Does Skyrizi cause hair loss? This is a question raised by some patients starting risankizumab for plaque psoriasis, psoriatic arthritis, or Crohn's disease. Based on current UK regulatory documentation — including the MHRA-approved Summary of Product Characteristics and the EMA European Public Assessment Report — alopecia is not listed as a recognised adverse reaction to Skyrizi. However, the underlying conditions treated by Skyrizi can themselves cause hair thinning and shedding, making it important to investigate any hair changes thoroughly rather than attributing them automatically to the medication.
Summary: Does Skyrizi cause hair loss? Based on current UK regulatory documentation, hair loss is not a recognised adverse reaction to Skyrizi (risankizumab), though underlying conditions it treats can themselves cause hair thinning.
- Alopecia is not listed in the UK Summary of Product Characteristics (SmPC) or EMA EPAR for Skyrizi (risankizumab).
- Skyrizi works by selectively inhibiting interleukin-23 (IL-23) via its p19 subunit; there is no established evidence this mechanism disrupts the hair growth cycle.
- Scalp psoriasis, psoriatic alopecia, and nutritional deficiencies associated with Crohn's disease are recognised causes of hair loss that may coincide with Skyrizi use.
- The most commonly reported side effects in clinical trials were upper respiratory tract infections, headache, fatigue, and injection-site reactions.
- Unexpected side effects, including hair loss, should be reported via the MHRA Yellow Card scheme and discussed with your prescribing clinician.
- Patients should never stop a prescribed biologic without specialist guidance, as abrupt discontinuation may trigger a disease flare.
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Hair Loss as a Reported Side Effect of Skyrizi
Hair loss is not listed as a recognised adverse reaction in the UK SmPC or EMA EPAR for Skyrizi; underlying conditions such as scalp psoriasis or Crohn's-related nutritional deficiencies are more likely causes of hair changes.
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Skyrizi (risankizumab) is a biological therapy approved in the UK by the Medicines and Healthcare products Regulatory Agency (MHRA) and the European Medicines Agency (EMA). It is indicated for the treatment of moderate-to-severe plaque psoriasis, psoriatic arthritis, and Crohn's disease in adults.
Alopecia (hair loss) is not listed as a recognised adverse reaction in the UK Summary of Product Characteristics (SmPC) for Skyrizi, nor in the EMA European Public Assessment Report (EPAR). Based on current regulatory documentation, there is no established link between risankizumab and hair loss.
It is important to consider that the underlying conditions for which Skyrizi is prescribed can themselves contribute to hair changes. Scalp psoriasis and psoriatic alopecia are well-recognised causes of hair thinning and shedding. In people with Crohn's disease, nutritional deficiencies — including low iron, vitamin B12, vitamin D, or zinc — as well as active inflammation and unintentional weight loss, can also cause or worsen hair loss. Distinguishing between disease-related hair changes and any potential medication effect can therefore be clinically challenging.
If you notice hair thinning or shedding after starting Skyrizi, discuss this with your prescribing clinician rather than assuming a direct causal relationship. Further investigation is usually needed to identify the underlying cause.
| Side Effect | Frequency | Severity | Management |
|---|---|---|---|
| Hair loss (alopecia) | Not listed in UK SmPC; no established causal link | Not applicable — investigate underlying cause | Discuss with prescribing clinician; investigate thyroid, iron, vitamin deficiencies, telogen effluvium |
| Upper respiratory tract infections | Very common (>1 in 10) | Usually mild | Symptomatic management; inform specialist if severe or persistent |
| Headache, fatigue | Common (up to 1 in 10) | Mild to moderate | Symptomatic relief; review with specialist if ongoing |
| Injection-site reactions | Common (up to 1 in 10) | Mild to moderate | Monitor site; contact specialist if severe, spreading, or not resolving |
| Serious hypersensitivity / anaphylaxis | Uncommon but reported with biologics | Severe | Call 999 or attend A&E immediately if facial swelling, breathing difficulty, or rapid heartbeat |
| Infections (including serious) | Not significantly increased vs placebo in trials (EMA EPAR) | Potentially severe | Screen for latent TB before starting; avoid live vaccines; seek prompt review if signs of infection |
| Tinea infections / folliculitis | Common (up to 1 in 10) | Mild to moderate | Report to GP or specialist; standard antifungal or antibiotic treatment as appropriate |
What the Clinical Trial Data Shows
Across large-scale clinical trials including UltIMMa-1 and UltIMMa-2, hair loss was not identified as a frequently reported or clinically significant adverse event in risankizumab treatment arms compared to placebo.
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Risankizumab has been evaluated in several large-scale, randomised controlled trials, including the UltIMMa-1, UltIMMa-2, IMMhance, and IMMvent studies for plaque psoriasis, as well as dedicated trials for psoriatic arthritis and Crohn's disease. These trials involved thousands of participants and assessed both efficacy and safety over extended periods. Safety findings are summarised in the EMA EPAR and the UK SmPC.
