Hair texture change post Ocrevus / Methylprednisolone

[stewardcity]

**** updated on 4 April 2026 ****

Male in mid/late thirties, diagnosed with RRMS (2024), Ocrevus administered in January 2025, February 2025 and August 2025, had the premedication steroid Methylprednisolone on the second half-dose, but refused it at others.

Pre-Ocrevus…my hair was coarse and wavy, but could be dried into a relaxed style. I am mixed race: heritage Irish and Ugandanasian. Some family members have wiry coarse hair, so perhaps the medication exacerbated that underlying hair texture. I had some mild hair recession on my right temple, but nothing on the left-side.

I went on holiday in Sep 2024 before the first Ocrevus infusion, and when viewing holiday photos of my hair, it’s clear it was in better condition prior to this medication.

Post-Ocrevus and Methylprednisolone…there has been a drastic alteration in my hair texture as it became coarser and wiry with kinks. Furthermore, there has been drastic onset of hair recession, shedding, hair diffusion at left temple hairline. If there was underlying androgenetic hair recession, then I wonder if the Methylprednisolone steroid pre-med accelerated that if it alters DHT levels. I suspect it may be from hair follicle sensitivity to DHT. The hairline recession is considerable when compared to before medication.

After reading about other people’s experiences, it seems that both the Ocrevus and Methylprednisolone risk changing hair texture.

The hair texture change became noticeable at 6-8 months after the infusion: I first noticed the change when my hair brush was tugging in early September 2025 and my hair was appearing curly and wiry in photos.

Google AI says immuno-modulators (antineoplastic agents) can result in hair texture changes (either persistent or temporary depending on individual), Ocrevus and other MS medications fall under that medication classification as they are Monoclonal Antibody treatments.

The Methylprednisolone caused weight gain and fat redistribution to chin and midsection that remains unresolved after 13 months.

21 October 2025: Neurologist says that I am their first patient to mention the post Ocrevus hair texture change side effect.

28 October 2025: Thyroid normal, Thyroid Anti-body normal, Vitamin D low but in range, Vitamin B12 normal, Vitamin A, E and K normal.

28 November 2025: Iron and ferritin levels normal.

I have relayed these side effects to the MHRA.

On 9 Feb 2026, I received a formal letter from the Medical assessor at the MHRA who responded to my complaint about my side effects.

The MHRA said there are 61 reports of alopecia from Ocrevus, but nothing in relation to brittle hair texture (trichorrhexis), abnormal hair texture or hair injury.

I did not attend my Feb 2026 Ocrevus infusion and the NHS hospital delayed it until May, but I wish for a longer break from this medication for the reasons outlined, while I am concerned of immunosuppression. I developed mild acid reflux after this medication and aching/weakness in knees and legs.

The Neurologist mentioned the alternative options of Mavenclad or Briumvi, however they come with their own risks.

Unfortunately, the post-Ocrevus/Methylprednisolone hair texture change remains unresolved as of 22 March 2026.

If you have experienced hair texture changes or hair thinning, hair diffusion or hair recession from Ocrevus or the pre-medication steroid Methylprednisolone, then please share your experience or whether it’s reversible or not?

Shall endeavour to keep post updated.

[croney2012]

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.

[stewardcity]

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

[ssaf]

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!

[alison100]

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.

[stewardcity]

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.

[LunaMoon]

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.

[stewardcity]

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.

[animali]

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.

[Cavworld]

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.

[stewardcity]

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.

[stewardcity]

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.

[bazmill73]

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?

[animali]

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.

[bazmill73]

Do they let anyone go in with you during the infusion

[animali]

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

[stewardcity]

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.

[stewardcity]

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.