{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T10:12:01Z","timestamp":1789726321890,"version":"4.0.1"},"reference-count":13,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,2,14]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>Warfarin is frequently prescribed as a long-term anticoagulant in patients with end-stage kidney disease as direct oral anticoagulants undergo renal excretion. Anticoagulation is a rare cause of alopecia in adults and is thought to be due to the promotion of the \u2018resting phase\u2019 of hair follicles. In this case report, a prevalent haemodialysis female patient required long-term anticoagulation following a complex pulmonary embolus and dialysis access complications. After commencing warfarin therapy, the patient reported generalised loss and thinning of her hair. All other potential causes were excluded. Cessation of warfarin therapy and conversion to apixaban with close monitoring alleviated the hair loss. Warfarin therapy is a rare cause of alopecia but should be considered in patients on long-term anticoagulation when other diagnoses have been excluded. Hair loss has a profoundly negative impact on patient quality of life and should prompt investigation to determine the underlying cause.<\/jats:p>","DOI":"10.1136\/bcr-2020-240579","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T10:58:33Z","timestamp":1614682713000},"page":"e240579","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Resolution of warfarin-induced alopecia with conversion to apixaban"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0028-5408","authenticated-orcid":false,"given":"Katherine Leigh","family":"Hull","sequence":"first","affiliation":[{"name":"Cardiovascular Sciences, University of Leicester, Leicester, UK"},{"name":"John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Gooding","sequence":"additional","affiliation":[{"name":"Haematology, University Hospitals of Leicester NHS Trust, Leicester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James O","family":"Burton","sequence":"additional","affiliation":[{"name":"Cardiovascular Sciences, University of Leicester, Leicester, UK"},{"name":"John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK"},{"name":"School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"key":"2025082711053281000_14.3.e240579.1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfu080"},{"key":"2025082711053281000_14.3.e240579.2","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2012.160"},{"key":"2025082711053281000_14.3.e240579.3","first-page":"284","article-title":"Systematic approach to hair loss in women","volume":"8","author":"Tr\u00fceb","year":"2010","journal-title":"J Dtsch Dermatol Ges"},{"key":"2025082711053281000_14.3.e240579.4","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1046\/j.0412-5463.2001.00110.x","article-title":"Causes of hair loss and the developments in hair rejuvenation","volume":"24","author":"Rushton","year":"2002","journal-title":"Int J Cosmet Sci"},{"key":"2025082711053281000_14.3.e240579.5","doi-asserted-by":"publisher","DOI":"10.4103\/0974-7753.58553"},{"key":"2025082711053281000_14.3.e240579.6","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/S0733-8635(05)70085-1","article-title":"Photographic documentation of hair growth in androgenetic alopecia","volume":"17","author":"Canfield","year":"1999","journal-title":"Dermatol Clin"},{"key":"2025082711053281000_14.3.e240579.7","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1111\/jdv.13455","article-title":"Towards a consensus on how to diagnose and quantify female pattern hair loss - The 'Female Pattern Hair Loss Severity Index (FPHL-SI)'","volume":"30","author":"Harries","year":"2016","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2025082711053281000_14.3.e240579.8","article-title":"Anticoagulant-Associated adverse drug reactions in 2013-15","volume":"138","author":"Eek","year":"2018","journal-title":"Tidsskr Nor Laegeforen"},{"key":"2025082711053281000_14.3.e240579.9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s40801-015-0056-z","article-title":"Traditional anticoagulants and hair loss: a role for direct oral anticoagulants? 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