Can Psoriatic Arthritis Cause Hair Loss?

If your hair is feeling a little less full these days, it’s easy to wonder … is my PsA to blame?

Your joints are aching. Your skin is irritated and flaking. And you’ve just found an alarming amount of hair in your brush. You’re already dealing with so many frustrating symptoms, and now you might worry that psoriatic arthritis causes hair loss, too. How much more unfair can this condition get?

First, some slightly good news: psoriatic arthritis doesn’t necessarily cause hair loss in and of itself. So if you’re living with this chronic condition, you shouldn’t assume you’ll have to say goodbye to your lovely locks.

That being said, there are several correlated reasons you might experience hair loss if you’re living with PsA.

Because you’re experiencing an increased level of inflammation with PsA, it can sometimes trigger temporary stress-related hair loss. Or, if psoriasis develops on your scalp, excessive scratching or itching may cause hair follicle damage.

Certain PsA medications may also cause hair loss as a side effect.

But even if you’re experiencing psoriatic alopecia — the medical term for psoriasis-impacted hair loss — hope isn’t lost. Hair almost always grows back once the condition is managed.

Read on for more details about the type of hair loss linked to psoriatic arthritis, as well as treatments for scalp psoriasis and hair loss.

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Types of hair loss linked to psoriatic arthritis

Psoriatic alopecia

If psoriasis is one of the symptoms of your psoriatic arthritis, you may be at risk of psoriatic alopecia. Around 40–80% of people with psoriasis experience itchy plaques on the scalp.

Scratching at your scalp may cause damage to hair follicles, which in turn can trigger hair loss. If the scratching is severe and causes scarring, the follicle may not be able to regrow — but follicle scarring is quite rare.

Symptoms include:

• thinning of hair on the scalp
• itchiness on scalp
• dandruff-like flakes or severe plaques on the scalp

Telogen effluvium

Though the arthritis itself doesn’t affect your scalp or hair follicles directly, it can raise inflammation levels. This stress on the body can trigger telogen effluvium.

Telogen effluvium is a type of temporary hair loss. It typically affects the top of your scalp. Luckily, it’s extremely rare that it would cause your hairline to recede, or make you lose all your hair.

And the keyword here is temporary. TE is not permanent, and in most cases, hair returns to its normal growth pattern within 6 months (though it may take up to 18 months to fill back in completely).

Symptoms of telogen effluvium include:

• thinning hair on the scalp
• in severe cases, loss of eyebrow hair or pubic hair

Causes of hair loss related to PsA

Stress

Stress can trigger flares of psoriasis in addition to causing arthritic flare-ups. If that psoriasis impacts the scalp, itching may be unavoidable, which in turn, may harm hair follicles.

Lowering stress has all sorts of benefits beyond preventing hair loss, of course. Practice yoga, meditate, and connect with nature and loved ones to keep stress levels low.

Inflammation

Inflammation is a common symptom of PsA, but one that may trigger telogen effluvium (temporary, stress-related hair loss).

Talk with your doctor about medications to help manage inflammation and pain. There are also self-care practices you can do at home to help reduce inflammation day to day.

• Try low impact exercises such as swimming and yoga.
• Limit alcohol intake.
• Be gentle on your joints during everyday tasks.
• Maintain a healthy weight.
• If you smoke, try to stop.

Medications

Some medications that can help reduce PsA and psoriasis symptoms have an unfortunate side effect of hair loss. That might include:

• Leflunomide is a popular disease-modifying antirheumatic drug that can bring relief for PsA, but it’s responsible for hair loss in 10% of patients.
• Methotrexate is another common DMARD, which causes hair loss in up to 3% of people prescribed.
• Biologic agents (TNF inhibitors) aren’t likely to cause hair loss, but specific types like adalimumab and etanercept have a higher chance.
• Oral retinoids have a possible side effect of hair loss.

Treatments for scalp psoriasis and hair loss

The world of pharmaceuticals offers many treatments for scalp psoriasis, including:

• Calcipotriene
• Tazarotene
• Betamethasone-calcipotriene
• Cyclosporine and tacrolimus

Ultraviolet light therapy has also been shown to be effective for treating psoriasis, as have laser treatments.

Additionally, avoiding stress and practicing low-inflammation activities should reduce the odds of hair loss.

Takeaway

Hair loss may have a correlation with psoriatic arthritis, but it’s very unlikely to be permanent. If your hair loss may be caused by medication, talk with your doctor about alternative options.