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Experiencing Hair Loss From Psoriasis Treatments

Posted on December 22, 2021
See how 74 members reacted on this article
Medically reviewed by
Kevin Berman, M.D., Ph.D.
Article written by
Megan Cawley

Are you treating your psoriasis or psoriatic arthritis and experiencing hair loss? You’re not alone. Several members of MyPsoriasisTeam have reported hair loss or thinning hair after they started psoriasis treatments.

One member asked the team if anyone else had experienced hair loss while taking methotrexate. One member replied, “I lost a lot of hair from that med. What used to be a very thick ponytail is now a thinned out ponytail.” A second chimed in: “It works great! Just taking it for five weeks, and my skin is almost clear, but my hair is falling out like crazy.”

Hair loss is a common symptom of psoriasis, and it’s also a possible side effect of its treatments. It can help to learn more about hair loss as a side effect, its causes, and ways to handle it. This can help you move forward confidently while living with psoriasis.

The Effect of Hair Loss on Those With Psoriasis

Hair loss can have negative physical, emotional, and mental impacts on those with psoriasis. The loss may be accompanied by worry or lowered self-esteem. “If I keep losing hair, I’m afraid that I will need a wig,” one MyPsoriasisTeam member wrote. Another posted, “I love the wonderful stares I get, like I’m contagious. And the fact that my hair is thinning is just killing me.”

Can Psoriasis Itself Cause Hair Loss?

Psoriasis — scalp psoriasis, in particular — can lead to an uncomfortable dry, itchy, flaky, and irritated scalp. Members may find themselves scratching or picking endlessly at their lesions and scales. This picking can damage your hair follicles and lead to hair loss. Psoriasis-related inflammation on your scalp can also lead to hair loss if it, too, damages your hair follicles.

Psoriasis Treatments and Hair Loss

Some treatments for psoriasis and psoriatic arthritis may cause you to lose hair as a side effect.

Stelara

MyPsoriasisTeam members taking the biologic medication Stelara (ustekinumab) have reported hair loss as one of its most common side effects. However, in clinical trials, hair loss was not among the side effects caused by Stelara directly. Rather, doctors attribute hair loss while taking Stelara to two potential causes. This first is that it could be a symptom of your psoriasis itself. The second is that it could be a side effect of a different drug — methotrexate — that is often used in conjunction with Stelara to treat psoriasis and psoriatic arthritis.

Methotrexate

This multipurpose drug is used as an immunosuppressant and a disease-modifying antirheumatic drug (DMARD) to relieve symptoms of psoriasis, psoriatic arthritis (PsA), and other autoimmune diseases. Despite its benefits, methotrexate does come with some significant side effects. Hair loss occurs in between 1 percent and 3 percent of people who take the drug. This is because the drug can target hair follicles and deplete the body of vitamins that help with hair growth, leading to excessive hair shedding.

Humira

At least one member of MyPsoriasisTeam reported they lost hair while taking the biologic Humira (adalimumab). “I’m having terrible hair loss again,” they wrote. “Taking Humira. Anyone else have that side effect?” While Humira can, in some cases, lead to hair loss as a side effect, such cases are rare. Most people taking Humira do not report significant hair loss as a side effect.

If you are troubled by hair loss (or other side effects), always talk to your dermatologist before stopping any of your prescribed psoriasis treatments. Your doctor will help you weigh the benefits versus the risks of changing course. If you decide to discontinue a treatment, they can help you safely stop — which may involve tapering down your dosage or starting a replacement treatment first. They can also recommend the best alternatives for you.

Other Causes of Hair Loss

There are many potential causes for hair loss apart from psoriasis or its treatments. Aside from medication side effects, stress and infections can be the culprit. That can happen when stress or certain infections (such as streptococcus) trigger your psoriasis and psoriatic arthritis to flare. If plaques then worsen on your scalp, your ability to grow healthy hair is impacted.

