Does lisinopril cause hair loss?

In this article:

• Can lisinopril cause hair loss?
• Is hair loss from lisinopril reversible?
• How to stop hair loss from lisinopril
• The bottom line

In this article

• Can lisinopril cause hair loss?
• Is hair loss from lisinopril reversible?
• How to stop hair loss from lisinopril
• The bottom line

The heart pumps 5–6 liters of blood per minute. That’s 7,200–8,640 liters per day. The whole time, that blood flow pushes on the artery walls, creating blood pressure. High blood pressure (hypertension) can put a constant strain on your cardiovascular system, but medications like lisinopril can help. This ACE inhibitor drug works to relax the blood vessels, reducing the pressure necessary for blood to flow.

However, it may also cause side effects, including hair loss. It doesn’t happen to everyone, but it’s possible—read on for the important details.

Can lisinopril cause hair loss?

​​According to the prescribing information for Zestril—a brand name for lisinopril—alopecia (hair loss) is one of the drug’s side effects. Additionally, certain case studies have found lisinopril to cause the patients’ hair loss, which reverses after they discontinue the drug.

Fortunately, lisinopril-induced hair loss is a fairly rare side effect, appearing in less than 1% of patients during clinical trials reported on the prescribing info. “If it does happen, then it is most commonly associated with the impact of the drug in the body of aldosterone, which itself regulates hair growth,” says Dr. Shahinaz Soliman, MD, founder of Shantique Medspa. ACE inhibitors block the body’s angiotensin-converting enzyme, which produces angiotensin II, a substance that narrows blood vessels. In some cases, this may also cause the hair to thin. 

While these instances are rare, certain factors might increase someone’s risk of hair loss. Some of the most common include genetics, hormonal changes (like pregnancy or menopause), stress, nutrient deficiencies, weight loss or gain, or harsh hair products. Some of these are unavoidable, but of the ones you can control, avoiding them during lisinopril treatment may reduce your risk of hair loss.

Drug-induced hair loss isn’t limited to ACE inhibitors either. Other antihypertensive medications—specifically calcium channel blockers, some diuretics, or beta blockers like metoprolol, atenolol, and propranolol—have been linked to temporary hair loss. Other types of drugs that may cause hair loss include:

• Chemotherapy drugs
• Some anticoagulants (blood thinners like warfarin or captopril)
• Some antidepressants (like paroxetine or fluoxetine)
• Certain contraceptives (birth control pills)
• Some cholesterol medications
• Hormone replacement therapy
• Some anticonvulsants
• Some retinoids

Is hair loss from lisinopril reversible?

If you start noticing some extra hair on your pillow or circling the drain, don’t panic. “Lisinopril-induced hair loss is generally mild and may subside as soon as the drug is discontinued,” Dr. Soliman says.

Dr. Viktoryia Kazlovskaya, MD, Ph.D., board-certified dermatologist and owner of Dermatology Circle PLLC, adds: “To be certain that a medication caused the hair loss, other possible causes should be ruled out, and hair loss should improve once the medication is discontinued.”

This type of hair loss is called telogen effluvium, a condition that increases the amount of hair you shed. In most cases, telogen effluvium is a response to a stressor or change in the body, like childbirth, severe infections, major surgery, crash diets, or new medications. It usually only affects hairs in the telogen phase (resting) instead of the anagen phase (growing). An estimated 85% of the hairs on the head are in the anagen phase, so it shouldn’t cause complete baldness.

Typically, people first notice this hair loss 2–3 months after the event that triggered it. After that, the Journal of Clinical & Diagnostic Research says it takes 3–6 months to stop, and hair regrowth will start 3–6 months after removing the initial cause. Of course, this timeline can vary based on the person, the inciting event, and more.

Telogen effluvium isn’t the only cause of hair loss, and other, more permanent types might look very similar. For example, male pattern baldness, female pattern baldness, and thyroid issues are other causes that are less temporary but still not impossible to treat.

New hair regrowth may start after discontinuing or switching the medication for lisinopril-induced telogen effluvium. Yet that doesn’t mean anyone should just stop taking lisinopril if they start losing hair. “Patients should never discontinue or modify the use of their medicine without interaction with the prescribing doctor,” Dr. Soliman says. 

Dr. Kazlovskaya agrees. “I strongly advise against discontinuing a medication without a doctor’s guidance,” she says. “Some drugs, like lisinopril, are prescribed for life-threatening conditions, and abrupt termination could pose significant risks.”

How to stop hair loss from lisinopril

Sudden hair loss can be alarming, but it doesn’t have to be discouraging. Just knowing that telogen effluvium is often temporary may provide some solace, but you can also take certain steps to slow, prevent, or reverse that hair loss. Here are several of the most effective.

• Ask about alternatives: As we’ve mentioned, some blood pressure medications can cause hair loss while others won’t. “If there is a serious concern that hair loss may be related to a medication, it is wise to consult a physician about switching to an alternative,” Dr. Kazlovskaya says. Some antihypertensives, like minoxidil and spironolactone, may even have the opposite effect, as studies show that they can stimulate hair growth. Ask your doctor for alternatives that will work for you.
• Adjust your dose: In some cases, dosage could be the primary issue. If a patient experiences side effects like hair loss, their healthcare provider might suggest reducing the lisinopril dose. However, it is important to seek approval from a medical provider before doing so. 
• Take vitamin supplements: Since hair loss can often stem from certain nutritional deficiencies, make sure you’re getting enough protein, vitamins, and minerals in your diet. If not, supplements might help. Vitamin A, B, C, D, E, iron, selenium, and zinc are especially important for healthy hair.
• See a dermatologist: “If hair shedding is severe, a dermatologist should be consulted to screen for other causes of hair loss and, at times, a different antihypertensive medication may be advised,” Dr. Soliman says. Hair follicles are part of the skin, so dermatologists are well-versed in how to treat them. They can provide medical advice on how to keep your scalp, follicles, and hair healthy.
• Try hair loss medications: You can find over-the-counter hair growth products like Rogaine at most major pharmacies or ask your healthcare provider about a prescription drug like Propecia (finasteride). Always consult a healthcare provider before starting a new medication, though, especially if you’re already taking lisinopril.
• Manage stress: Stress affects all of us, and it’s not always something you can just shrug off. Research has shown that chronic stress might contribute to hair loss. So, if you’re dealing with stressful circumstances, meditation, exercise, and mental health therapy might help.
• Be nice to your hair: “Maintaining a healthy diet and practicing gentle hair care may help slow down hair loss,” Dr. Kozlovskaya says. Additionally, some haircare products and styling (curling, straightening, coloring, etc.) can damage or weaken your hair, making it more susceptible to thinning. Try using a gentler shampoo/conditioner and avoiding harsh treatments or excessive sun exposure.
• Try ketoconazole shampoo: This is primarily used as an antifungal treatment, but a study on female pattern hair loss demonstrated an ability to promote hair regrowth.

These methods aren’t universal solutions, so they might not be ideal for everyone, but for certain people, they might help maintain healthy hair and stave off hair loss.

The bottom line

Hair loss might not be a common side effect of lisinopril and other blood pressure meds, but it’s still possible. The good news is that medication-induced hair loss is typically temporary, and there are many potential solutions. Anyone taking lisinopril who notices shedding should talk to a healthcare provider. They can get to the root of the issue, recommend alternative types of medication, and recommend ways to slow or reverse hair loss.