Travel to the tropics – the Caribbean, Latin American, along with most of Africa, Asia and the Pacific islands means taking anti-malaria medications. Chances are, you’ll suffer some hair loss when you do. Frequent travelers who must rely on these medications often complain about their side effects. If you or your loved ones are traveling or working in the tropics, and take anti-malarial drugs, be forewarned about malaria drugs and unexplained hair loss.

Quinine was the most widely used anti-malaria medication for most of the 20th century. It has been replaced by chloroquine (Aralen), mefloquinine (Lariam, Mephaquine, Melfiam), and Daraprim (pyrimethamine). In 1963, the Walter Reed Army Institute of Research initiated a search for more effective anti-malarial drugs, due to Vietnam War fighting conditions. The FDA approved mefloquinine in 1989. Now it is widely prescribed for thousands of Peace Corps volunteers, Foreign Service employees, and military personnel. Many take Lariam, because of its convenient weekly dosing.

These anti-malarial medications cause telogen effluvium, sudden hair loss. It’s easy to detect. It is usually occurs near the front of the head or hairline. Hairs in the resting (telogen) phase develop small white nodules on the end of the shaft, while the scalp prepares to shed them. However, it can take up to three months for your scalp to eject the dead hair. You may not experience this side effect until your trip is long over.

The medications can cause up to 30 percent of your hair to switch from the normal growth phase into a resting phase. Since 10 percent of your hair is usually in a resting phase at all times, your total hair loss suddenly jumps to 40 percent.

Malaria kills up to one million unprotected people every year. If you don’t die, you’re sick enough to want to die. So, it’s a good idea to take the pills. Research has been underway since 2004 for malaria medications to replace mefloquinine, because of some other disturbing side effects. Some promising alternatives may be available soon. However, ask your physician if sudden hair loss is a known side effect of any new malaria medications.