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How can I reduce the effects methotrexate has on my hair?

Q) As someone who takes methotrexate for rheumatoid arthritis I'm concerned at the effect it has on my hair – thinning and falling out. Is there anything that I can take to minimise this effect of the drug?
Patricia, London (Spring 2009)

A) This is an unfortunate side-effect of methotrexate therapy. As doctors, we don’t appreciate how important this is, especially for women. And even low-dose methotrexate can cause hair loss to some extent. The only way to reduce the side-effect is to reduce the dose of the drug, as far as I'm aware. However, taking folic acid on non-methotrexate days usually helps the other side-effects and if you're currently on folic acid just once a week (as some people are) then it might be worth taking it on the six non-methotrexate days.

This answer was provided by Dr Philip Helliwell for the Spring 2009 edition of our magazine, Arthritis Today, and was correct at the time of publication.

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