Management of DR-TB ADR: Alopecia

Alopecia is a rare, minor Adverse Drug Reaction (ADR) that is observed in patients on regimens with Isoniazid (H) and Ethionamide (Eto). It presents with patchy hair loss, mostly from the scalp. It can be easily identified by field-level health care workers and is often reported by patients on their own.

Figure: Patchy Hair Loss from Scalp (Alopecia)

Suspected agent(s): Isoniazid (H), Ethionamide (Eto)

Suggested Management Strategies

• Hair loss can occur or there can be significant thinning of the hair, but this is temporary and not progressive during treatment.
• Encourage patients to tolerate this side effect.

Points to Note 

• Significant cosmetic change has not been reported.

Resources

• Guidelines for Programmatic Management of Drug-resistant Tuberculosis in India, March 2021.
• Ready Reckoner for Medical Officer - Adverse Drug Reactions Associated with Anti-TB Drugs Identification and Management, 2019.​

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