Most people associate hair loss with genetics or aging. But sometimes the cause is the immune system itself. In autoimmune conditions, the body mistakenly attacks its own healthy tissue, and in some cases that includes hair follicles.
Autoimmune hair loss can look different from typical thinning. It may appear as sudden round patches, rapid shedding or changes in the scalp. Here is what to know about the autoimmune conditions that affect hair, how they are diagnosed and what treatment options are available.
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What Is Autoimmune Hair Loss?
Autoimmune hair loss happens when the immune system targets hair follicles directly, or when an autoimmune condition elsewhere in the body disrupts the hair growth cycle.
In some cases the follicles stay alive and hair can regrow. In others, inflammation causes scarring that permanently damages the follicle, which is why an early diagnosis matters.
Autoimmune Conditions That Can Cause Hair Loss
Alopecia Areata
Alopecia areata is the most common autoimmune cause of hair loss. The immune system attacks hair follicles, causing smooth, round patches of hair loss on the scalp, beard or eyebrows. In rarer forms, it can cause loss of all scalp hair or all body hair. The American Academy of Dermatology notes that it often runs in families and is more common in people who have other autoimmune conditions.
Thyroid Disease
Autoimmune thyroid conditions, including Hashimoto’s thyroiditis and Graves’ disease, can cause diffuse thinning across the scalp. Both an underactive and an overactive thyroid can disrupt the hair growth cycle. Thyroid disease is also more common in people with alopecia areata. Read more about other diseases that can cause hair loss.
Lupus
Lupus can cause thinning across the scalp during flares. A form called discoid lupus affects the skin of the scalp and can cause scarring, which may lead to permanent hair loss in those areas.
Psoriasis
Scalp psoriasis causes thick, scaly patches. It does not usually destroy hair follicles, but inflammation, scratching and removing scale can lead to temporary hair loss that typically regrows once the psoriasis is under control.
Lichen Planopilaris and Frontal Fibrosing Alopecia
These less common inflammatory conditions attack the follicles and cause scarring hair loss, often with redness, itching or burning. Frontal fibrosing alopecia gradually moves the hairline back and is seen most often in postmenopausal women.
Celiac Disease and Type 1 Diabetes
Other autoimmune conditions, including celiac disease and type 1 diabetes, have been linked with a higher rate of alopecia areata. Celiac disease can also affect hair by making it harder to absorb nutrients such as iron.
Signs Your Hair Loss May Be Autoimmune
- Sudden, smooth, round patches of hair loss
- Hair loss in the beard, eyebrows or eyelashes
- Rapid shedding along with fatigue, weight changes or feeling unusually cold or hot
- Redness, scaling, itching or burning on the scalp
- Shiny, smooth areas where hair does not regrow
- A personal or family history of autoimmune disease
Any of these is a reason to get checked rather than wait it out.
How Is Autoimmune Hair Loss Diagnosed?
Diagnosis starts with a detailed history and a close examination of your hair and scalp. Depending on what your provider sees, they may recommend:
- Blood tests, such as a thyroid panel, an ANA (antinuclear antibody) test to screen for lupus and related conditions, and markers of inflammation
- Nutrient levels, including iron and vitamin D, which can also contribute to shedding
- A scalp biopsy in some cases, especially when scarring is suspected
Because more than one type of hair loss can happen at the same time, a thorough evaluation helps make sure each cause is treated.
Can Autoimmune Hair Loss Be Treated?
There is no cure for most autoimmune diseases, but the hair loss they cause can often be managed and, in many cases, reversed. The National Institute of Arthritis and Musculoskeletal and Skin Diseases explains that hair sometimes regrows on its own in alopecia areata, while other people need treatment. Options may include:
- Corticosteroids, applied to the skin or injected into patches, to calm the immune response
- JAK inhibitors, a newer class of oral medications approved for severe alopecia areata
- Treating the underlying condition, such as thyroid medication or managing lupus and psoriasis flares
- Regenerative treatments such as PRP hair restoration, which may support regrowth once the condition is under control
- Hair transplant for stable, scarred areas, in carefully selected patients whose condition has been inactive for a long time
Care for autoimmune conditions is often coordinated with your primary care doctor, dermatologist or rheumatologist.
Why Choose BayMed Hair & Aesthetics?
At BayMed Hair & Aesthetics in St. Petersburg, FL, we take the time to find out what is really behind your hair loss. Dr. Stavros Papandreou and our team review your history, examine your scalp and recommend any testing you may need. If an autoimmune condition is involved, we work alongside your other providers to build a hair restoration plan that fits your situation. Learn more about the causes of hair loss we treat.
Frequently Asked Questions
Can autoimmune hair loss grow back?
Often, yes. In alopecia areata the follicles usually stay alive, so hair can regrow on its own or with treatment. In scarring conditions, early treatment is important to protect the follicles that remain.
Is alopecia areata contagious?
No. It is an autoimmune condition and cannot be passed from person to person.
Can stress trigger autoimmune hair loss?
Stress may trigger flares of alopecia areata in some people, although it is rarely the only cause. Learn more about stress and hair loss.
What kind of doctor treats autoimmune hair loss?
A hair loss specialist or dermatologist can diagnose the type of hair loss, while your primary care doctor or a rheumatologist may manage the underlying condition. Working together gives you the best chance of regrowth.
Summary
Autoimmune conditions such as alopecia areata, thyroid disease, lupus and psoriasis can all cause hair loss. Some types are temporary, while others can cause permanent scarring, so an accurate, early diagnosis is important.
If you are noticing patches, sudden shedding or changes in your scalp, book a consultation with BayMed Hair & Aesthetics in St. Petersburg.
