Can prednisone cause hair loss? It is a question many patients ask when starting a course of corticosteroids. In UK clinical practice, prednisolone is the standard oral corticosteroid, with prednisone used less commonly — both share the same active mechanism and side-effect profile. Whilst hair loss is not listed as a common side effect in UK prescribing references such as the BNF or product SmPCs, some patients do report thinning or shedding during or after treatment. Crucially, the underlying condition being treated may itself be the primary cause of hair changes, making careful clinical assessment essential.

Can Prednisolone or Prednisone Cause Hair Loss?

Hair loss is not a commonly documented side effect of prednisolone in UK prescribing references, and where alopecia is noted in SmPCs its frequency is listed as 'unknown'; the underlying condition being treated is often the more likely cause.

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In the UK, prednisolone is the standard oral corticosteroid prescribed for a broad range of conditions, including inflammatory disorders, autoimmune diseases, asthma, and certain cancers. Prednisone — which is converted to prednisolone in the body — is used less commonly in UK clinical practice. The information in this article applies to both medicines, as they share the same active mechanism and side-effect profile.

Systemic corticosteroids work by suppressing the immune system and reducing inflammation throughout the body.^[1][3] Whilst they are effective and often essential medicines, patients and healthcare professionals sometimes ask whether they can cause hair loss.

Hair loss is not listed as a common side effect of prednisolone in UK prescribing information, including the Summary of Product Characteristics (SmPC) available via the electronic Medicines Compendium (emc) or the British National Formulary (BNF). Where alopecia is mentioned in SmPCs for corticosteroid preparations, its frequency is typically recorded as 'unknown' or not specified. However, some patients do report changes in hair texture, thinning, or shedding during or after a course of treatment.

Importantly, in many cases the underlying condition being treated — rather than the medication itself — may be the primary driver of hair changes. Understanding this distinction is essential for appropriate management and reassurance.

If you believe prednisolone or prednisone may be causing a side effect, you can report this to the Medicines and Healthcare products Regulatory Agency (MHRA) via the Yellow Card scheme at yellowcard.mhra.gov.uk or through the Yellow Card app.

How Corticosteroids May Affect Hair Growth

Corticosteroids bind to glucocorticoid receptors in hair follicle cells and may shift follicles into the resting (telogen) phase, but evidence directly linking systemic prednisolone to telogen effluvium in humans is limited and should be interpreted cautiously.

To understand how prednisolone might influence hair, it helps to consider the normal hair growth cycle. Hair follicles cycle through three phases:

• Anagen – the active growth phase

• Catagen – a transitional phase

• Telogen – the resting and shedding phase

Corticosteroids such as prednisolone bind to glucocorticoid receptors found throughout the body, including in hair follicle cells. There is some evidence that high levels of glucocorticoids — whether produced naturally by the body (as in Cushing's syndrome) or taken as prescribed medicines — may influence hair follicle cycling.^[2] However, it is important to note that the evidence directly linking systemic corticosteroid use to telogen effluvium (diffuse hair shedding) in humans is limited, and mechanistic claims should be interpreted cautiously.

Telogen effluvium is a well-recognised condition in which a physiological or psychological stressor causes hair follicles to shift prematurely into the resting phase, resulting in diffuse shedding typically noticed two to three months after the triggering event. The physical and psychological stress of serious illness — for which prednisolone is often prescribed — is itself a well-established trigger for telogen effluvium, according to British Association of Dermatologists (BAD) guidance. Disentangling the contribution of the medication from that of the underlying condition can therefore be clinically challenging.

It has previously been suggested that long-term corticosteroid use might elevate androgen levels and contribute to pattern hair loss (androgenetic alopecia). However, this claim is not well supported for exogenous corticosteroids: systemic prednisolone typically suppresses the hypothalamic-pituitary-adrenal (HPA) axis, which tends to reduce rather than increase adrenal androgen production.^[1][3] There is currently insufficient evidence to link prescribed corticosteroids to androgenetic alopecia, and patients should not be concerned about this on the basis of current data.

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How Common Is Hair Loss With Prednisolone?

Hair loss is not classified as a common adverse effect of prednisolone; it appears more likely with higher doses or prolonged use, and most cases resolve naturally once treatment ends, consistent with self-limiting telogen effluvium.

Hair loss is not classified as a common adverse effect of prednisolone in UK prescribing references, including the BNF and emc SmPCs. The more frequently documented side effects of systemic corticosteroids include weight gain, raised blood glucose, mood changes, osteoporosis with long-term use, and skin thinning.^[1][3]

Where hair loss is reported by patients taking prednisolone, it appears more likely to occur with higher doses or prolonged courses of treatment, or during tapering after long-term use, when hormonal fluctuations may temporarily affect the hair cycle. No specific dose threshold can be cited as a reliable cut-off, as the relationship varies by indication, individual factors, and duration of treatment.

There is currently no robust UK epidemiological data quantifying the precise incidence of corticosteroid-associated hair loss. Much of the available evidence is anecdotal or derived from case reports. Clinicians should therefore approach this topic with nuance — acknowledging patient concerns without overstating the causal link.

In many reported cases, hair regrowth occurs naturally once the course of prednisolone is completed or the dose is reduced, consistent with the self-limiting nature of telogen effluvium, which typically resolves within six to twelve months of the triggering event resolving, as described in BAD patient information on telogen effluvium.

Managing Hair Loss During Prednisolone Treatment

Gentle hair care, nutritional support, and using the lowest effective prednisolone dose for the shortest necessary duration are the key management strategies; never stop prednisolone abruptly without medical supervision.

