Hair loss, a phenomenon often associated with genetic factors or stressful events, can also be a tell-tale sign of more profound health problems, including autoimmune diseases. Understanding the link between autoimmune diseases and hair loss is essential if we are to tackle the problem in an informed way, identify early symptoms and find appropriate solutions. Find out all you need to know about hair loss and autoimmune diseases.
What is an autoimmune disease?
An autoimmune disease is a condition resulting from an immune system dysfunction. The immune system turns against the normal components of the body, mistakenly recognising them as foreign elements. Instead of defending the body against infection or foreign substances, the immune system attacks and damages its own tissues.
While the exact cause of autoimmune diseases remains unknown, it is thought that a combination of genetic and environmental factors, such as viral infections, plays a role.
There are more than 80 different autoimmune diseases. Among the most common are rheumatoid arthritis, lupus, multiple sclerosis, Hashimoto's disease, type 1 diabetes and coeliac disease.
Autoimmune disease and hair loss: what is the link?
The link between autoimmune diseases and hair loss lies in the abnormal reaction of the immune system which, instead of protecting the body against external threats (such as viruses and bacteria), attacks the body's own cells. In the context of hair loss, the immune system can target hair follicles, which leads to hair loss.
Hair loss associated with these conditions can be temporary or permanent, according to the disease and the severity of the immune attack. Note also that hair loss can be influenced by other factors, including stress, genetics or other medical conditions.
If you suspect that your hair loss is due to an autoimmune disease, it is vital to consult a specialist to obtain an accurate diagnosis and discuss treatment options.
What is alopecia areata ?
Hair loss can be caused by a number of factors, including certain autoimmune diseases. These include alopecia areata.
Alopecia areata is characterised by sudden and often unexpected hair loss in both men and women, usually in small, rounded patches. Although the exact cause of alopecia areata is not fully understood, it is known that the immune system attacks the hair follicles, causing a hair loss. This reaction can be influenced by genetic and environmental factors.
What types of alopecia areata are there?
This disease can take several forms:
- Localised alopecia areata: this is the most common form of the disease. It is characterised by one or more rounded bald patches on the scalp or other parts of the body. These areas may remain isolated or spread.
- Alopecia totalis: this form represents a complete loss of hair on the scalp. It may evolve from localised alopecia areata or begin as such.
- Alopecia universalis: this is the most severe form of alopecia areata. It is manifested by the loss of all body hair, including eyelashes, eyebrows and pubic hair.
- Alopecia ophiasis: this is a variant of alopecia areata which is characterised by a loss of hair in bands, generally at the back and sides of the scalp. It is often more resistant to treatment than the other forms.
How is alopecia areata treated?
Although there is no definitive remedy for alopecia areata, there are a number of treatments that can help promote hair regrowth or slow down hair loss. Corticosteroids are among the main treatment options. They can be topical, i.e. applied directly to the bald areas, or injected into the affected areas of the scalp. In more severe cases, oral corticosteroids may be prescribed, but these can have significant side effects.
Minoxidil can also help stimulate hair regrowth. It is available without prescription in various strengths. It is advisable to seek medical advice to ensure there are no contraindications.
What other autoimmune diseases affect hair loss?
Although alopecia areata is the best known of the autoimmune diseases that cause hair loss directly, others can also have hair loss as a secondary symptom or consequence. These may include the following conditions:
- Systemic lupus erythematosus (LES): hair loss is a common symptom of lupus. People with lupus may lose their hair in patches or more evenly. This loss may be reversible with treatment, although scarring of the scalp can sometimes prevent regrowth.
- Sjögren's syndrome: although mainly associated with dry eyes and mouth, Sjögren's syndrome can also cause hair loss.
- Autoimmune thyroiditis: Hashimoto's thyroiditis (hypothyroidism) and Graves' disease (hyperthyroidism) are two autoimmune diseases that affect the thyroid gland. One of the common symptoms is hair loss. Treatment of thyroid disorders can often reverse hair loss.
- Dermatomyositis: this is an inflammatory disease that can lead to skin rashes and muscle weakness. Hair loss is also a possible symptom.
- Scleroderma: this autoimmune disease causes the skin and connective tissue to harden and tighten. When scleroderma affects the scalp, it can lead to hair loss.
- Celiac disease: although mainly associated with gluten intolerance and gastrointestinal problems, coeliac disease can also cause hair loss in some patients.
Hair loss and autoimmune disease: the importance of diagnosis
Hair loss can be an emotionally and psychologically devastating experience. When it is associated with an autoimmune disease, the complexity of diagnosis and management increases.
Hair loss can be due to a multitude of reasons: stress, genetic factors, infectious diseases, hormonal imbalances, etc. When it is caused by an autoimmune disease, accurately identifying the underlying condition is the first step towards proper management.
A precise diagnosis allows us to target the most appropriate treatment. For example, if the hair loss is due to alopecia areata, treatments such as topical corticosteroids may be effective. If the cause is systemic lupus erythematosus, treating the disease itself is the priority, and hair loss may improve with treatment of the lupus.
Without a correct diagnosis, patients run the risk of trying treatments which, at best, will not be effective and, at worst, could worsen the situation or cause undesirable side-effects.
The Paris-based Centre Clauderer is expert in the diagnosis and treatment of hair disorders, either face-to-face or remotely. Once the diagnosis has been made, your Clauderer specialist will present his or her conclusions. He or she will detail the realistic results you can achieve and propose a tailor-made treatment solution to help you achieve the expected results.
Jean-François Cabos is the creator of a unique hair care method based on the research he coordinated, which led to the publication of the book Hair, Roots of Life with Hélène Clauderer published by Robert Laffont (Collection "Réponses/ Santé").
