Hair texture change post Ocrevus / Methylprednisolone

Symptoms and treatments
1

** Updated 12 October 2026 **

This is my personal experience and I remain mindful that side effects vary between patients. Unsure whether my hair changes are related to Ocrevus or its Methylprednisolone premedication. AI used to condense my original forum post.

Background & Treatment History

Male, mid-to-late 30s, mixed Irish and Ugandan-Asian heritage; diagnosed with RRMS in July 2024. Ocrevus infusions were received in January and February 2025, August 2025 and August 2026. There was a year-long gap between the last two infusions due to a low B-cell % (0.2).

Hair texture change & other symptoms

I’ve experienced significant scalp hair shedding, a coarser, wiry texture with kinks, spiral curls and flyaways (also noticed by hairdresser), and recession/thinning around the left temple. These hair texture changes have persisted for over 18 months, including during the year-long infusion gap. There is an irritating chronic nasal vinegary discharge attributed to Ocrevus. NHS Neurologist concluded that Methylprednisolone caused chronic reflux, affecting my vocal range and resulting in a permanent loss of my singing ability.

Steroid Premedication

I refused Methylprednisolone before my first infusion (January 2025); it was given with the second half-dose infusion (February 2025). I suspect it may also have been administered inadvertently in August 2025, when I experienced severe stomach symptoms. There was temporary steroid-related weight gain and my facial hair has become coarser. Neurologist advised that steroids would be unnecessary for second dose once the body acclimatised to Ocrevus compound. Since then, I’ve opted for only IV antihistamines and paracetamol as premedication.

Investigations

Blood Work (Oct/Nov 2025): Normal thyroid panels/antibodies, B12, vitamins A/E/K, iron, and ferritin. Vitamin D was low but within range. Formal letter from MHRA confirmed 61 reports of alopecia associated with Ocrevus, but no reports relating to brittle or abnormal hair texture or hair damage.

Conjecture

I’m unsure whether the hair texture change stems from Ocrevus or Methylprednisolone. From what I understand, immunomodulatory medications may trigger hair texture alteration. I also recognise there may be other contributing factors to my hair texture change. If there is an underlying genetic susceptibility (a family history of wiry hair), with Ocrevus exacerbating the texture changes or if the premed steroid accelerates androgenetic hair recession through hormonal/DHT effects. Given the timing, severity and persistence, I suspect Ocrevus likely had an effect on my hair texture.

For now, remaining on Ocrevus. Alternative medications discussed such as Briumvi or Mavenclad. My health deteriorated rapidly following the Pfizer mRNA COVID-19 vaccinations in 2021 (autonomic dysfunction and inflammation of central nervous system).

Questions

Has anyone experienced persistent hair-texture changes, shedding or hairline recession while taking Ocrevus or Methylprednisolone? If so, did these changes eventually reverse?

hair texture summary
hair texture summary3510×2640 1.53 MB

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Hi. I had no idea it affected hair. I’ve always had thick hair but every time I go to hairdresser she runs her fingers through my hair and says ‘it’s got thicker’ ocrevus hasn’t had any other side affects. I have ppms and haven’t had any new lesions for the 7 years I’ve been on it so I’m sticking with it. Sorry that you’ve had unwelcome affects.

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Thank you for the reply, it’s really helpful and hopefully the doctor can decipher cause of my symptoms.

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Hello! I am also on Ocrevus and have had 2 doses so far. After my first, (and this is slightly different to what you’re experiencing but also hair-related) I suffered with Telogen Effluvium. I thought it was the Ocrevus that had caused it but my doctor (clinical lead for MS research at UCLH) believed it was not linked to the treatment as it apparently is not a side effect of Ocrevus but is likely to be linked to the stress of diagnosis/the whole ordeal. If your diagnosis process was anything like mine - that made complete sense. After googling, it normally occurs 3 months after the stress. Don’t know if this makes any sense for you?

Either way, he recommended that I take a good biotin supplement for 1 month. I did and it worked. My hair is arguably healthier than before but I imagine that also has to do with the positive changes to my diet which I have implemented. The British Supplements website is great, if you do want to purchase some and see how you go.

Like I said, I know it’s a different issue but as it’s hair related I thought this could maybe help! Good luck!

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I get my supplements from British Supplements too, and have been doing so for years. They’re not the cheapest, and they have plenty to say about the low quality supplements typically available on the Hight Street, but I think the quality is good and worth it. That’s great news that the biotin seems to be helping you.

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Appreciate your thoughtful response, I experienced telogen effluvium from the 2021 Pfizer mRNA vaccine, although the hair eventually returned, by contrast, the trichology issues from 2025 Ocrevus and Methylprednisolone are somewhat different as they seem to have accelerated what appears to be androgenetic hair recession, I suspect it may be from hair follicle sensitivity to DHT and therefore vitamins may not assist, the only option (for me) is just coming to terms with it. But it’s strange how my hair recession rapidly increased after the Ocrevus and pre-med steroid (only had it on second infusion, refused it on others) notwithstanding the onset of hair texture change. Pre-med steroid resulted in weight redistribution and I think it messed up my hormones.

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Yep, did the same to me. I was diagnosed 2022, started treatment in 2023. I’ve had several doses now but even since the first half I noticed a difference. My hair sheds a lot, the texture changed and I’ve also become mega sensitive to certain foods that it burns my tongue (tomatoes, Banana, apples). My consultant and ms nurse have said these aren’t common reactions and haven’t heard of this but I am convinced it is because of ocrevus. The upside is that the treatment is working and I’ve had no new lesions so I’m grateful for that although sad about my hair and food choices now.