If you notice hair thinning or increased shedding whilst taking prednisolone, there are several practical steps that may help minimise the impact and support hair health during treatment.

General hair care advice:

• Use a gentle shampoo and avoid excessive heat styling

• Avoid tight hairstyles that place mechanical stress on the hair shaft

• Handle hair gently when wet, as it is more vulnerable to breakage

Nutritional support: Ensure adequate intake of nutrients known to support hair health, including iron, zinc, and protein. Corticosteroids can affect appetite and metabolism, so a balanced diet is particularly important. If nutritional deficiency is suspected, your GP can arrange blood tests to assess levels and treat any confirmed deficiency appropriately. Routine supplementation with biotin (vitamin B7) is not recommended unless a deficiency has been confirmed, as there is limited evidence to support its use in non-deficient individuals. Additionally, the MHRA has issued a Drug Safety Update warning that high-dose biotin supplements can interfere with a range of laboratory blood tests, potentially causing misleading results.

Dose optimisation: Where clinically appropriate, your prescribing doctor may consider using the lowest effective dose of prednisolone for the shortest necessary duration. This principle is reflected in BNF and NHS guidance on systemic corticosteroid use, which emphasises minimising systemic exposure to reduce adverse effects.

It is important not to stop prednisolone abruptly without medical supervision. Sudden discontinuation can cause adrenal insufficiency — a potentially serious condition — particularly after prolonged use.^[1][3] Any adjustments to your corticosteroid regimen must be made in consultation with your GP or specialist. Hair loss related to prednisolone is generally considered reversible, and most patients see improvement once treatment concludes or the dose is reduced.

When to Speak to Your GP or Specialist

Seek GP advice if hair loss is sudden, patchy, accompanied by scalp changes, causing significant distress, or persists after completing prednisolone; a dermatology referral may be arranged if the cause remains unclear.

Whilst some degree of hair shedding during or after prednisolone treatment may be self-limiting, there are circumstances in which it is important to seek medical advice.

Contact your GP or specialist if you experience:

• Sudden or severe hair loss, including loss in patches (which may suggest alopecia areata or another specific cause)

• Hair loss accompanied by scalp redness, scaling, or pain

• Significant hair thinning that is causing distress or affecting quality of life

• Hair loss that persists or worsens after completing your course of prednisolone

• Any new or worsening symptoms that may indicate a flare of your underlying condition

Seek urgent medical attention if, after reducing or missing doses of prednisolone, you develop symptoms that may suggest adrenal insufficiency, such as severe fatigue, dizziness, nausea, or vomiting.

Your GP may arrange initial blood tests to help identify the cause of hair loss before attributing it to medication alone. These typically include a full blood count (FBC), ferritin, thyroid function tests (TSH), and may include vitamin B12 and vitamin D levels, depending on your clinical history.

Your GP may refer you to a dermatologist for specialist assessment if the cause of hair loss is unclear or if it does not resolve. A dermatologist can perform a thorough scalp examination, trichoscopy, or scalp biopsy if indicated, and can distinguish between different types of alopecia. NICE clinical knowledge summaries provide guidance on the assessment and referral of patients with alopecia in UK primary care.

It is also worth discussing with your prescribing clinician whether your current dose and duration of prednisolone remain appropriate. In some cases, alternative immunosuppressant or anti-inflammatory agents may be considered as steroid-sparing options, in line with condition-specific NICE clinical guidelines. Open communication with your healthcare team is key to balancing effective disease management with minimising unwanted side effects.

Other Medications and Conditions That Affect Hair Loss

Many conditions treated with prednisolone — such as lupus and thyroid disorders — cause hair loss independently, and other prescribed medicines including methotrexate, beta-blockers, and anticoagulants are also recognised causes.

When evaluating hair loss in a patient taking prednisolone, it is essential to consider the broader clinical picture. Many of the conditions for which prednisolone is prescribed — such as lupus, rheumatoid arthritis, inflammatory bowel disease, and thyroid disorders — are themselves associated with hair loss as a disease manifestation. In these cases, effective treatment of the underlying condition may actually help to stabilise or improve hair loss over time.

Other commonly prescribed medications associated with hair loss include (this list is not exhaustive):

• Methotrexate – used in rheumatoid arthritis and psoriasis

• Hydroxychloroquine – used in lupus (though it may also help preserve hair in this condition)

• Beta-blockers – used for cardiovascular conditions

• Anticoagulants such as heparin or warfarin

• Antithyroid medications such as carbimazole

• Retinoids – used in dermatological conditions

• Sodium valproate – used in epilepsy and mood disorders

• Some antidepressants, including certain SSRIs

If you are concerned that any prescribed medicine may be contributing to hair loss, speak to your GP or pharmacist before making any changes. Do not stop any prescribed medicine without first consulting your clinician, as this may have serious consequences for your health.

Hormonal factors also play a significant role in hair loss. Thyroid dysfunction, polycystic ovary syndrome (PCOS), iron deficiency anaemia, and significant psychological stress are all well-established causes of telogen effluvium and should be excluded through appropriate blood tests before attributing hair loss solely to prednisolone.

In summary, whilst hair loss is not a commonly documented side effect of prednisolone in UK prescribing references, a possible contribution — particularly with higher doses or prolonged use — should not be dismissed without proper assessment. A holistic evaluation by a qualified healthcare professional remains the most reliable way to identify the cause and guide appropriate management. Suspected side effects from any medicine can be reported to the MHRA via the Yellow Card scheme at yellowcard.mhra.gov.uk.

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