Across these clinical programmes, hair loss was not identified as a frequently reported or clinically significant adverse event in the risankizumab treatment arms compared to placebo. The most commonly reported side effects in trial data — as reflected in the UK SmPC — included upper respiratory tract infections, headache, fatigue, and injection-site reactions.
The mechanism of action of Skyrizi involves selective inhibition of interleukin-23 (IL-23) by targeting its p19 subunit. IL-23 drives inflammatory pathways, particularly those involving T-helper 17 (Th17) cells. There is no established evidence that IL-23 inhibition directly disrupts the hair growth cycle (the anagen, catagen, and telogen phases), which is consistent with the absence of drug-induced alopecia in clinical trial data.
Post-marketing surveillance continues to collect real-world safety data on all licensed medicines. Patients and clinicians are encouraged to report any unexpected side effects through the MHRA Yellow Card scheme (yellowcard.mhra.gov.uk), regardless of whether a causal link has been confirmed. This voluntary reporting system helps regulators monitor the real-world safety of all medicines.
Other Common and Serious Side Effects to Be Aware Of
The most common side effect of Skyrizi is upper respiratory tract infection; serious risks include hypersensitivity reactions, infections, and reactivation of latent TB, requiring screening before treatment begins.
Whilst hair loss does not appear to be a recognised concern with Skyrizi, patients should be aware of the full safety profile before and during treatment. The frequencies below are based on the UK SmPC.
Very common side effects (affecting more than 1 in 10 people):
- Upper respiratory tract infections (such as the common cold, sinusitis, and pharyngitis)
Common side effects (affecting up to 1 in 10 people):
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Headache
-
Fatigue
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Injection-site reactions (redness, swelling, or discomfort at the injection site)
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Pruritus (itching)
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Tinea infections (fungal skin infections)
-
Folliculitis
Important safety considerations:
-
Hypersensitivity reactions: Serious allergic reactions, including anaphylaxis, have been reported with biologic therapies. If you experience facial or throat swelling, difficulty breathing, a rapid heartbeat, or feel faint after an injection, call 999 or go to your nearest A&E immediately.
-
Infections: Because Skyrizi modulates the immune system, there is a theoretical risk of increased susceptibility to certain infections. Serious infections were not significantly more frequent in clinical trials compared to placebo (per the EMA EPAR), but patients with a history of recurrent or serious infections should be carefully assessed before starting treatment.
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Tuberculosis (TB): Screening for latent TB is required before initiating treatment. If latent TB is identified, it should be treated prior to starting Skyrizi, in line with the UK SmPC.
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Live vaccines: Live vaccines should not be administered during treatment with Skyrizi.
Dosing by indication: For plaque psoriasis, Skyrizi is given as a subcutaneous injection of 150 mg at weeks 0 and 4, then every 12 weeks thereafter. For Crohn's disease, the regimen differs: an intravenous induction phase (typically 600 mg at weeks 0, 4, and 8) is followed by subcutaneous maintenance doses (180 mg or 360 mg) every 8 weeks, as specified in the SmPC. Your specialist team will confirm the schedule appropriate for your condition.
Adherence to the prescribed schedule and regular monitoring appointments are important aspects of safe long-term use. Your specialist team will review your response and tolerability at regular intervals, in line with NICE guidance.
When to Speak to Your GP, Dermatologist, or Specialist Team
Report any new or worsening hair loss to your specialist, who will investigate causes such as thyroid dysfunction, iron deficiency, or telogen effluvium before attributing it to Skyrizi.
If you are taking Skyrizi and notice any new or worsening symptoms — including unexpected hair loss — raise these concerns with your healthcare team. Any change in your health during treatment warrants professional assessment to identify the cause and ensure your treatment plan remains appropriate.
Seek emergency care immediately (call 999 or go to A&E) if you experience:
-
Facial or throat swelling, difficulty breathing, or a rapid heartbeat — these may indicate a serious allergic reaction (anaphylaxis)
-
Signs of severe infection, such as high fever, rigors, or rapidly worsening symptoms
Contact your GP, dermatologist, or specialist team promptly if you experience:
-
Noticeable or progressive hair thinning or shedding
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Signs of infection, such as fever, persistent cough, or skin wounds that are slow to heal
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Worsening of your underlying skin condition or new skin changes
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Injection-site reactions that are severe, spreading, or not resolving
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Any symptoms that feel unusual or concern you, even if not listed in the patient information leaflet
For people being treated for Crohn's disease, your gastroenterology or IBD team should be your first point of contact for any treatment-related concerns.
