Response to Mounessa et al.'s 'Commonly Prescribed Medications Associated with Alopecia'

The document discusses the omission of oral retinoids, isotretinoin and acitretin, from a review on medications associated with alopecia by Mounessa et al. Despite being excluded due to low-level evidence, the authors argue for their inclusion due to their significant association with telogen effluvium. Isotretinoin, used for severe acne, has a hair loss incidence of 0.28% to 12%, with higher doses increasing the risk. Acitretin, used for severe psoriasis, shows hair loss in 50% to 75% of cases. Both drugs cause hair follicles to prematurely transition from anagen to telogen, leading to hair loss. The authors emphasize the importance of considering these medications in discussions about drug-induced alopecia.