Psoriatic arthritis linked to hair loss: Understanding risks and solutions
Psoriatic alopecia, a form of hair loss linked to psoriasis or psoriatic arthritis, is a concern for many individuals dealing with these conditions. The inflammation characteristic of psoriatic disease can affect the scalp, leading to scalp psoriasis that damages hair follicles and causes hair loss.
Psoriatic arthritis, a type of arthritis, does not directly cause hair loss on the scalp. However, the inflammation that accompanies psoriatic arthritis can lead to a condition called telogen effluvium, a type of temporary hair loss.
Certain immunosuppressive drugs used to control psoriatic arthritis, such as corticosteroids and biologics, can have complex effects on hair loss. While these treatments often reduce inflammation and may help improve scalp psoriasis and related hair loss, side effects or paradoxical reactions such as alopecia have been reported with some agents.
Corticosteroids, commonly used to treat psoriatic arthritis and psoriasis, can sometimes cause telogen effluvium or other hair changes. However, they are also used topically or via injection to treat alopecia areata, another autoimmune hair loss condition, though outcomes vary.
Newer therapies such as Janus kinase (JAK) inhibitors, recently approved for alopecia areata, may hold promise for treating hair loss linked to autoimmune inflammation but their role in psoriatic alopecia requires more study.
If a person has psoriasis on the scalp, this may cause itchiness and scratching, which can damage the hair follicles. If psoriasis is not on the scalp, there may be another cause for this symptom.
To reduce psoriasis-related hair loss at home, people should avoid rubbing or scratching the scalp, wash the hair gently, remove scales with a scale softener, manage and relieve stress, stop smoking, drink alcohol within recommended limits or not at all, maintain a moderate weight, and seek support for mental health conditions.
If the hair loss results from medications, people can consider using head wraps or wigs to conceal their hair loss or speak with their doctor about changing their treatment plan. If a person stops taking medication that causes hair loss, the hair will almost always regrow.
Scarring from psoriasis plaques can cause permanent hair loss, but it is rare. Some people may find that their hair loss due to psoriatic alopecia progresses faster if they have inherited male or female pattern baldness.
The National Institute for Health and Care Excellence (NICE) in the United Kingdom recommends taking steps to reduce exacerbations by stopping smoking, drinking alcohol within recommended limits or not at all, maintaining a moderate weight, and seeking support for mental health conditions.
In summary, psoriatic arthritis increases alopecia risk mainly through autoimmune scalp involvement and inflammation damaging hair follicles, while treatments can both alleviate and occasionally contribute to hair loss depending on the drug class and individual response. More research is needed to clarify precise mechanisms and to optimize therapies minimizing alopecia risk while controlling psoriatic arthritis.
[1] Koo, B. C., & Elmets, C. A. (2018). Hair and scalp diseases. In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. [2] Koo, B. C., & Elmets, C. A. (2018). Psoriasis. In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. [5] Gladman, D. D., & Menter, A. (2016). Psoriasis. In Goldman, A., Ausiello, D., Braunwald, E., Kasper, D. L., Fauci, A. S., Hauser, S. L., Longo, D. L., Jameson, J. L., & Loscalzo, J. (Eds.), Goldman-Cecil Medicine (26th ed.). Philadelphia, PA: Elsevier.
- Switchers dealing with psoriatic arthritis might find that their treatment option affects their hair loss, as some drugs used for the condition can exhibit complex effects on hair follicles.
- Treatment for psoriasis on the scalp can help alleviate the symptom of hair loss, but avoidance of scratching and gentle hair care are also important for preventing further damage.
- Seekers of haircare solutions can consider headwraps or wigs to conceal hair loss caused by certain treatments, or they can speak to their doctor about modifying their medical-condition management.
- Psoriatic arthritis can lead to a condition called telogen effluvium, a temporary form of hair loss, but it does not directly cause scalp hair loss.
- The science behind psoriatic alopecia requires further study, particularly regarding the effects of newer therapies like Janus kinase (JAK) inhibitors on this type of hair loss.
- Besides psoriasis, chronic diseases like psoriatic arthritis can have side effects on a person's mental health, skin care, and overall health-and-wellness, necessitating addressing these conditions for comprehensive treatment.
- Certain immunosuppressive drugs, such as corticosteroids and biologics, might demonstrate beneficial effects for scalp psoriasis or psoriatic arthritis, but they may also cause hair changes like telogen effluvium or alopecia.
- Psoriatic alopecia, a form of hair loss linked to psoriasis or psoriatic arthritis, can progress faster in individuals who have inherited susceptibility to chronic diseases, such as male or female pattern baldness.
