Beta-blockers are among the 20 most commonly prescribed drugs worldwide, and they cause hair loss in 1 to 5% of users. If you have started a beta-blocker for blood pressure, heart rate, or anxiety and noticed increased shedding, objective density tracking establishes the connection your prescriber needs to consider alternatives.
How Beta-Blockers Affect Hair Follicles
Beta-blockers interfere with the hair growth cycle by prematurely shifting follicles from the anagen (growth) phase into the telogen (resting) phase. This is called telogen effluvium.
The timeline is consistent across most patients:
| Timeline | What Happens |
|---|---|
| Weeks 0-4 | No visible change, follicles beginning to shift |
| Weeks 4-8 | Follicles enter telogen phase |
| Weeks 8-16 | Shedding becomes visible (telogen release) |
| Months 4-8 | Peak shedding, maximum density loss |
| Months 8-12 | Recovery begins if medication changed |
The delay between starting the medication and seeing hair loss is what makes beta-blocker shedding hard to identify without tracking. By the time you notice shedding at month 3 or 4, you may not connect it to a medication you started months earlier.
Beta-Blocker Hair Loss Risk by Drug
Not all beta-blockers carry equal hair loss risk. The following table summarizes commonly prescribed beta-blockers and their reported association with hair shedding:
| Beta-Blocker | Brand Names | Hair Loss Risk | Common Uses |
|---|---|---|---|
| Propranolol | Inderal | Higher | Hypertension, anxiety, migraine |
| Metoprolol | Lopressor, Toprol-XL | Higher | Hypertension, heart failure |
| Atenolol | Tenormin | Moderate | Hypertension, angina |
| Nadolol | Corgard | Moderate | Hypertension, angina |
| Bisoprolol | Zebeta | Lower | Hypertension, heart failure |
| Nebivolol | Bystolic | Lower | Hypertension |
| Carvedilol | Coreg | Lower | Heart failure, hypertension |
If your current beta-blocker is in the "higher" risk category and your tracking shows density decline, this data supports a conversation with your prescriber about switching to a lower-risk alternative.
Step 1: Capture Your Pre-Medication Baseline
The most valuable tracking data for beta-blocker hair loss begins before you start the medication. If you know a beta-blocker prescription is coming, take baseline density photos immediately.
Photograph five areas: hairline, left temple, right temple, crown, and mid-scalp. Upload to myhairline.ai and label with the date and "pre-medication" tag.
If you have already started the medication without a baseline, start tracking now. Even without a pre-medication reference, tracking from this point forward documents the progression pattern.
Step 2: Log Your Medication Start Date
Record the exact date you began the beta-blocker, the drug name, and the dosage. This timestamp is critical for establishing the 2 to 4 month lag between medication start and telogen effluvium onset.
If you later discuss findings with your prescriber, having an exact start date paired with density readings creates a clear cause-and-effect timeline.
Step 3: Track Biweekly for the First 6 Months
During the critical first 6 months, photograph all five areas every two weeks. This frequent cadence catches the onset of shedding early and documents the exact week density decline begins.
Expected density pattern for beta-blocker telogen effluvium:
| Tracking Point | Expected Change |
|---|---|
| Weeks 0-8 | Stable, no measurable change |
| Weeks 8-12 | First measurable density decline (3-8%) |
| Weeks 12-20 | Accelerating decline (8-20%) |
| Weeks 20-32 | Plateau at maximum loss (15-25% reduction) |
If your tracking data matches this pattern, the correlation with beta-blocker use is strong.
Step 4: Document the Pattern for Your Prescriber
Your prescriber may not immediately connect hair loss to a beta-blocker, especially if the medication was started months ago. Objective data changes the conversation.
Prepare a summary showing:
- Your pre-medication density (or earliest available reading)
- The medication start date
- The week density decline began
- The current density loss percentage
- The match between your timeline and expected telogen effluvium onset
This data-driven approach gives your prescriber confidence to consider a medication change without dismissing the concern as coincidental.
Step 5: Track Recovery After Medication Change
If your prescriber switches you to a different beta-blocker or alternative antihypertensive, continue tracking to document recovery.
Recovery from beta-blocker telogen effluvium typically follows this timeline:
- Weeks 1 to 4 after switch: Shedding may continue briefly
- Months 2 to 3: Shedding slows, new growth begins
- Months 6 to 9: Density returns toward pre-medication levels
- Month 12: Full recovery in most cases
Not all density loss reverses completely. If beta-blocker use coincides with androgenetic alopecia (pattern hair loss), the medication-related component recovers but the genetic component does not. Tracking data helps distinguish between the two.
Separating Beta-Blocker Shedding from Pattern Hair Loss
Many beta-blocker users are in the 40 to 65 age range, an age when androgenetic alopecia is also common. Distinguishing medication-induced shedding from genetic hair loss requires attention to the shedding pattern.
Beta-blocker telogen effluvium produces diffuse, evenly distributed thinning across the entire scalp. No specific zone is affected more than others.
Androgenetic alopecia produces patterned loss, concentrated at the temples, hairline, and crown. The donor zone (back and sides) remains largely unaffected.
If your tracking data shows diffuse, uniform density decline beginning 2 to 4 months after starting a beta-blocker, telogen effluvium is the probable cause. If the loss is concentrated in typical pattern areas, genetic hair loss may be the primary driver.
When to Escalate
Consult your prescriber promptly if:
- Density loss exceeds 25% from baseline
- Shedding has not stabilized after 8 months on the medication
- Recovery has not begun within 4 months of a medication switch
- You notice patchy (non-diffuse) hair loss, which may indicate a different condition
Never stop a beta-blocker without medical guidance. Blood pressure and heart rate management must take priority, and your prescriber can find alternatives that maintain cardiovascular control while reducing hair loss risk.
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Never modify or discontinue blood pressure medication without consulting your prescriber. Hair loss evaluation should include a qualified dermatologist or trichologist.
Start tracking your medication-related hair changes today. Get your free density analysis at myhairline.ai/analyze and build the data your prescriber needs.