ (The mechanism of acetaminophen is completely different--and so is the high-dose acute toxicity vs. chronic low-dose use. It's good to see that for women, aspirin is too weak to cause cochlear ear hair loss, but I usually take 3 ibuprofen when I really hurt, and yes, the cochlear ear hair is actually highly related to your head-hair in how it grows and how it is protected--a lot of hair loss remedies are used to try to counteract ototoxicity in certain antibiotics, with reasonable success.) I will DEFINITELY keep my ibuprofen and naproxen use below 2x per week, on average!

[Reyesuela]

I'd really like to see source material on this.

I'm betting that the 81 mg aspirin hair loss has many additional factors. Many
And likely a gender disparity.

Who funded the studies, etc?

There is a gender disparity. Men appear much more susceptible because the seem to have lower PGE2 as they age.

[Decoy24601]

I'd really like to see source material on this.

I'm betting that the 81 mg aspirin hair loss has many additional factors. Many
And likely a gender disparity.

Who funded the studies, etc?

Also, to add to this, correlation is not the same as causality. There could have been many contributing factors.

I would also like to see the source material/studies.

[Reyesuela]

I take a baby St. Joseph aspirin daily 85mg daily. Will that cause any hair loss?

Based on the studies on hearing loss--cochlear hair is NOT head-hair, but they both need PGE2 to grow, so it's very suggestive--as a WOMAN, the baby aspirin is probably just fine. As a man, I'd worry a bit.

[Dark40]

I would also like to see some source material/studies too.

[Dark40]

Based on the studies on hearing loss--cochlear hair is NOT head-hair, but they both need PGE2 to grow, so it's very suggestive--as a WOMAN, the baby aspirin is probably just fine. As a man, I'd worry a bit.

Ok, now I understand.

[Reyesuela]

Also, to add to this, correlation is not the same as causality. There could have been many contributing factors.

I would also like to see the source material/studies.

Hair cannot be grown without COX-1. If the amount of COX-1 in the scalp is less than what is needed for normal growth, growth will be stunted. If there is more than enough, even if it is lowered, then it will not be stunted.

The mechanism isn't weird or mysterious or confusing in this case. PGE2 is a main regulator of Wnt signaling in all animals--even fish! Wnt signaling in hair follicles is what makes hair grow.

It appears to generally be less of an issue in women than in men, which is why minoxidil is generally more effective in women than in men--women apparently usually have more spare COX-1 in the scalp.

[Decoy24601]

Hair cannot be grown without COX-1. If the amount of COX-1 in the scalp is less than what is needed for normal growth, growth will be stunted. If there is more than enough, even if it is lowered, then it will not be stunted.

The mechanism isn't weird or mysterious or confusing in this case. PGE2 is a main regulator of Wnt signaling in all animals--even fish! Wnt signaling in hair follicles is what makes hair grow.

It appears to generally be less of an issue in women than in men, which is why minoxidil is generally more effective in women than in men--women apparently usually have more spare COX-1 in the scalp.

Yes, but I would like to see studies/source material that show a link between the reduction of COX-1 and the chronic use of NSAIDS. I would like to see what the study concluded is the likelihood of NSAIDS causing this. I'm not saying it's a "weird or mysterious or confusing". I just want to see the studies.

[truepeacenik]

Reyesuela has the references up thread.
Thanks for that. And, yeah, I eye rolled at the UK Daily Fail. ;)

My concern was that some mercola-like page had it, and with the overuse of tech terms, I was... Assuming a sales pitch was the origin.

[PixieP]

:shrug:

I have taken minimum 600mg of Ibuprofen 4-5 times a week for 6 years or so, due to fibromyalgia, chronic headaches/migraines, and severe psoriasis. I also go on low dose chemo (not for cancer, for the psoriasis, it's a very very small dose compared to cancer patients). I have PCOS, I am on birth control pills, I am overweight, I have in periods very very bad diet, up until late October I smoked... All these things are supposed to cause hair loss and/or thinning. Theoretically I shouldn't have hair left on my head, and certainly not be able to grow it long or keep sort of healthy.

But I have hip length hair that is quite healthy and even though I'm on the lower end of ii, it's still ii. So again :shrug: I feel like this is slightly fearmongering TBH.

[Cg]

My husband took low-dose aspirin daily for many years with absolutely no hair thinning. It's possible other factors are involved.

[ravenreed]

Hmm. I have been experiencing hair thinning for quite a while. I also chronically take ibuprofen for pain. It wouldn't surprise me if this was a side effect of the NSAID. I take enough that I experience bruising if I am not careful. The hair thinning bothered me so much that I started minoxidil after my doctor was unable to figure out a cause. I am not sure if my thickness is coming back yet since I am only a few months in, but my hair is growing much faster than usual. I don't think that would be happening if the ibuprofen was counteracting the minoxidil. Unfortunately, stopping the ibuprofen is not an option at this point. I wish it were.

[Aphra]

I guess the question is not what is the mechanism (which seems quite clear), but whether the dose and cumulative effect are sufficient to reduce COX-1 in the scalp by enough to impact hair growth.

Although to be honest, if someone said I could have my hair or my migraine meds, I'd buy a wig, because there are very few things in life I rank as more important than avoiding that pain (not that I take a lot of NSAIDs, as naproxen is the only one I'm allowed to take, and I do that as infrequently as possible for the sake of my stomach)

[PixieP]

I guess the question is not what is the mechanism (which seems quite clear), but whether the dose and cumulative effect are sufficient to reduce COX-1 in the scalp by enough to impact hair growth.

Although to be honest, if someone said I could have my hair or my migraine meds, I'd buy a wig, because there are very few things in life I rank as more important than avoiding that pain (not that I take a lot of NSAIDs, as naproxen is the only one I'm allowed to take, and I do that as infrequently as possible for the sake of my stomach)

Agree! If I cannot take Ibuprofen all I will do all day is lie in bed and cry from the pain. Doesn't matter then how long or thick my hair is if I am crippled by pain. I have had an ulcer because of my ibuprofen use and now have to take additional medication with it to prevent it from hurting my stomach again. But without it, I have no life!

[Anje]

Granted, anecdotal evidence isn't worth much, but I take fairly large doses of ibuprofen frequently. (By the time I'm in enough pain to bother taking it, 800mg is the dose that's actually likely to have an effect. Not sure if it's a higher pain threshold or just tolerance.) My hair grows at a pretty normal rate and has gotten thicker over the past few years.

[ArienEllariel]

Yikes. That's something I'll have to watch out for. I was taking ibuprofen if not something stronger daily for a bit. Yay chronic pain conditions. My hair has just been thinner and breaking off as is though I think the breakage has more to do with things than my nsaid use. This hard water has just wrecked my hair the past few months.