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Biotin is an alternative medication used in the management and treatment of pathological hair conditions. It is in the vitamin class of drugs. This activity reviews the indications, action, and contraindications for biotin as a valuable agent in the therapy of biotin deficiency and hair conditions. In addition, this activity will highlight the mechanism of action, adverse event profile, and other key factors (e.g., off-label uses, dosing, pharmacodynamics, pharmacokinetics, monitoring, relevant interactions) pertinent for members of the healthcare team in the management of patients with brittle hair and related conditions. Objectives: Review the treatment considerations for patients with brittle hair and nails. Explain the indications for biotin use. Outline the typical presentation of a patient with biotin deficiency. Summarize the importance of collaboration and communication amongst the interprofessional team to enhance the delivery of care for patients affected by pathological hair conditions and patients receiving biotin. Access free multiple choice questions on this topic.

There is no specific antidote for overdosing on biotin. Excess in the body is rare, and since biotin is a water-soluble vitamin, it is excreted in the urine when in excess. Signs and symptoms of biotin overdose may include and are not limited to insomnia, excessive thirst, and urination. Since biotin has documentation in playing a role in postprandial glucose control, it bears mention that excess would cause signs and symptoms of a person experiencing hyperglycemia (e.g., increased thirst).[13] Diabetic patients should, therefore, be cautious before taking biotin. Although not impossible, it would be very difficult to overdose on biotin. Anaphylaxis is always a common concern with any medication but would present with systemic signs and symptoms. In rare cases, eosinophilic pleuropericardial effusion, a life-threatening condition, may occur.[14] Poison control centers should always be contacted with a suspected overdose.

Clinicians, nurses, physician assistants, and pharmacists must educate patients when confronted with the matter that regular biotin use is not indicated and also not well-documented. Interprofessional team members should be aware that biotin marketing often claims it is "a magic pill for hair and nails," but the benefits remain unclear. Without the research to support regular usage, heavily marketed claims by the beauty and supplementation industry need to be challenged to examine the efficacy and safety of this drug, which they advertise for regular use. With the epidemic of type 2 diabetes in the United States, further exploration regarding biotin's role in glucose control requires investigation since studies have concluded it may be beneficial for obese patients and those with type 2 diabetes.[13]