For hair loss specifically, your clinician may investigate other potential causes, including thyroid dysfunction (TSH), iron deficiency (ferritin, full blood count), vitamin B12 or vitamin D deficiency, telogen effluvium (stress-related shedding), or alopecia areata — all of which are unrelated to Skyrizi but may coincide with its use. Blood tests and a thorough medical history will usually guide this assessment (see NICE CKS: Alopecia).
You should never stop taking a prescribed biologic without first consulting your specialist, as abrupt discontinuation may lead to disease flare.
Alternative Treatments If Side Effects Are a Concern
NICE-approved alternatives to Skyrizi for plaque psoriasis include other IL-23 inhibitors, IL-17 inhibitors, ustekinumab, TNF-alpha inhibitors, apremilast, and conventional systemic therapies; choice depends on diagnosis and individual circumstances.
If you have concerns about Skyrizi's side-effect profile — whether related to hair loss or other issues — discuss these openly with your dermatologist, gastroenterologist, or rheumatologist before making any decisions about your treatment. The most appropriate alternative will depend on your diagnosis, disease severity, previous treatment history, and individual health circumstances.
For moderate-to-severe plaque psoriasis, NICE-approved alternatives include:
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Other IL-23 inhibitors, such as guselkumab (Tremfya) and tildrakizumab (Ilumetri)
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IL-17 inhibitors, including secukinumab (Cosentyx) and ixekizumab (Taltz)
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IL-12/23 inhibitors, such as ustekinumab (Stelara)
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TNF-alpha inhibitors, including adalimumab (Humira) and etanercept (Enbrel)
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Apremilast (Otezla), an oral phosphodiesterase-4 (PDE4) inhibitor, available under specific NICE guidance as a non-biologic option
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Conventional systemic therapies, such as methotrexate, ciclosporin, and acitretin, for those who are not suitable candidates for biologics
For psoriatic arthritis and Crohn's disease, your specialist will consider the full range of licensed biologics and small-molecule therapies, including JAK inhibitors such as upadacitinib, available under specific NICE guidance. Note that IL-17 inhibitors are not used in Crohn's disease and may exacerbate inflammatory bowel disease; your specialist will take this into account when discussing options.
Some TNF-alpha inhibitors have been associated with reports of hair loss in post-marketing pharmacovigilance data; however, causality has not been definitively established, and these reports are based largely on case reports rather than controlled trial evidence. Switching between biologics should always be guided by your specialist team, taking into account both efficacy and tolerability, and with reference to the relevant NICE Technology Appraisals for your condition. The goal is to find a treatment that effectively controls your condition whilst maintaining the best possible quality of life.
Frequently Asked Questions
Can Skyrizi cause hair loss, or is something else to blame?
Skyrizi (risankizumab) is not recognised as a cause of hair loss in UK regulatory documentation, including the MHRA-approved SmPC and EMA EPAR. Hair thinning experienced during Skyrizi treatment is more likely related to the underlying condition — such as scalp psoriasis or nutritional deficiencies in Crohn's disease — or to an unrelated cause such as telogen effluvium or thyroid dysfunction.
How does Skyrizi work, and why wouldn't it affect hair growth?
Skyrizi works by selectively blocking interleukin-23 (IL-23) via its p19 subunit, dampening the inflammatory Th17 pathway responsible for conditions like psoriasis. There is no established evidence that IL-23 inhibition interferes with the hair growth cycle (anagen, catagen, and telogen phases), which is consistent with the absence of drug-induced alopecia in clinical trial data.
Does Skyrizi cause hair loss more or less often than other biologics for psoriasis?
Hair loss is not a recognised side effect of Skyrizi, whereas some TNF-alpha inhibitors such as adalimumab and etanercept have been associated with hair loss in post-marketing case reports, though causality has not been definitively established. If hair loss is a specific concern, discuss the relative safety profiles of available biologics with your dermatologist or specialist.
What blood tests should I ask for if I'm losing hair while on Skyrizi?
Your clinician will typically check thyroid function (TSH), ferritin and full blood count for iron deficiency, vitamin B12, and vitamin D levels, as deficiencies in these are common causes of hair shedding unrelated to Skyrizi. A thorough medical history will also help identify telogen effluvium or alopecia areata as possible explanations.
Should I stop taking Skyrizi if I notice my hair thinning?
No — you should never stop a prescribed biologic without first consulting your specialist, as abrupt discontinuation can trigger a disease flare. Instead, report the hair thinning to your prescribing clinician so they can investigate the cause and advise on whether any change to your treatment plan is needed.
How do I report a side effect I think might be linked to Skyrizi in the UK?
In the UK, you can report any suspected side effect — including unexpected hair loss — through the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk; you do not need to be certain of a causal link to submit a report. Your prescribing clinician or pharmacist can also submit a report on your behalf, and doing so helps regulators monitor the real-world safety of all medicines.
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