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Appreciate your helpful insight, and sorry to hear of the hair shedding and long-term hair texture change, just hope it resolves for you. Glad to hear the medication has at least helped your MS. Unfortunately my Ocrevus / Methylprednisolone hair texture change and hair recession is still unresolved after 6 months. Hearing your experience and comparing it with mine shows that my hair texture change may be permanent. The reality of this medication is rather upsetting, but sadly I wasn’t warned of that side effect. Just added an update at the beginning of my post, as I received a response from the MHRA. If you have time, might be worth reporting your experience to Yellow-Card.

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Hi, I started ocrevus in October last year due to reactions on kesimpta. But my hair has completely changed texture it’s now course, dry. I think you have to weigh up what’s important too you. I now uses better conditioner and when it’s cold I always wear a hat. I hope you get some answers.

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Well funny enough, yesterday I bought some keratin treatment for my hair as it has gone so brittle and dry, hadn’t considered it could be down to Ocrevus but now am not so sure, also though, I don’t know if it worry me enough to stop the Ocrevus.

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Thank you for your insights, I had debated Kessimpta, but thought the self administration might be challenging. I had thought of switching to a different medication this year, but decided against it as they have their different risks. I was due my third Ocrevus infusion in two days, but I am debating having a short break from this medication, my B-cell percentage is at 0.2, so the neurologist said provided it’s below 1%. It will be interesting to see if my hair recession or hair texture finds a miracle in this intervening period (*sorry correction: Neurology have postponed infusion three months, but I would have liked more time off). Ultimately, it seems that I am damned whatever I do, but hopefully something good comes from this.

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Reading online, it seems immuno-modulators cause hair texture change. There seem to be other MS medications that cause it as well. However, nothing on Mavenclad, was debating switching to that one, but may complicate my situation because I have an underlying Liver condition. Gonna take a break from Ocrevus and decide in six months, probably will just stay on Ocrevus and lament my hairline and hair texture, unless a miracle cure comes through.

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Ive been offered Ocrevus after a server reaction to kesimpta on my 7th dose. how are you finding day to day life on Ocrevus? and have you had to make any addaptions with the new medication?

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So far I’ve had the 2 half doses of ocrevus, I’m still getting some psoriasis but that was expected and it’s bearable. I’ve noticed my fatigue levels aren’t as bad as when I was taking kesimpta and I’m not experiencing infections like I was, so that’s a bonus. No adaptation made, and so far so good.
I hope you get on ok with the infusion, take a good book or something to watch as the first half dose takes a while and the next half dose will be quicker if you’ve had no reaction. But they usually give pre meds of methyl prednisone and antihistamine before the infusion.

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Do they let anyone go in with you during the infusion

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Yes my sister took me and stayed for a while then went shopping and picked me up later.

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In terms of my daily experience post Ocrevus (one year now), I noticed increased dizziness/vertigo, weakness/aching in my legs/knees, so that’s reduced my walking distance and stamina, previously a long-distance walker, however I struggle to find comfy trainers. The Methylprednisolone risks osteoporosis and cataracts. I have noticed more floaters in my vision. At the infusion I request Antihistamine only. The Ocrevus worsened my clinical depression and gastro condition as detailed. Also have chronic vinegar fluid in my nose after Ocrevus. My predominant concern with the medication from my experience is immuno-suppression, risk of ulcerative colitis and the hair side effects. Neurologist recently suggested Mavenclad for my case, but that has different risks, so it’s become a dilemma somewhat. I want a year-off but it’s probably inadvisable for my case.

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At an NHS Hospital in London, in the Neurosciences Treatment Unit, from my experience, they prohibit others accompanying patients for infusions, but perhaps there could be an exemption depending upon the case. I have to go alone and get very stressed because I find medical matters daunting. At the NTU they only allowed my family member to accompany me for a Lumbar Puncture but that was done in a private room. At the NHS Hospital where I go, the infusions are done in a large room amongst other patients who sit adjacent having their infusions, but it may be different elsewhere. Ocrevus is a long infusion, so arrival is at 8am, by 10am the nurses would have setup infusion, then sometimes they slow down infusion speed if there is an infusion reaction as I only request Antihistamine without the Methylprednisolone steroid. If you feel unwell during infusion just notify them. It usually finishes at 15:00pm, then head back home.

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Hair texture can change for many reasons, so it’s interesting to compare experiences and see what routines work best for different hair types, and Solawave offers skincare and beauty devices designed for at-home routines that can be worth exploring.

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Hi

I’ve had 4 ocrevus infusions and apart from the 3rd one I had no issues .

Felt like I had the flu and had 2 nose bleeds that lasted for 7 hours and I looked like a bottle of milk :joy:

I’m sick of hospitals so I just didn’t bother going to do anything about it , I digress the hair thing is a strong possibility as I am now 51 male and have to get a hair cut every 4 weeks !!

Even the hair dresser says she can’t believe how thick my hair is for my age.

So I am going to take that as a positive, a parking attendant said I had the willy wonka golden ticket as I had the blue parking badge !!!

I said you are more than welcome to have my MS and my blue badge , seems people look you at think your fine you start walking zigzag and looking for things to hold onto