Other factors unrelated to psoriasis or its treatments can also play into hair loss. Certain inherited genes can result in hair loss and thinning. Other causes might include the following:

  • Age
  • Hormone imbalances
  • Anemic condition
  • Alopecia areata diagnosis

Certain medical treatments, most notably drugs used to treat cancer, can also cause similar symptoms. Even certain hair care routines — wearing your hair in too-tight styles (braids, ponytails, or buns) or overusing chemicals or heat — can result in hair loss.

Managing Hair Loss With Psoriasis

There are several ways of preventing, managing, or treating your hair loss if it is associated with your psoriasis treatments. Though as always, talk to your dermatologist or health care provider for medical advice before trying any new product or treatment.

Treat Your Scalp Psoriasis

If you have scalp psoriasis, one of the best things you can do to prevent or manage related hair loss is to treat psoriasis' underlying causes. You and your dermatologist can work together to find the best treatment — or combination of treatments — that will both manage your psoriasis and pose minimal side effects.

Medications like corticosteroids can help provide quick relief of the psoriasis symptoms that can contribute to hair loss. One member posted that their dermatologist prescribed an effective liquid corticosteroid (steroid) treatment for their scalp and plaques.

Another member described having a positive experience with the topical treatment Dovobet Gel, a corticosteroid with vitamin D3. “I had to use it nightly at first,” they wrote, “but now, two or three times a week. Most of my hair has grown back. Talk to your dermatologist, and good luck.”

Switch Medications

If you find that treating your psoriasis comes with hair loss as a side effect, tell your dermatologist. They may be able to suggest a different treatment that can effectively treat your psoriasis while minimizing (or eliminating) hair loss.

Over-the-Counter Products

Another approach to managing your psoriasis-related dry hair, itchy and irritated scalp, and hair loss is to try over-the-counter hair health products. MyPsoriasisTeam members have given many recommendations. One posted their regimen: “Baby oil on my scalp, massage it in, then cover it up with a shower cap for 10 to 15 minutes.” That approach, they said, eased the tightness and itching on their scalp.

Moisturizing oils and conditioners work by alleviating scalp dryness. That reduces itching, which in turn leads to less scratching and inflammation. Cutting down on those can help cut down your hair loss.

Care for Your Scalp

The American Academy of Dermatology has shared ways people with plaque psoriasis care for their scalps and prevent hair loss. Those include:

  • Alternating medicated shampoos with gentler ones
  • Brushing your hair softly to remove scales
  • Minimizing the use of heat-styling tools like blow dryers

And, as a member also advised, “Don’t pick any plaques!”

Try Different Hairstyles

People with psoriasis and long hair are advised to avoid tight hairstyles, as they can increase scalp irritation and tension on the hair follicles and contribute to hair loss. Instead, consider looser styles, like loose ponytails and braids, especially if your goal is to camouflage your psoriasis or hair loss without aggravating your scalp further.

Take Care of Your Mental Health

It’s important to remember that, more often than not, hair loss related to psoriasis is not usually scarring, so it is not permanent. As one member wrote, “Hair regrowth starts within three months. Depending on age, health, genetics, et cetera, your hair will grow one-eighth to one-quarter inch each month.”

Still, even if you lose hair only temporarily, it can be tough to deal with, especially on your own. That is why it’s important to take care of your mental health if you have psoriasis and also experience hair loss. Some MyPsoriasisTeam members reported having low self-esteem or a poor body image. If you experience the same, consider therapy or other forms of emotional support. Such assistance can help you cope with your feelings and offer you the support you need.

Find Your Team

MyPsoriasisTeam is the social network for people with psoriasis and psoriatic arthritis, and their loved ones. On MyPsoriasisTeam, more than 100,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis and psoriatic arthritis.

Have you experienced hair loss from psoriasis treatments? How have you managed it? Share your experience and tips in the comments below or by posting on MyPsoriasisTeam.

Kevin Berman, M.D., Ph.D. is a dermatologist at the Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Learn more about him here.
Megan Cawley is a writer at MyHealthTeams. She has written previously on health news and topics, including new preventative treatment programs. Learn more about her here.

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