Methotrexate and hair loss: Hi. I was just diagnosed... - NRAS


34,726 members43,169 posts

Methotrexate and hair loss

Murphie profile image
25 Replies

Hi. I was just diagnosed with seronegative RA in November. It attacks my chest wall/very painful and high fever. I went through several types of doctors before finally getting referred to rhemutologist and being diagnosed. I lived on prednisone for months before being put on methotrexate. I have been on this drug for about 8 weeks and have had no more RA problems.

My question is about my hair? I do take 1 mg. folic acid every morning(expect on the day I take the methotrexate). I wash my hair every other night and when I comb it out, I notice more shedding than normal. How many of you out there have taken this drug for a long time...years etc. and have just noticed thinner hair? I can handle thinner hair(although mine isn't very thick to begin with) but I just cannot go bald! Would love to hear some input about how long on methotrexate, hair issues, what helped the hair loss while staying on methotrexate. etc, I really hate to change medications as this one seems to stop the pain. But if I am going to go bald, I will have to. I would welcome any advice.

Thank you,


25 Replies

My hair has got so much thinner this year and always had really full hair and seeing such a loss on mm scalp a few weeks ago was a moment I almost cried. My niece a hairdresser and someone on here said take biotin 10,000mg I got mine on amazon. So on week 2 but been told need a month to see a change. I used to wash hair every day and now every 2 days and I rub coconut oil in scalp to help promote a good scalp too.

Natasha1976 profile image

Hello Murphie I have been taking methotrexate for 2 to 3 years I'm taking 20 mg a week and also on folic apart from metho day unfortunately I haven't found anything to ease the hair loss and I have very long hair it clogs the hoover up so much it gets a haircut I just put up with the hair loss as I have just been moved onto biologics and the methotrexate as my rhumy wasn't responding maybe you could get some advice from a hairdresser when you can stay safe.

helixhelix profile image

My hair thinned when I started MTX, but it settled down and is now same as ever.

Neonkittie17 profile image
Neonkittie17 in reply to helixhelix

Yes same here, it settled after about 18 months. x

When I started initially I lost a lot of hair and it got thinner . No bald patches thank goodness. I took high strength biotin which helped a little. I also have dry skin. I visited a beautician who told me to take collagen as it might help my skin. I started taking marine collagen powder with my biotin and 6 weeks later my skin was better but it was my hair that improved the most much less fall out hair thicker and softer over a year later still taking both and my hair is great .

springcross profile image

Hi Murphie. I lost loads when my MTX was upped from 15 mg (injection) to 20 mg and I didn't exactly have thick hair before either. I had (and still have a few) bald patches and was so upset to see what I was losing, it was so embarrassing too and I didn't want to go out anywhere. My MTX was reduced back down to 15 mg and I was put on another med too but stopped that after a while. I started taking Biotin as J1707 had said that it helped her but I take 5000 ug and also started the marine collagen powder which I used to put in my tea in the morning. It has helped but so has the reduction in MTX. I hope you can get it sorted as I found it quite depressing.

oldtimer profile image

After any severe illness hair loss can occur because the hair follicles stop growing and the hair then falls out about 8-12 weeks later. So your hair loss currently is a reflection of what happened back then and not what will happen in the future. Some people do find that methotrexate is associated with thinning hair, but this may happen with other drugs also. It may also be a reflection of how active the disease is rather than a side effect. Some people have reported that taking folic acid daily except on the day of taking the methotrexate helps.

There's some advice here:

And if you put hair loss into the search box (top right) you will find lots of previous posts.

Murphie profile image
Murphie in reply to oldtimer

Thank you. I will try that🙂

Ali_H profile image

It might be worth asking to raise your folic acid as I take 5mg twice a week which amounts to more than your current 1mg 6X in a week.All the best


Downtime profile image

Hi Murphie, my hair thinned quite a bit when I started Mxt and it’s pretty miserable. I used to sweat at night a lot then and I looked like a frizzy mess when I got up! Gradually it’s improved probably due to my folic acid being upped to 5mg taken 3 times a week. Due to mouth sores I now take it for 3 days running after my Mxt and it’s improved matters. My hair has been much better for quite a while. I’ve now started Leflunomide as well so I’m just crossing fingers it doesn’t happen again as I know it can on this drug.

I’m currently on 10mg MTX and 5mg folic acid once a week and I end up clearing what my OH calls a small hamster every once in a while from the drain outside due to what I’ve lost in the shower. Luckily I’ve fairly thick hair so don’t really notice it overall but I definitely lose more than I used to.

Angjoplin profile image

I've never had thick hair and now its very thin. Been on mtx for years and my hairs definitely got thinner. Never got any bald spots though.I use a boar bristle hair brush, meant to be better for your hair. I swear by tresemme collagen fullness balm. Helps stop the frizz. I also try to only wash it every 3 days if I can get away with it.

Recently I took the plunge and had it cut short. Its actually improved my confidence, wish I'd have done it earlier.

