Hair Loss and Diabetes

Hair loss is a common condition affecting millions of people each year. Hair loss occurs for a variety reasons. Diabetes is one of them.

One of the lesser-known effects of fluctuating blood sugar levels is losing hair all over the body. Understanding and acknowledging the relationship between diabetes and hair can help you handle the issue effectively. This article will explore the connections between hair loss and diabetes.

When Should You Worry About Hair Loss?

According to the American Academy of Dermatology (AAD), adults lose about 50-100 strands of hair a day, which is to be expected. AAD calls this hair shedding, which is different from hair loss. 

Hair loss occurs when there is excessive hair shedding. Here are some signs that may tell you that you could be losing hair. 

Visibly receding hairline
The appearance of bald patches
Widening center or side partitions
Unusually increased hair fall
Hair falling out in clumps
A noticeable reduction in hair thickness or density

While hair loss is a natural part of aging (for both men and women), you’ll probably know when your hair loss has accelerated to an unexpected level.

How Diabetes Causes Hair Loss

Diabetes mellitus can affect every part of the body, including the hair follicles. The relationship between diabetes and hair loss is complex and multifaceted.

Unfortunately, there’s not much data on the prevalence of diabetes-relaated hair loss. One academic survey suggests that African-American women with diabetes could have a 68 percent increased risk of severe hair loss in the central scalp area, though these results were based only on self-reported responses to an online questionnaire.  

Here are different ways in which this chronic condition affects hair.  

Poor blood circulation 

The hair follicles need oxygen-rich blood flow to grow. Chronic hyperglycemia (high blood sugar levels) will damage blood vessels, including those carrying blood to the hair follicles. This, in turn, will disrupt hair regrowth and lead to shedding. A 2016 article suggests that uncontrolled diabetes leads to diffuse hair loss, characterized by hair thinning and low hair density. 

In fact, your blood sugar concentrations affect hair so directly that your hair preserves evidence of your recent blood glucose history. Some researchers have even proposed using chemical analysis of hair to improve upon a traditional A1C measurement.

Diabetes-induced vascular damage can make you lose hair in other parts of the body, like in the legs or the arms. Losing hair in the extremities could be a definite sign of high blood sugar levels, which should be addressed immediately.

The diabetes -autoimmune relationship

People with type 1 diabetes frequently experience additional autoimmune conditions. One interest here is alopecia areata (AA). According to Everyday Health, AA is a condition where the body’s immune system attacks the hair follicles, leading to hair loss. 

A 2013 study analyzed the prevalence of AA in 3,568 individuals between 2000 and 2011. According to this study, 11.1 percent of individuals with AA also had type 1 diabetes. If you have type 1 diabetes and experience an itchy, tingly scalp with hair falling out in clumps, talk to your healthcare provider so they can test you for this autoimmune condition.  

Use of certain diabetic medications

Certain diabetic medications may encourage excess hair loss. In particular, dipeptidyl peptidase 4 (DPP-4) inhibitors have been associated with hair loss and alopecia in case reports

Semaglutide (Ozempic), the diabetes drug the world’s raving about, reportedly causes hair loss. Ozempic controls type 2 diabetes by increasing insulin secretion, reducing appetite, and promoting weight loss. While semaglutide doesn’t directly affect the hair follicles, the dramatic weight loss it causes is known to cause hair loss due to a condition named telogen effluvium. The metabolic stress of rapid weight loss leads to thinning hair, but yhankfully, Ozempic-induced hair loss appears to be temporary.

Other medications commonly taken by people with diabetes are also associated with hair loss, including medications for hypertension, high cholesterol, gout, and depression.

Interestingly, some studies say that metformin, one of the most commonly used medications for treating type 2 diabetes, may actually be beneficial in promoting hair follicle regeneration and helping individuals with male or female pattern hair loss. 

The diabetes -thyroid relationship 

Did you know that there is a relationship between diabetes, thyroid dysfunction, and hair loss? People with diabetes, particularly type 1 diabetes, have a higher risk of developing both hyperthyroidism and hypothyroidism

These thyroid conditions are strongly associated with hair loss. According to a 2023 study, 33 percent of people with hypothyroidism and 50 percent of people with hyperthyroidism may experience excessive hair shedding.

