When most people think about Rheumatoid Arthritis (RA), they imagine painful joints and morning stiffness, not unusual changes in their hairline. While joint damage is the main symptom hallmark of RA, the disorder and its treatment can affect far more than just your bones.
For many people with Rheumatoid Arthritis, hair loss is an unexpected and unpleasant addition to an already difficult diagnosis. If you’ve ever wondered whether RA could be behind your changing hairline or thinning strands, you’re not alone.
Understanding why does Rheumatoid Arthritis cause hair loss may help you regain control if you find more hair in your brush than usual. Let’s dive in to know more about the link between Rheumatoid Arthritis and hair loss.
Does Rheumatoid Arthritis cause hair loss?
Yes, Rheumatoid Arthritis (RA) can lead to hair loss. It is a chronic autoimmune condition that usually affects the joints, but its impact can extend throughout the body, occasionally leading to hair loss.
The specific causes are unknown; however, it is believed that the inflammatory processes in RA may alter the normal hair development cycle, resulting in greater shedding or thinning. Although hair loss is not a distinguishing feature of RA, it can occur as a direct or indirect result of the disease or, more usually, as a side effect of certain RA medications.
Let’s see how this disease directly or indirectly affects your hairline.
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Rheumatoid Arthritis medications that cause hair loss
The more common link between RA and hair loss is often the medications used to treat the condition. Certain medications prescribed for RA can lead to hair loss as a side effect. These often include Disease-Modifying Antirheumatic Drugs (DMARDs), biologics, and steroids.
Disease-modifying Antirheumatic Drugs (DMARDs)
Methotrexate, one of the most often used RA medications, is a Disease-modifying Antirheumatic Drug (DMARD). It inhibits the immune system and may affect quickly dividing cells, such as hair follicles. According to a journal published in the Polski Merkuriusz Lekarski Polish Medical Journal in 2019, hair loss is a frequently reported side effect with the medication.
However, it usually happens in a small number of individuals and is mild, resulting in thinning rather than complete baldness.
Another DMARD, Leflunomide, can cause hair loss in some individuals (around 10%). The mechanism is similar to Methotrexate, affecting rapidly growing cells in hair follicles. However, regrowth can be seen after discontinuation of the medicine.
Biologics
These are genetically designed medications that target specific immune system components that cause inflammation. While biologics are typically thought to have fewer side effects than traditional DMARDs, some, such as Etanercept and Adalimumab, have been linked to rare cases of hair loss.
According to a case report published in the International Journal of Trichology in 2019, Etanercept can lead to Alopecia in individuals already susceptible to the condition. The reasons for this are unclear; however, they may be related to their effects on particular messenger molecules involved in hair follicle regeneration.
Steroids
Prednisone and other steroids are used to lessen inflammation and discomfort in RA patients, leading to hair loss, especially with prolonged or high-dose usage.
Co-occurring autoimmune conditions
People who have one autoimmune illness, such as RA, are somewhat more likely to get another. There are two autoimmune diseases that can cause hair loss in people with RA, including:
- Thyroid disease: It starts when your thyroid gland produces too much or too little of vital hormones that perform essential tasks in your body’s systems. As per an article published in The Cureus Journal of Medical Science in 2023, severe and chronic thyroid dysfunction, including Hypothyroidism (less thyroid hormone) or Hyperthyroidism (higher thyroid hormone), can produce hair loss in the majority of individuals with the condition.
- Lupus: Systemic Lupus Erythematosus (SLE): It is another autoimmune illness associated with RA that can result in hair thinning or loss due to extensive inflammation of the skin and scalp.
Other contributing factors
Hair loss in RA patients is not always directly related to the disease or its therapy. Other common causes of hair loss may include:
- Inflammation: Chronic inflammation caused by RA can damage multiple organs, including the skin and scalp, potentially resulting in hair loss. However, this is rare and generally shows as small thinning rather than large bald patches.
- Stress and illness: Living with a chronic condition like RA may be physically and emotionally stressful. This stress can cause a condition known as Telogen Effluvium (TE), in which more hair follicles move to the resting phase, causing significant shedding. TE is frequently transient and disappears within months when the underlying stress is treated.
- Nutritional deficiencies: RA or its therapies can occasionally affect appetite or nutritional absorption, potentially leading to deficiencies that influence hair health (e.g., iron deficiency).
Rheumatoid Arthritis hair loss treatment
If you are noticing hair loss due to RA, the following treatment approaches can help reduce the effect:
- Medication adjustment: If hair loss is associated with a specific RA medication, a doctor may advise modifying the dose or switching prescriptions to help lessen the impact.
- Supplements: Folic acid is frequently administered with Methotrexate to minimize side effects, although the evidence for its benefit in reducing hair loss is conflicting. Biotin and other B vitamins may also be beneficial in some situations.
- Stress management: Managing physical and mental stress by lifestyle changes, counseling, or stress-reduction approaches can help reverse stress-induced hair loss.
- Hair care: Practicing gentle hair care and avoiding harsh treatments might help prevent further hair damage during shedding.
When to see a doctor?
Seek the assistance of a certified medical expert if you observe:
- Sudden and severe hair loss
- Patchy bald patches
- Hair loss with fatigue, weight shifts, or skin changes
A rheumatologist, dermatologist, or trichologist can help you determine the underlying cause and propose the best therapy.
Conclusion
While hair loss is not the most talked-about symptom, it is a significant issue for many individuals with Rheumatoid Arthritis (RA). The answer to the question “does Rheumatoid Arthritis cause hair loss” is conflicting, as it is not a direct sign of the illness but a side effect of its medications, inflammation, stress, and other associated diseases.
But the best part is that hair loss can frequently be controlled or reversed with the right medical advice, lifestyle changes, and supportive care. If you are experiencing sudden hair thinning, consult your healthcare provider to determine the underlying reason and the best course of action.
Frequently Asked Questions
Is it possible to entirely reverse hair loss by discontinuing Methotrexate?
No. Methotrexate-induced hair loss usually improves after discontinuing or modifying the dose. However, total regeneration is not assured and depends on the duration of usage, personal health, and other contributing variables such as dietary conditions or associated autoimmune disorders.
Is RA-related hair loss more frequent in women than in men?
Yes, women with RA are more prone to hair loss. This is partly due to hormonal causes, longer hair length, which makes the loss more obvious, and an increased frequency of underlying thyroid diseases, which may worsen hair shedding.
How fast does hair loss begin after taking RA medication?
Hair loss can occur within weeks or months of starting RA therapy, particularly Methotrexate or Leflunomide. The timing varies according to individual sensitivity, medication dosage, folate supplementation, and ongoing stress or sickness.
Do RA flare-ups increase the probability of hair loss?
Yes, RA outbreaks cause increased stress and chronic inflammation, which can drive more hair follicles into the resting phase, resulting in temporary shedding. Properly managing flare-ups lowers this risk and promotes hair regrowth.
Can biologic medicines used in RA promote hair growth rather than loss?
Yes. Some biologics may lower inflammation sufficiently to indirectly restore hair health, particularly if the hair loss was caused by systemic inflammation. However, hair growth as a direct result is uncommon and not scientifically proven.
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