BigJazza profile image

I also lose hair on MTX 15 mg/week but no bald patches after 9 months so don't worry too much about it. Biotin may also be helping me but no clear evidence that it does.

Tree57 profile image

Hi Murphie, I have been on methotrexate injections from July 2020 (20mg) - previously on tablets for about a year but they changed me to injections. I noticed a lot of hair around on the floor and in the shower and my hairdresser confirmed it (this was sept/oct) I went to see a trichologist and she diagnosed me with chronic telogen effluvium, where some of your hairs shed at an increased rate. She wrote to my GP for tests including iron and vit B. The tests came back normal for general health but she said my iron and Vit B12 levels were too low for hair health. I take 5mg folic acid daily apart from injection day. I am also a veggie so have upped foods containing iron and eat more protein and take supplements now for iron and B vitamins. A friend had already told me about marine collagen so I take that daily too. I suppose its a bit too early to tell if any of it's working but its not getting worse. I spoke to the RA consultant and she said it would grow back in 4 months anyway even if I stayed on methotrexate (which I don't want to stop) I think the most reassuring thing the trichologist said was "you are not going to lose all your hair" which immediately put my mind at rest. Hope that helps.

CagneysMum profile image

I had the same issue when I started methotrexate 3 years ago and my rheumatologist suggested trying biotin as other patients had reported good results. I took daily for 18 months until I felt confident that my hair loss had ceased, and then stopped taking biotin to see what would happen. Hair is still stable, normal hair loss (although interestingly it can be more when I’m having a flare up) and my hairdresser has commented on how well it has grown back and thickening up.

Allije profile image

My RA consultant immediately stopped the Methotrexate when I told him about the hair loss. When tablets became available I tried them too but again serious hair loss. There are plenty other options available. Methotrexate is drug of choice for many Health Professionals and the cynic in me would say it's because of cost. Hope you are offered something else soon. Life is generally a bit depressing at the moment for us all without RA and associated illness AND hairloss.

Murphie profile image
Murphie in reply to Allije

Yes you are right. RA is e nough without hairloss! I am also a type 2 diabetic for the last 6 years and today I found out my pressure in my eye is high so I'm going to see a glaucoma specialist. I have had enough. I do plan to ask my rhuematologist about taking something new without the hair loss issue being a side effect.Thanks for responding

in reply to Murphie

I would advise being wary of switching from MTX if it is working well on the RA. It is the gold standard treatment and has been around for a long time, so a lot is known about it. Yes, there are other drugs, but their side-effects can be much worse than hair loss (e.g. recurrent chest infections). If the MTX is working well, you may be able to reduce the dose in future and that should help the hair loss. Also, you could try taking Vitamin B12 or Biotin as people suggest, or taking more folic acid. Honestly, if MTX works well for your RA you are very fortunate. I hope you can work something out with your consultant.

Angels54 profile image

Hi I had same problem, couldn’t bel bald patches I thought about getting a wig , and then had to stop it , it’s better than it was , I did buy lots of hair thickener and oils but it didn’t work. Good luck

Murphie profile image

Thank you all for the replies. I appreciate them so much. This is all very new to me. I plan to go ahead and ask my rheumatologist about trying something new. I just have enough on my plate right now without hairloss. I'm 48 and have also been a type 2 diabetic for the last 6 years and pressure in my eyes is high probably due to all the steroids to control my pain since July. I just cannot handle anything else right now.😟

bubblyalex profile image

My hair started coming out when I shifted from 15mg tablets to 25mg injection ... my rheumy reduced my dose to 15mg injection and started me on a different med Amgevita... the MXT wasn’t helping me sadly. My hair isn’t growing back... it has all stopped growing. I was only on the increased dose for a couple of months I think. I was told was my hair would grow back when I stopped the meds... loosing it hair was just a step too far for me.

Lyneal profile image

Hi there, I had hair loss with Methotrexate, I was told by my RA nurse that I wouldn’t got bald, but hair would go thinner in some people. It did stop eventually. So don’t worry you won’t go bald.

bubblyalex profile image
bubblyalex in reply to Lyneal

I have read some have obvious bald patches and my hair line is practically bald... and my hair isn’t growing back. I have no armpit hair and leg hair at all.

Lyneal profile image

I would talk to your RA nurse about that. I have started shaving my legs again now that I have been off Methotrexate.

lily2003 profile image

I started at 7.5 mg MTX with 1 mg folic acid (FA) daily (even MTX day) 17 months ago. The MTX was gradually raised to 15 mg since this past spring. I had noticed more hair in my hands in the shower, though I have thick hair and didn't notice it missing when dry.

Still, my rheumy upped my FA to 3 mg daily, which I've done since spring also. Plus I decided to switch my practice of daily shampooing to every other day. Then I went to every two days and now I'm around every 5 days. I still shower and "wash" my hair with water and put on a touch of conditioner. In the past few months, it seems I don't have nearly as many strands of hair in my hands in the shower.

Upshot for me: more daily FA, less shampoo, more time I've been on MTX. All three help, I'm guessing.

You may also like...