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Chemical
/ metal induced effluvium
As with drug induced telogen effluvium, the mechanism of chemical
induced alopecia has not been investigated in detail. Some of
the metals listed such as iron are actually beneficial to health
until they reach toxic levels. As with almost all causes of effluvium,
avoidance of the trigger factor permits gradual hair regrowth.
Chemical or metal induced effluvium is not permanent.
Among the industrial and pharmaceutical chemicals and metals
causing a reversible effluvium type of hair loss are;
- Monomeric/dimeric chloroprene - Produced during rubber
manufacturing
- Potassium thiocyanate - Used to treat hypertension
- Trimethadione - An anticonvlusant used to treat epilepsy
- Bismuth - Used in the metal industry and bismuth salts
are found in some antacids, antibacterials, and cosmetic formulations
where they impart pearlescence to lipstick, nail polish, and
eye shadow
- Lithium salts - Used in aluminum smelting and in drugs
for antidepressants, antimanic agents, and antipsychotics
- Iodine - Too much or too little iodine can profoundly
affect the thyroid gland and may promote hypothyroidism (too
little thyroid hormone production) or thyrotoxicosis (too much
thyroid hormone production) that leads to effluvium
- Iron - Too little or too much both cause effluvium.
See also Hemochromatosis
- Lead - Lead intoxication is most frequently observed
due to contamination of water supplies particularly in old European
houses where water may be supplied through lead pipes
- Gold - Gold salts can occasionally contaminate water
supplies
- Aluminum - Aluminum intoxication most is most frequently
observed due to contamination of water supplies with aluminum
sulfate
- Arsenic - A poison found in insecticides, rodent poisons,
fungicides, and wood preservatives
- Boric acid, Borates - Used in some mouth washes, laundry
washing powders, fireproofing, and pesticides
- Mercury - Mercury intoxication is most frequently observed
due to contamination of water supplies or consumption of contaminated
seafood. At least one journal article questions the effect of
mercury in amalgam on hair loss and another reports on hair
loss due to hair bleaches containing mercury.
- Selenium - Selenium preferentially replaces cysteine
which is fundamentally important to healthy hair follicle activity
and hair fiber production
- Chemicals in plants - Selenocystothione is a selenium
containing chemical naturally produced by lecythis plants
such as the coco de mono plant of South America. Leucaena
gluca plants contain mimosine and Abrus precatorius
yellow locoweed (milk vetch) plant seeds contain abrin, a fast
acting poison. Tubers of several lily family plants contain
colchicine
- Thallium salts - Used as rat poison and also in some
forms of heart treatment (cardiac perfusion). Has been found
as a contaminant in a Chinese herbal treatment on at least one
occasion.
- Ionizing radiation - X rays, gama rays, beta rays (potential)
- Zinc - Too much or too little zinc may cause effluvium.
Galvanised water pipes are a possible source of excess zinc
intake.
- Cytostatic drugs - Used in the treatment of cancer,
these chemicals have a nonspecific antiproliferative action
on cells. See also Drug
telogen effluvium
Chemical
/ metal induced effluvium references
- Feldman
J, Levisohn DR. Acute alopecia: clue to thallium toxicity. Pediatr
Dermatol. 1993 Mar;10(1):29-31.
- Borroni
G, Brazzelli V, Minoia C, Bosincu LA, Vignoli GP, Donadini A,
Rabbiosi G. [Thallium-induced alopecia]. G Ital Dermatol Venereol.
1989 Apr;124(4):167-70.
- Metter
D, Vock R. [Structure of the hair in thallium poisoning]. Z
Rechtsmed. 1984;91(3):201-14.
- Stuttgen G,
Haas N, Mittelbach F, Zesch A. [Acute, toxic, reversible hair
loss through drain and sanitary cleansing vapors containing
sodiumhypochloride and sodiumhydroxide]. Wien Klin Wochenschr.
1982 Oct 1;94(18):479-84.
- Moore D, House I, Dixon A. Thallium poisoning.
Diagnosis may be elusive but alopecia is the clue. BMJ. 1993
Jun 5;306(6891):1527-9.
- Schaumburg HH, Berger A. Alopecia and
sensory polyneuropathy from thallium in a Chinese herbal medication.
JAMA. 1992 Dec 23-30;268(24):3430-1.
- Koblenzer PJ, Weiner LB. Alopecia secondary
to thallium intoxication. Arch Dermatol. 1969 Jun;99(6):777.
- Hubler WR. Hair loss as a symptom of
chronic thallotoxicosis. South Med J. 1966 Apr;59(4):436-42.
- Herzberg JJ. [Cytostatic alopecia, including
thallium alopecia]. Arch Klin Exp Dermatol. 1966;227(1):452-68.