Diabetes-induced iron deficiency 

There is a positive correlation between higher A1C levels and iron deficiency. Iron deficiency, on the other hand, directly contributes to both androgenetic alopecia (pattern baldness) and telogen effluvium (excessive hair shedding due to stress).

Polycystic ovarian syndrome (PCOS)

PCOS may affect as many as 10 percent of women during their reproductive years. It shares a common cause with type 2 diabetes — insulin resistance — and the two conditions often coexist.

Polycystic ovarian syndrome is generally characterized by an excess of androgen, a family of sex hormones associated with masculinity, including testosterone. When women secrete too much testosterone, hair thinning is a common side effect, along with facial hair growth, weight gain, and irregular periods. There is no cure for PCOS, but doctors can use many medications to help manage its diverse symptoms, including hair loss.

Mental health challenges

We all agree that managing a chronic condition like diabetes can get challenging. People with diabetes have a higher risk of developing diagnosable mental health issues like depression and anxiety, or of experiencing diabetic distress.

These mental health conditions can affect the body in different ways, including increasing your stress hormone called cortisol. Higher levels of cortisol reduce the levels of certain proteins needed for the hair follicles to function well, causing hair loss. Some studies suggest that stress can also extend the hair resting phase, reducing regrowth. 

Tips to Manage Diabetic Hair Loss

Managing blood sugar levels

If high blood sugars are causing alopecia, stabilizing it as quickly as possible with drugs, diet, and lifestyle changes may help curb and hopefully reverse the condition

Early screening for hair loss

If you have type 1 or type 2 diabetes, speaking to a doctor can help you understand what’s your ‘normal’ hair loss. If you think you are suddenly losing a lot of hair, spotting bald patches, or finding an unexplained reduction in hair density, early screening will help identify the root cause and get preventive measures in place.

Medications

There are many medications approved to treat hair loss.

Minoxidil is an FDA-approved topical medication that may help in hair regrowth. Minoxidil also comes in a pill — in this form, it is only approved as a therapy for hypertension, but some doctors prescribe it off-label to help with hair loss.

Corticosteroids (oral, injectibles, and topical) are commonly used in treating AA. However, there is a risk of steroids causing or worsening hyperglycemia, which may make them less appropriate for people with diabetes.

Other medications that may be used to treat hair loss include:

Birth control pills that contain estrogen can help address androgenetic alopecia.
Spironolactone (topical and oral applications) to treat both male and female androgenic alopecia.
Finasteride (5-alpha reductase inhibitor for male pattern baldness).
Dutasteride (for male hair loss)

Dietary supplements

There is a strong connection between diabetes and nutritional deficiencies, which studies may cause changes in hair structure and affect hair regrowth.  

Metformin can cause vitamin B12 deficiency, which can lead to hair loss. Low vitamin D levels, which are common in people with types 1 and 2 diabetes, may also contribute to hair loss. It is possible that dietary supplements could help address these deficiencies.

Aesthetic solutions 

A more direct approach is to adapt your look to hide hair loss. Everyday Health recommends experimenting with coverings, including wigs, scarves, and hats, or using other cosmetics to camouflage hair loss. A new haircut or hairstyle could help, as well as clip-in extensions and wiglets.

Platelet-rich plasma (PRP) is a treatment in which your own blood is collected, refined, and injected directly into the skin along the scalp. This refined blood is especially rich in platelets, which secrete growth factors that can act directly on hair follicles, stimulating hair growth. PRP is used specifically to treat androgenetic alopecia.

Finally, hair transplant surgery is always a solution to permanent balding or excessive hair shedding. 

Takeaways

Diabetes is one of many factors that can contribute to excessive hair shedding. There are no easy answers, but optimal blood sugar control, good nutrition, and stress reduction can all help curb hair loss and may even promote new hair regrowth. While you concentrate on getting your diabetes management under control, a doctor can also recommend medications that may help your scalp, and there are many aesthetic solutions available, from wigs to hair transplant surgery.

Do You Have Hair Loss or Hair Shedding? American Academy of Dermatology Association.

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Huang K et al. Autoimmune, Atopic, and Mental Health Comorbid Conditions Associated With Alopecia Areata in the United States. JAMA Dermatology. July 2013.

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