Can Blood Pressure Medication Cause Hair Loss? What to Know

For general educational purposes only, not a substitute for specific medical advice. Consult with a licensed provider before implementing any adjustments to your treatment regimen.

Yes, it can, although it isn’t one of the usual side effects most people have. Some blood pressure and heart medicines, including beta blockers, ACE inhibitors and calcium channel blockers, have been linked to a temporary type of shedding called telogen effluvium. Hair usually grows back once the trigger is addressed.

Hair loss also has many other causes that often show up around the same time, so the timeline matters. And one rule comes first: don’t stop a blood pressure medicine on your own. Talk with your clinician or pharmacist before making any change.

How Medication-Related Shedding Works

Hair grows in cycles. Each hair has a long growing phase, then a resting phase, and then it falls out as a new hair grows in. A trigger such as a new medicine, an illness or a stressful event can push more hairs than usual into the resting phase at once. This is telogen effluvium, and it is the way almost all medicine-related hair loss happens, apart from chemotherapy.

The key clue is timing. The extra shedding usually shows up two to four months after the trigger, not right away. Hair may come out in handfuls when you shampoo or comb, and the thinning is spread across the scalp rather than in bald patches. Telogen effluvium is usually temporary, although it can sometimes become long-term.

Heart and Blood Pressure Medicines That Have Been Linked

Medical references list several heart-related medicines among the many drugs that can trigger shedding:

• Beta blockers, such as metoprolol, atenolol and propranolol
• ACE inhibitors, such as lisinopril and enalapril
• Calcium channel blockers, such as amlodipine and diltiazem
• Blood thinners, such as heparin and warfarin, and possibly newer ones like apixaban and rivaroxaban
• Cholesterol-lowering drugs, a group that includes statins

Being on a list does not mean your medicine is the cause. For most of these drugs, hair loss is an occasional side effect, not an expected one, and many people take them for years with no hair changes. Statins appear on these lists too. If you take one and notice shedding, mention it, but it’s worth looking at other causes as well.

Other Causes That Often Overlap

People who start a blood pressure or cholesterol medicine are often in midlife or later, when other causes of thinning are also common. A clinician will usually consider:

• Hereditary (pattern) hair loss. This is the most common cause of hair loss. It develops gradually. In women, the first sign is usually overall thinning or a widening part. In men, it’s often a receding hairline or thinning on top. A family history is a clue.
• Thyroid problems. Thyroid disease can cause thinning hair, and treating it can reverse the loss.
• Low iron or poor nutrition. Too little iron or protein, or a crash diet, can lead to noticeable shedding.
• Illness, surgery or stress. A fever, an operation or a hard stretch in life can cause the same delayed shedding a few months later. Sometimes the illness or hospital stay that led to a new prescription is the real trigger.
• Other medicines. Starting or stopping birth control, certain antidepressants and retinoids can also cause shedding.

More than one cause can be present at once. Our guides to medications that can cause hair loss in women and causes of hair loss in men go into more detail.

Why You Shouldn’t Stop Your Blood Pressure Medicine

It’s tempting to quit a pill you think is costing you your hair. Please don’t. Stopping some medicines suddenly can cause serious health problems. With a beta blocker such as metoprolol, stopping suddenly can lead to serious heart problems.

Medicine-related shedding is usually not dangerous, and it often improves once the cause is found and addressed. Talk with your clinician or pharmacist before you stop, skip or change a dose. If side effects are bothering you, that conversation is the safest way to find a better fit.

What a Clinician Reviews and What Your Options Are

Much of this evaluation works well by video. A clinician will usually ask about:

• When the shedding started, and every medicine started or changed in the three months before you noticed it
• Any illness, surgery, weight loss, diet change or major stress in that window
• Whether the loss is all over, in patches or in a pattern, and whether family members have thinning
• Supplements and over-the-counter products

Clear, well-lit photos of your part and hairline help. If the cause isn’t clear, blood tests at a local lab often include a blood count, iron studies and thyroid tests. Patchy loss, redness or scaling, or an uncertain picture may need an in-person scalp exam or a dermatologist referral, sometimes with a scalp biopsy.

If a medicine looks like the likely trigger, your clinician may talk with you about adjusting the dose or switching to a different type of blood pressure medicine. Home blood pressure readings help make any change safely. Any switch depends on your health history, and a visit does not guarantee a specific medication. After the trigger is removed, shedding can take up to six months to settle. Regrowth is usually visible within three to six months, but full recovery can take a year or more.

When to Get Care Right Away

Hair loss on its own is rarely an emergency. Call 911 if you have chest pain, trouble breathing, fainting, a sudden severe headache, or sudden weakness, numbness or trouble speaking. Also get emergency care for swelling of the face, lips or throat or a widespread blistering rash after starting a new medicine.

Book a prompt visit if you notice:

• Hair loss in patches, or bald spots in your eyebrows or beard
• Pain, itching, redness or scaling on your scalp
• Very rapid hair loss
• Fatigue, feeling cold, weight gain or muscle weakness along with thinning
• Shedding that hasn’t eased after several months

The Short Answer

Blood pressure and heart medicines, including beta blockers, ACE inhibitors and calcium channel blockers such as diltiazem, can occasionally trigger temporary shedding, usually two to four months after starting. Statins are on the list as well. Thyroid problems, low iron, stress and pattern hair loss often overlap. Keep taking your medicine, note the timeline and talk with a clinician, who can check labs and discuss alternatives if needed.

Learn more on our online dermatology page.

Get Support

Wade’s Care First provides telehealth care in Arizona, Florida, Illinois, Indiana, Kentucky, Michigan, Nevada and New York, with same-day appointments when available. Visits are with Charles Wade, FNP-BC, a board-certified family nurse practitioner.

We accept many major insurance plans, including Original Medicare (Indiana only), Medicaid (Indiana, Illinois and Nevada only), UnitedHealthcare, Aetna, Humana and Cigna. Plan participation varies by state, and self-pay visits are available.

If you’ve noticed more shedding since a medicine change, a visit can help you find the cause without putting your blood pressure at risk.

Book at wadescarefirst.com.