- Bank WJ, Pleasure DE, Suzuki K, Nigro
M, Katz R. Thallium poisoning. Arch Neurol. 1972 May;26(5):456-64.
- Stein KM, Odom RB, Justice GR, Martin
GC. Toxic alopecia from ingestion of boric acid. Arch Dermatol.
1973 Jul;108(1):95-7.
- Schuppli R. [The toxicity of the boric
acid]. Dermatologica. 1970;141(2):130-6.
- Schuppli R, Seiler H, Schneeberger R,
Niggli H, Hoffmann K. [Toxicity of boric acid]. Dermatologica.
1971;143(4):227-34.
- Schillinger BM, Berstein M, Goldberg
LA, Shalita AR. Boric acid poisoning. J Am Acad Dermatol. 1982
Nov;7(5):667-73.
- Tan TG. Occupational toxic alopecia due
to borax. Acta Derm Venereol. 1970;50(1):55-8.
- Pinetti P, Biggio P. [Alopecia inducing
action of cantharides in humans]. Boll Soc Ital Biol Sper. 1968
Apr 15;44(7):675-6.
- Kwiatkowska E, Plonka T. [Case of alopecia
due to DDT]. Przegl Dermatol. 1971 Mar-Apr;58(2):187-90.
- Gooneratne BW. Massive generalized alopecia
after poisoning by Gloriosa superba. Br Med J. 1966 Apr 23;5494:1023-4.
- Nagaratnam N, De Silva DP, De Silva N.
Colchicine poisoning following ingestion of Gloriosa Superba
tubers. Trop Geogr Med. 1973 Mar;25(1):15-7.
- Field LM. Toxic alopecia caused by pyridostigmine
bromide. Arch Dermatol. 1980 Oct;116(10):1103.
- Chapman RS, Main RA. Diffuse thinning
of hair in iodide-induced hypothyroidism. Br J Dermatol. 1967
Feb;79(2):103-5.
- Freinkel RK, Freinkel N. Hair growth
and alopecia in hypothyroidism. Arch Dermatol. 1972 Sep;106(3):349-52.
- Gschnait F, Schwarz T, Pesendorfer FX, Luger
A. [Exogenous zinc deficiency syndrome]. Wien Klin Wochenschr.
1982 Oct 1;94(18):475-9.
- White J. Postpartum alopecia and zinc.
Med J Aust. 1983 Apr 30;1(9):406.
- Mulhern SA, Stroube WB Jr, Jacobs RM.
Alopecia induced in young mice by exposure to excess dietary
zinc. Experientia. 1986 May 15;42(5):551-3.
- Beach RS, Gershwin ME, Hurley LS. Growth
and development in postnatally zinc-deprived mice. J Nutr. 1980
Feb;110(2):201-11.
- Obeck DK. Galvanized caging as a potential
factor in the development of the "fading infant" or "white monkey"
syndrome. Lab Anim Sci. 1978 Dec;28(6):698-704.
- Warkany J. Acrodynia--postmortem of a
disease. Am J Dis Child. 1966 Aug;112(2):147-56.
- Zaun H. [Amalgam and effluvium in women].
Hautarzt. 1993 Sep;44(9):602-3.
- Wustner H, Orfanos CE, Steinbach H, Kaferstein
H, Herpers H. [Nail changes and loss of hair: cardinal signs
of mercury poisoning from hair bleaches]. Dtsch Med Wochenschr.
1975 Aug 22;100(34):1694-7, 1692.
- Wagner KD, Teicher MH. Lithium and hair
loss in childhood. Psychosomatics. 1991 Summer;32(3):355-6.
- Silvestri A, Santonastaso P, Paggiarin
D. Alopecia areata during lithium therapy. A case report. Gen
Hosp Psychiatry. 1988 Jan;10(1):46-8.
- Yassa R. Hair loss during lithium therapy.
Am J Psychiatry. 1986 Jul;143(7):943.
- Mortimer PS, Dawber RP. Hair loss and
lithium. Int J Dermatol. 1984 Nov;23(9):603-4.
- Orwin A. Hair loss following lithium
therapy. Br J Dermatol. 1983 Apr;108(4):503-4.
- Yassa R, Ananth J. Hair loss in the course
of lithium treatment: a report of two cases. Can J Psychiatry.
1983 Mar;28(2):132-3.
- Dawber R, Mortimer P. Hair loss during
lithium treatment. Br J Dermatol. 1982 Jul;107(1):124-5.
- Van Neste DJ, Rushton DH. Hair problems
in women. Clin Dermatol. 1997 Jan-Feb;15(1):113-25.
- Auerbach R. Low iron levels. Arch Dermatol.
1968 Dec;98(6):681.
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