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Does Xolair Cause Severe Hair Loss While Treating Eczema And Rhinitis?

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Posted on Fri, 22 Jan 2016
Question: Hi !!
I am a 34 year old woman and was given xolair 150 mg in a gap of 3 to 4 weeks to treat my eczema and rhinitus (my ige level is close to 10,000) . After the third shot I have noticed that I've lost a lot of hair . My doctor feels it's alopecia areata looking at the bald patches . I feel that somehow xolair is related to my hair fall. Now my doctor wants to give me Tricort injections on the bald spots and has prescribed MorrF 3 percent and Diprovate plus to apply on the scalp. She has also told me to have Zempred 24mg twice a week and Dicerus 50mg (levomisol) twice a week along with keraboost everyday . Will my hair grow back ? How long does it take ? Is it medicine induced alopecia or a side effect of xolair or does it have no connection to xolair ? Is it safe to use Morr F being a woman ? I've stopped xolair now after the third injection which was a month ago. Please help !
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Answered by Dr. Dr. Kakkar (31 minutes later)
Brief Answer:
Alopecia areata has an underlying immune mechanism

Detailed Answer:
Hello. Thank you for writing to us

I have gone through your query and I have noted your concern.

Omalizumab is an anti-IgE therapy i.e it has an immune mechanism of action. Although, at first instance, it does not seem to me that this drug would be the cause of alopecia areata because it is a specific IgE blocking antibody and there is no role for these IgE antibodies in alopecia areata. However, alopecia areata too has an immune mechanism of action and there might be an underlying immune link between omalizumab and alopecia areata which is not yet known.
Alopecia areata mostly arises de novo without any underlying cause.
Regarding treatment of alopecia areata, minoxidil and injectable as well as oral steroids are common practice and the choice of treatment depends on the severity/extent of involvement with bald patches. Fortnightly intralesional injections of steroids alone may be effective in a localised patch of alopecia areata, however, it can also be combined with topical minoxidil solution as well. On the other hand oral steroids (zempred) are usually reserved for expanding patches Or new patches Or extensive involvement.
Response to treatment is usually evident after a few weeks of treatment i.e on an average of 4-6 weeks.
Therefore as far as treatment of alopecia areata is concerned, minoxidil is safe for you, though I would suggest plain minoxidil solution (morr 5% or morr 3%) rather than monoxidil with finasteride combination, because finasteride has no role in alopecia areata. Finasteride is not for females.
Minoxidil is to be used only the affected area, twice daily and it is safe for women.
Levamisole and keraboost too, are fine and can be continued..

Regards
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Kakkar

Dermatologist

Practicing since :2002

Answered : 9612 Questions

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Does Xolair Cause Severe Hair Loss While Treating Eczema And Rhinitis?

Brief Answer: Alopecia areata has an underlying immune mechanism Detailed Answer: Hello. Thank you for writing to us I have gone through your query and I have noted your concern. Omalizumab is an anti-IgE therapy i.e it has an immune mechanism of action. Although, at first instance, it does not seem to me that this drug would be the cause of alopecia areata because it is a specific IgE blocking antibody and there is no role for these IgE antibodies in alopecia areata. However, alopecia areata too has an immune mechanism of action and there might be an underlying immune link between omalizumab and alopecia areata which is not yet known. Alopecia areata mostly arises de novo without any underlying cause. Regarding treatment of alopecia areata, minoxidil and injectable as well as oral steroids are common practice and the choice of treatment depends on the severity/extent of involvement with bald patches. Fortnightly intralesional injections of steroids alone may be effective in a localised patch of alopecia areata, however, it can also be combined with topical minoxidil solution as well. On the other hand oral steroids (zempred) are usually reserved for expanding patches Or new patches Or extensive involvement. Response to treatment is usually evident after a few weeks of treatment i.e on an average of 4-6 weeks. Therefore as far as treatment of alopecia areata is concerned, minoxidil is safe for you, though I would suggest plain minoxidil solution (morr 5% or morr 3%) rather than monoxidil with finasteride combination, because finasteride has no role in alopecia areata. Finasteride is not for females. Minoxidil is to be used only the affected area, twice daily and it is safe for women. Levamisole and keraboost too, are fine and can be continued.. Regards