I sometimes get emails from people who have had a positive blood test for ANA (antinuclear antibody test) or suspect they have an autoimmune disorder that has contributed to changes in their hair, including loss, shedding, thinning, and changes in color and texture. In the following article, I’ll go over some well-known and lesser-known autoimmune conditions that commonly contribute to hair change or loss, and tell you how they often affect the hair and scalp.
Alopecia areata (AA): When most people think of autoimmune hair loss, AA is usually the first thing that comes to mind. This condition is known as the reason Princess Caroline of Monaco temporarily lost her hair. The condition most often occurs in hair loss that is defined by bald spots that are round and patchy. Often the hair around the patches is totally normal, but the round areas with patches are smooth and sometimes completely bald.
Another condition that goes hand in hand with AA is alopecia areata universalis. In this case, you will often have hair loss all over your body, including your entire head (often total baldness), as well as in other areas such as eyelashes, eyebrows, pubic hair, the beard area, underarms, etc. Sometimes when this process is in progress, you will see “exclamation point hairs”. These are hairs that break and taper to be much narrower the closer you get to the scalp. They flare at the broken ends.
There is a lot of controversy about what actually causes AA. Most agree that it is autoimmune in nature, but some believe it is aggravated by stress, allergies, or viruses. Treatment often consists of oral steroids, corticosteroid injections, or experimental scalp stimulation with herbs such as rosemary and lavender.
Lupus and hair loss: Probably the second most common autoimmune disorder causing hair problems is systemic lupus or lupus erythematosus. People with this condition are often affected by a malar rash that can affect the scalp and cause scarring that can lead to temporary or permanent hair loss. You may also see hairs with exclamation marks with lupus.
Thyroid problems: Graves’ disease and Hashimoto’s thyroiditis: Many people who think about thyroid problems and hair loss are aware of hypothyroidism, but many are not aware of autoimmune thyroid problems. The first one is a serious condition where you will usually see the hair become much finer and you will see more pronounced hair loss. The texture becomes much looser and unable to hold a style. The supports can also become lighter in color. The opposite is true with Hashimoto. In this case, the hair becomes very coarse and dry, but hair loss is accelerated nonetheless.
Lesser known autoimmune disorders that can affect hair: In truth, almost any disorder that has an autoimmune component can affect hair or cause thinning, shedding, or loss. This includes things like rheumatoid arthritis, intestinal cystitis, and fibromyalgia (although not everyone agrees that these two fall into this category), celiac disease, and guillain-barre syndrome, to name just a few.
Medicines to reduce inflammation and hair loss: Many of the medications given for these conditions are given to reduce the inflammatory process, and in fact this seems to fit quite well with the treatment of hair loss, as there is almost always an inflammatory component. However, many of the commonly used steroids have the unfortunate side effect of more shedding or loss, leaving the patient often wondering if it is the disorder that is affecting their hair or the medication being used to treat it. It is often wise to focus on a healthy diet and healthy, natural ways to maintain a healthy scalp and reduce inflammation while encouraging healthy growth.
